Managing vulnerability: nursing treatment for heroin addicts.

Grounded theory methodology was used to study nursing interventions in a methadone maintenance clinic. Participant-observation as a clinic staff nurse over four months was the principal method of data collection. A substantive theory called "managing vulnerability" was developed to describe nursing treatment of heroin addicts during methadone maintenance. Managing vulnerability has three parallel stages for the client and nurse. These stages are (a) learning to be vulnerable, (b) living with vulnerability and (c) beyond vulnerability. Basic conditions for this process are dispensing (giving) medication; therapeutic neutrality, which is the attitude assumed by the nurse; effective staff communication and clear clinic policy. Managing vulnerability illustrates the complexity of a therapeutic psychological nursing process.