NURS 491 - Nursing Management (D)
Liberty University
Name
2022
OPERATIONAL DEFINITION: Recovery can either be viewed as straight forward, or have
a more nebulous sense, it all depends on the intended use. Considering my practice change
problem of heroin relapse and low program retention rates, recovery is more of a dynamic
interpersonal process projected to protect the self-worth of individuals suffering from heroin
abuse. Generally speaking, recovery can be described as the process of returning back to a
normal state, whether in health, mind or strength. It could also have the meaning of giving back
something that was lost (Merriam Webster Online, 2015). When discussing operational
definition, the aim is to give the reader a general sense of the empirical factors of that concept
and measurements used to further illustrate it (Chinn & Kramer, 2011). When looking at
recovery in heroin users, we generally focus on a period of time void of relapse. According to the
Substance Abuse and Mental Health Services (SAMHS), recovery includes four dimensions:
health, home, purpose, and community (Lifering, n.d.). Recovery can be measured by
overcoming disease in order to be able to live to one’s full potential, as it relates to health. In
regards to home, recovery can also be measured as having a stable place to live. To live
purposefully, a person in recovery would be able to live a purposeful life with integrity, being
able to be a part of their local community, as evidenced by creating social networks for support
and friendship.
RELATED CONCEPTS: Merriam Webster Online (2015) defines the related concept of
recruitment as: “the process of adding new individuals to a population or subpopulation (as of
breeding or legally catchable individuals) by growth, reproduction, immigration, and stocking;
also:4 a measure (as in numbers or biomass) of recruitment”. Another related concept, revival, is
defined as: “the growth of something or an increase in the activity of something after a long
period of no growth or activity” (Merriam Webster Online, 2015). When looking at related
meanings, it helps to identify characteristics that are vital to constructing the main concept
(Brennaman & Lobo, 2011). The term recruitment signifies what a company, or place of
employment might set out to do in order to achieve growth. The purpose recruiting is to achieve
further advancement or growth, whereas recovery simply illustrates returning back to a state of
oneness, from a place of lack or disease. The term revival signifies bringing a dead or dull thing
back into action again, emphasis is placed on inactivity and not lack or disease, as in the concept
of recovery.
EXEMPLAR CASE: Jason, a 26-year-old male, has been suffering from heroin addiction for 5
years. Jason, grew up in a sound home, both of his parents are still married. Jason describes his
father as laid back and easy going, but says that is mother is was more of the disciplinarian while
growing up. Jason has an older brother, who had also struggled with heroin addiction, but is
currently clean and sober for 2 years. Jason graduated high school and moved away, on campus
to a local in-state university. While in college, Jason started hanging around a group of young
adults who were into smoking marijuana and using other illicit substances. Jason, easily
followed, started abusing OxyContin pills, then within several months, started snorting and
shooting heroin. Jason, was unable to complete his final year in the university, dropped out, then
went back home to live with his parents. He and his mother would continue to argue, which then
made Jason substitute the anger and frustration with more heroin use, now, he is using up to 50
bags intravenously, every day.
Jason knew that this was not the life he wanted, however, he felt so far gone and knew
that he had lost his chance of making something out of him by dropping out of college. News
came to Jason, that one of his close friends and died of a heroin overdose. This had really
affected Jason, to the point of deep depression and more drug use. With the help of family and
friends, Jason agreed to rehab. After spending 90 days in an out of state facility, Jason came back
home, sober. He continued with Narcotics Anonymous (NA), attending group therapy, was
seeing a psychiatric nurse practitioner on a regular basis for medication management for
depression, and was even able to secure a job. Jason is now one year sober from all forms of
substances, has re-enrolled himself back at the university to complete his final year. Jason has
learned a lot over the past several years, and thanks his family for the support. He is now doing
great, and has a sense of accomplishment and purpose.
