Nursing practice impaired by chemical dependency presents a danger to the public, a threat to the profession, and a tragedy to the impaired nurse. The etiology of impairment is not clear, but there are indicators that family origin issues are significant factors in the backgrounds of impaired nurses. The purpose of this study was to describe and compare child and adolescent experiences of previously impaired and non-impaired registered nurses, with focus upon their family of origin. The investigation used a naturalistic, grounded theory approach to obtain recollections of experiences. Qualitative interview guidelines were developed from a review of literature. Theoretical sampling guided selection of six non-impaired and eleven previously impaired informants. Each informant was interviewed; some informants required three interviews to give complete data, others needed only one interview. Most interviews were approximately one hour in length. Interviews were audio-tape recorded and transcribed for analysis. Transcripts were coded on three levels according to grounded theory methodology. Codes were sorted and analytic and process memos were recorded throughout the study. A model was created to depict the findings of the study. Confirmatory interviews with three informants from each group supported the accuracy of the findings. The basic social psychological problem identified was the disruption or diminishment of security, love, and belonging secondary to conflict and/or loss. The process of seeking security, love, and belonging began with fears and/or feelings of abandonment, rejection, guilt, and/or shame. Informants described many behaviors through which they attempted to (re)gain security, love, and belonging. These included caretaking, compliance, attempting perfection, restricting emotional expression, creating substitute parents, becoming involved in church, and excelling in school. The non-impaired informants reported successful results with their seeking behaviors. The previously impaired informants described poor results, with continuing fears and/or feelings of abandonment, rejection, guilt, and/or shame and continued seeking behaviors. Their process of seeking security, love, and belonging became a repetitive cycle.
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