The purpose of this study was to describe, explain, and compare the experiences of nurses who were completers and non-completers of an alternative diversion program for chemically dependent nurses. Risk factors for substance abuse are explored.Sixteen nurses who had participated in an alternative diversion program for chemically dependent nurses were interviewed for this study. Fourteen of these nurses completed second interviews. Qualitative analysis of these interviews was conducted utilizing the constant comparative method.Common issues for the nurses included medical conditions and dual diagnosis for which legal prescriptions were frequently obtained. Most of the nurses worked in critical care, noted stressful work conditions, and diverted medications from the workplace for their own use. They also listed emotional stresses associated with impaired practice and addiction, primarily isolation, depression, shame, and guilt. They noted a culture of stigma and mistreatment of addicts and alcoholics by many professionals.Positive commonalities included improved nursing practice, such as being more patient, tolerant, and compassionate, as a result of their own recovery work. They learned to utilize social support systems, which led them from isolation and hiding to involvement and disclosure. The nurses identified a pivotal event as being the leverage needed to move them into a lifestyle of recovery.Completers were highly motivated to retain their nursing licenses, and they strongly affiliated with other recovering nurses. In retrospect, they viewed the coercion of the program as having positive benefits. They took a brief amount of time off nursing early in their recovery. Most importantly, they had prepared and developed a relapse prevention plan.Non-completers were considering getting out of nursing or combining nursing with another field of endeavor. They did not feel affiliated with other nurses in recovery. They viewed the coercion of the alternative program as punitive and having no positive value. They felt they were forced out of participation in the program for unsupported reasons. In spite of this, seven of eight of the noncompleters remained in recovery.

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