She defines co-dependency as a pattern of behavior and emotion resulting from growing up under a system of oppressive family rules in which the expression of feelings and the discussion of problems are avoided. In other words, nurses who engage in substance abuse tend to come from fairly authoritarian households that do not much encourage self-expression.
Misiaszek feels that what happens with co-dependent nurses is that they find the hospital situation somehow evocative of their past life at home (perhaps best in order to a hospital to run efficiently, it formulates and adheres to numerous rules) and that they react to the hospital system as "family." As a result, this identification of hospital system and family causes co-dependent nurses to engage in a number of "nice" behaviors that one might do for a family member. For example, these nurses will work extra hours, or go out of their way to help other nurses as well as do a number of other extra tasks around the hospital for which most hospital staff and managers react with a good deal of gratitude.
Unfortunately, this gratitude helps to perpetuate the problem. This perpetuation occurs because the gratitude allows nurses to continue taking on more and more burdens which ultimately will push them into using drugs or alcohol as a way of coping with their overcrowded schedule and their personal feelings of burnout (feelings of cynicism, hopelessness, and so forth) arising as a result of the heavy workload.
In addition to the co-dependency issue, there is some evidence that other background/demographic factors can increase
level of risk for substance abuse. In one study, for example, 139 nurses recovering from chemical dependency were compared with 384 nondependent nurses on their reports of sexual abuse, negative outcomes of sexual experiences, and homosexual experiences.
A number of demographic, educational and professional variables were also assessed. Differ...