Award Date

December 2015

Degree Type


Degree Name

Doctor of Nursing (ND)



First Committee Member

Michele Clark

Second Committee Member

Carolyn Yucha

Third Committee Member

Alona Angosta

Fourth Committee Member

Gillian Pinchevsky

Number of Pages



Today over one million U. S. prisoners are being held in federal and state systems for substance use-related crimes. The financial, social, and emotional costs have turned policymakers’ attention to rehabilitation rather than incarceration. In an attempt to meet the challenge of recovery from addiction, prison systems around the nation have explored various options, including residential treatment programs. One such form of residential treatment is the modified therapeutic community (MTC) where inmates participate in a nine-month, cognitive-based treatment program. This model focuses on incarcerated individuals, addicted to substances, to assist them in developing behaviors to reduce antisocial peer associations and replace criminal thinking with prosocial alternatives. In the MTC, inmates, counselors, physicians, and nurses work closely together to form a very structured environment for treatment. Though this treatment has demonstrated positive outcomes for reducing addiction, studies do report nurses working in this environment suffer a high burnout rate. Nurses play a significant role in the MTC; however, previous studies indicate that nurses lack the knowledge and skills for this role. Based on an extensive literature review, little or no information exists on the effect this lack of knowledge might have on the nursing population.

This research undertakes a phenomenological inquiry to describe, interpret, and gain a deeper understanding of the nurses’ lived experiences while working with prisoners that are rehabilitating from substance use disorders in a secure MTC. The research data was analyzed using Max van Manen’s six research activities of hermeneutic phenomenology and Colaizzi’s seven-step method of data analysis which operationalizes van Manen’s approach. The question guiding this study is: What is the meaning and significance of the lived experience of a nurse working in a secure modified therapeutic community?

Ten nurses from three MTCs participated in the study. The findings from the interview data analysis led to the development of a model depicting the fundamental structure of the overall essence of a MTC-A Pathway to Professional Identity which includes three major themes and a total of twelve subthemes. The information gathered in this study will be useful for nurses who are preparing to engage in work at a secure MTC and for nursing directors and administrators who will be supporting them.



File Format


Degree Grantor

University of Nevada, Las Vegas




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Included in

Nursing Commons