Nancy Carlson

Date of Award


Document Type


Degree Name

Master of Science (MS)




This descriptive study was undertaken to examine the role of environmental work stressors and family-of-origin dysfunction in the gensis of professional codependency and compare rural and urban samples of nurses using those parameters. The nursing literature presents us with two contradictory explanations of the relation between codependency and nursing. Some see it emerge when a nurse’s wish to care for others is motivated by attempts to fulfill her or his own unmet needs from dysfuctional family experience. Others see the medical institutional expectation of devotion and self-sacrifice by nurses as a causal factor in codependency. Both interpretations are based on the predication that there is a high prevalence of codependency among nurses. A third factor, population density, specifically highly urban verses highly rural practice, may be tied to codependency in that the nature of rural nursing practice makes it especially difficult to distinguish between personal and professional roles.

Registered nurses (n = 202) who work in acute care settings in either rural North Dakota or metropolitan Minneapolis, Minnesota were surveyed to determine their codependency level, the presence of family traits associated with codependency and characteristics of their workplace. The Friel Codependency Assessment Inventory provided a tool to place subjects in categories of codependency from “few codependency concerns” to “severe codependency”. Perceived workplace stress was evaluated by the modified Ware Organizational Features scale which rates perceptions of environmental factors which may be stressful to the individual in the areas of professional practice, professional relationships and nursing unit management. Five questions about the subject’s childhood family life which have been previously linked to codependency provided data regarding family dysfunction,

Using the Chi-quare test, no statistically significant differences were found when the rural and urban samples were compared to the codependency categories. An Analysis of Variance revealed that there also was not a statistically significant relationship between codependency and family-of-origin dysfunction. When the codependency categories were compared to the mean organizational features scores however, an Analysis of Variance revealed that those subjects with few to mild codependency concerns had less perceived workplace stess than those with severe codependency.

The findings of this study did not support the view that children from dysfuctional families seek careers in nursing to meet their codependent needs for self-esteem, control or belonging. Instead, its findings indicate that structural and environmental factors of the modern healthcare workplace such as understaffing, lowering standards to meet financial agendas and multiple regulations may be antecedent to the development of codependent behavior in individual nurses. This finding is consistant with the general propositions of Field Theory where energy is present in a system and is used to exert influence, disequilibrium or polarization within conscious or subconscious environment.

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