【コラム】本邦のICUにおける特定行為研修を修了した看護師に期待される役割とは？—チーム医療を支えるコミュニケーション能力が必要

The expected roles for nurse practitioners in ICUs in Japan

特定行為研修を修了した看護師には，どの職種が担当すべきか明確に定めづらい業務をフォローし，患者ケアをより安全にスムーズに行うための調整役になってもらいたい。

　1960年代米国で始まったnurse practitioner（NP）やphysician assistant（PA）などのadvanced practice provider（APP）と同じような仕組みは，現在の日本ではまだ整っていない。日本では2008年に大学院修士課程として，日本版のNP（日本語名称としては診療看護師）の教育が始まったが，国の制度として公に開始されたのは，2015年の「特定行為に係る看護師の研修制度」以降である。特定行為研修を実施する教育機関はいくつか存在する。そのため臨床には，診療看護師（大学院修士課程を修了）と，特定行為研修修了者（大学院以外で研修を修了）が混在している。特定行為が行えるという点については同じかもしれないが，それぞれの役割と臨床で任される範囲は異なっている。これらをふまえたうえで，日本において期待される役割について述べる。

Japanese Advanced nurse providers usually work in hospitals, but their roles and working responsibilities are different at each hospital. However, they can play a key role to make good relationships between medical providers if they have a courteous attitude and trustable skills. In the 1960's, Nurse Practitioners and Physician Assistant Professions were developed in the United States of America （USA）, and are now called Advanced Practice Providers. The structure of Japanese advanced providers is not the same as in the USA and the roles of these providers are not yet finalized. In 2008, one Japanese university tried to develop a Master's Degree for Nurse Practitioners, but it has not yet been recognized with a national license in Japan. In 2015, the Japanese government developed a certificate system which includes designated procedures for nurses. The Master's Degree for Nurse Practitioners course is officially included in the certificate of designated procedures. In Japan, there are four different advanced providers in clinical settings；one is for people who graduated with a Master's Degree for Nurse Practitioners, including a certificate of designated procedures, and the other is for people who studied for the certificate of designated procedures. The roles and working responsibilities are different at each hospital for each of these groups of nurses. However, it is hoped that they will serve as a great coordinator caring for patients.