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To Report or Not to Report: Nurses' Attitudes toward Reporting Co-Workers Suspected of Substance Abuse

Using survey data from a stratified, random sample of New Mexico nurses (N=498), this study helps to explain why some nurses choose informal rather than formal reporting strategies when confronted with substance-abusing co-workers. The researchers mailed a questionnaire to male and female RNs and LPNs in 1989, two years after New Mexico established its diversion program for substance-abusing nurses. Using a combination of OLS and logistic regressions, the authors test the diffusion model predicting that program knowledge leads to program acceptance and implementation. Finding little evidence of a link between program knowledge and implementation, the authors then offer two alternatives. The vulnerability model predicts that workers in the least secure positions will be most likely to avoid making formal reports, whereas the occupational hegemony model argues that administrators will avoid formal reporting to maintain control over their own work settings. Because their results offer most support for the latter two models, the authors reject the diffusion model and conclude that occupational culture and organizational politics are the most important social forces intervening between program diffusion and implementation.