Uncovering the secret: giving voice to the experiences of nurses who misuse substances

Aim of the study. The aim of this study was to gain insight into the experience of being a nurse with a substance misuse problem. Rationale. Several members of the research team work in a withdrawal programme specifically designed for nurses by nurses. Gaining insight into nurses' experiences will contribute to the development of appropriate guidelines to assist with prevention, identification and intervention strategies. Background. Published research is almost exclusively from North America. Much of it represents work completed in the 1980s, with very few research-based accounts from the perspective of nurses, highlighting that this is a poorly researched and understood problem in Australia. Research methods. This phenomenological study used in-depth, unstructured interviews either face to face or via the telephone with a purposive sample of 12 nurses who had experienced problem substance use. Findings. Five major themes were identified: nurses' justification for using substances, the fear surrounding being 'discovered', the personal meaning for nurses, the professional impact and the turning point in their road to recovery. Discussion. The five themes derived from the data are inextricably linked to the nature of nursing and of the nursing workplace. Information about potential risk factors and the experiences of nurses with substance misuse problems is critical to the development of prevention and treatment strategies. Conclusions. Issues of occupational health and safety are raised due to the increasingly demanding and often traumatic nursing work environment. Fears about stigma and loss of their nursing identity highlight nurses' perceptions that treatment programmes are often punitive in nature. Guidelines for the workplace addressing issues such as confidentiality, stress reduction and strategies for handling situations where a colleague is suspected of having a problem are beginning steps that will help address the problem of substance misuse in the nursing profession.