Abstract
Nurses returning to work while in treatment for addictions are at risk for relapse to substance use. Little is known about the types of stressors that nurses experience during participation in alternative-to-discipline programs for addictions, and how the burden of life problems relate to their confidence in ability to resist relapse. Recovering nurses enrolled in an alternative-to-discipline program were surveyed anonymously (N= 622). The types of problems they experienced and their confidence in ability to resist relapse were measured. Three-fourths of nurses reported a lower burden of problems after enrolling in an alternative-to-discipline program, though some problems tended to persist. During recovery, the most common problems were financial (45% of respondents), eating/appetite/weight (31%), depression (29%), fatigue (27%), and tension (26%). Self-reported confidence in ability to resist relapse was very high (median 98, 0–100 scale). Logistic regression analyses were used to identify the association of problem burden to high (80–100) versus low (0–80) confidence in high-risk situations. There were significant relationships between low confidence and having problems with assertiveness (OR 2.79, 95%CI 1.46–5.33), aggression (OR 2.72, 95%CI 1.19–6.25), boredom (OR 3.84, 95%CI 2.04–7.26), depression (OR 1.84, 95%CI 1.01–3.37), and tension (OR 2.01, 95%CI 1.10–3.68). In addition, the higher the total “dose” of current problems experienced by nurses, the lower their confidence was in their ability to resist relapse, with each additional problem decreasing the level of situational confidence by 14% (OR 1.14, 95% CI 1.05–1.23). These results suggest that most nurses show improvement in problems after enrolling in an alternative-to-discipline program, and that some types of problems and a higher problem burden significantly reduced confidence in the nurses' ability to resist relapse to substance use.