Download the full-sized PDF of Nursing under the influence: understanding the situation of Alberta nursesDownload the full-sized PDF



Permanent link (DOI):


Export to: EndNote  |  Zotero  |  Mendeley


This file is in the following communities:

Graduate Studies and Research, Faculty of


This file is in the following collections:

Theses and Dissertations

Nursing under the influence: understanding the situation of Alberta nurses Open Access


Other title
perceptions of support
substance use disorders
perceptions of impaired practice
relational ethics
professional practice
Type of item
Degree grantor
University of Alberta
Author or creator
Kunyk, Diane
Supervisor and department
Austin, Wendy (Nursing, University of Alberta)
O'Brien, Beverley (Nursing, University of Alberta)
Reah, Trish (Business, University of Alberta)
Els, Charl (Medicine and Dentistry, University of Alberta)
Examining committee member and department
Mayan, Maria (Extension, University of Alberta)
Rodney, Patricia (Nursing, University of British Columbia)
Mill, Judy (Nursing, University of Alberta)
Faculty of Nursing

Date accepted
Graduation date
Doctor of Philosophy
Degree level
Nursing under the influence is a serious professional practice issue as it threatens patient safety and nurse health. Relational ethics, an applied ethic that situates ethical action within relationships while recognizing the interdependent environment, guided questioning regarding moral obligations for public safety and nurse health as well as fitting organizational responses. This ethical reflection guided a literature review that revealed the area lacks in-depth examination, particularly within the Canadian context. As a result, this research studied the prevalence of substance use disorders among Alberta nurses, risks to patient safety and nurse health, nurse perceptions of impaired practice, and nurse perceptions of support from their employer, college and association, and union. Nurses were recruited to an Internet survey through convenience sampling using multiple modalities. The 4,064 responses exceeded the minimum sample size required for statistical analysis to be meaningful. The prevalence of self-identified substance use disorders within the last 12 months among nurses was similar to the general population. Most nurses with self-identified substance dependence were currently practicing in nursing positions. The health of nurses with substance use disorders was compromised on measures of mental health, chronic pain, and smoking when compared with their nurse-peers. They were, in general, practicing among a community of nurse-peers who recognize the treatability of substance use disorders, organizational obligations to help, and who supported confidentiality. Although identifying and restricting impaired practice was acknowledged as necessary, nurses were not confident with their abilities to recognize or intervene when it occurs. Nurses perceived their practice environment as having uncertain support from their employer, and college and association; these perceptions were more pronounced for nurses with substance use disorders. Higher levels of support from the union were perceived by the sample. Study findings question the fit of current organizational responses, based on a hegemonic framework with a primary focus on dealing with and/or disciplining the individual, for dealing well with the situation. It is suggested that organizational policies more closely aligned with nursing ethical values, and that take into account the role of the interdependent environment, hold promise as more fitting responses.
License granted by Diane Kunyk ( on 2011-08-07T17:40:24Z (GMT): Permission is hereby granted to the University of Alberta Libraries to reproduce single copies of this thesis and to lend or sell such copies for private, scholarly or scientific research purposes only. Where the thesis is converted to, or otherwise made available in digital form, the University of Alberta will advise potential users of the thesis of the above terms. The author reserves all other publication and other rights in association with the copyright in the thesis, and except as herein provided, neither the thesis nor any substantial portion thereof may be printed or otherwise reproduced in any material form whatsoever without the author's prior written permission.
Citation for previous publication

File Details

Date Uploaded
Date Modified
Audit Status
Audits have not yet been run on this file.
File format: pdf (Portable Document Format)
Mime type: application/pdf
File size: 6261372
Last modified: 2015:10:12 12:21:26-06:00
Filename: Kunyk, D Dissertation Fall 2011.pdf
Original checksum: be48a52532f6db3ab30b2d6d57b0cb3f
Well formed: true
Valid: true
Status message: File header gives version as 1.4, but catalog dictionary gives version as 1.3
File title: Dissertation July 11
File author: Heather Diane Kunyk
Page count: 234
Activity of users you follow
User Activity Date