Stigmatization by nurses as perceived by substance abuse patients: A phenomenological study

Abstract

Background: Caring is a central concept to nursing. Nurses are well known for their caring attitudes and professional skills. However, nurses can also follow the views of society and stigmatize vulnerable populations of patients such as SA patients. The result could be poor quality of nursing care with consequent harm to the patient. The purpose of this study was to broaden the understanding of nurses who care for substance abuse (SA) patients by revealing real-life experiences of stigma as perceived by SA patients. The narratives of patients who perceive themselves stigmatized may lead to improved client-nurse interactions, empathy, and care.

Methods: The research design for this study was qualitative phenomenological method. The study sample included five adults currently enrolled in a residential substance abuse treatment program for treatment of substance abuse/dependence or having been enrolled in such a program within six months prior who engaged in a personal open-ended interview with the researcher. All interviews were recorded for accuracy as well as additional handwritten researcher notes. All interviews were transcribed from the recordings to paper verbatim. Central themes and relationships were exhaustively searched for until they emerged.

Results: A common theme that emerged from the data was experiences of stigmatizing behaviors from nurses, counsellors, therapists, doctors, and other ancillary staff within residential substance abuse programs including the feeling that treatment staff was placing their own needs above those of the clients. Another common theme was the experience of feeling that the treatment setting limited or eliminated their personal freedom. Caring behaviors of treatment providers were also described by participants.

Conclusions: The lived experience of patients includes feelings of being stigmatized by the behaviors and actions of some of their healthcare providers, including some nurses. Stigmatizing behaviors and actions decrease patient comfort and increase patient anger and frustration. Patients also feel that the residential treatment setting needlessly inhibits personal freedom; they compare it to jail or the military. These feelings increase the risk of the patient leaving treatment impulsively, acting inappropriately, or refusing to return to particular treatment settings. Conversely, patients can feel cared for by some of their healthcare providers in residential substance abuse treatment as well. Caring behaviors increase patient comfort, help alleviate frustration, and promote positive patient outcomes.