CONTRARY CASE: The idea of a contrary case is to state the opposite of what is presented in
the exemplar case. This will give readers a clearer picture or idea of the actual conceptual
meaning (Chinn & Kramer, 2011). In the case with Jason, we can say that after learning of the
death of his friend, his heroin abuse increased, but instead of his parents and family intervening,
they decide to stop enabling him and refused to have him continue to live with them. By doing
this, Jason’s parents were hoping that he would eventually realize that he cannot make it on his
own, and would then appreciate the help and support from them. However, Jason leaves, to only
find another enabler, a girlfriend, who also is using heroin. Together, the two of them use, he
lives between different friends, and finds himself caught up in a very bad circumstances, he
realizes he has only gone deeper in his addiction, and it appears harder to escape. Jason tries
returning back home to his parents for financial support for his habit, but is rejected at the front
door, as it is obvious that he has not gotten himself clean and has not made any previous attempts
to connect with them. His parents reluctantly close the door, closing him out of their lives, until
he proves his commitment for recovery and change. Jason feels worthless, depression is high,
and he turns to stealing to support his habit. Jason has not met all four dimensions described by
SAMHS: health, home, purpose, and community. His health is poor from consistent drug abuse,
In this case, there is no turn around period where Jason realizes the damage he has done.
He only continues to use heroin and associate with other users. Recovery has not been achieved.
RELATED CASE: Related cases share comparable meaning to the concept being used. They
are not exactly the same, but have some minor differences, yet are alike (Chinn & Kramer,
2011). Still using Jason’s case, it can be said that after he goes to rehab, he comes home, is clean
for 90 days, and starts attending NA and going for his regular medication management with his
nurse practitioner. Jason is clean from using heroin, has moved back in with his parents, and
even enrolled in the local university, where he first started. However, Jason has started using
alcohol to help cope with the stress of school. He has not been in the school environment and has
forgotten how much discipline is required to keep focused. On the weekends, Jason, usually have
one to two beers each on Friday and Saturday. He doesn’t drink to get drunk, is able to stop
when he wants to, but if not taken care of, his drinking could worsen.
In this example, Jason, has totally recovered from the debilitation of his heroin use, now
that he is back on track with school and health, still he seems to start becoming dependent on
another substance to deal with the stress of school. Jason, is on the right track, and has recovered
from his heroin use; however, another struggle seems to be surfacing.
BORDERLINE CASE: With borderline cases, subtle distinctions are made between
circumstances where the concept is and is not present (Brennaman & Lobo, 2011). Consider a
case involving Margaret, a 24 year-old female suffering from alcohol abuse. Margaret is a binge
drinker and has a 4 year history of binge drinking 4-5 days a week. Margaret has suffered severe
withdrawal symptoms with multiple seizure activity throughout her use. After getting help with
Alcohol Anonymous (AA) and family support, Margaret is able to support herself and continue
on with a sober life. However, due to the seizure activity, Margaret cannot carry out some basic
cognitive functions, as a result she can only engage in basic work activities, and is receiving
therapy to help with her mental deficits. Although, Margaret has recovered from alcohol use and
is able to function in society, with friends and family support, she is still plagued by her mental
deficits.
CONTEXTS AND VALUES: According to the practice change topic of heroin abusers and
retention rates, the concept of recovery is consistent with the context of substance abuse. When
discussing recovery, focus is placed on the four measures described by SAMHS to outline the
components needed to define the concept in its entirety. The recovery process is the result of
living a fulfilling life without the use and dependence of illicit substances.
The concept of recovery reveals values that surround ideas of hope, self-worth, positive
relationships and supports, and sobriety. Emphasis is placed on wholeness and continued success
in life, without the struggles that once came with previous drug use. Recovery, in any context
portrays a positive feeling of overcoming life’s struggles.
References
Brennaman, L., Lobo, M. (2011). Recovery from serious mental illness: A concept analysis.
Issues in Medical Health Nursing,32, 654-663. doi: 10.3109/01612840.2011.588372
In Merriam Webster Online (2015). Retrieved January 27, 2015, from http://www.merriam-
webster.com/dictionary/recovery.
Chinn, P. and Kramer, M. (2011). Integrated theory and knowledge development in
nursing.(8th ed.) St. Louis, MO: Elsevier Mosby
Lifering. (n.d.). SAMHSA’s Working Definition of Recovery from Mental Disorders and
Substance Use Disorders [Web log post]. Retrieved from
http://lifering.org/unused-pages/new-definition-of- recovery-from-the-substance-abuse
and-mental-health-services-administration
