ナラティヴ学習に基づく専門看護師の倫理調整役割開発プログラムの活用可能性

Possibility of utilizing a narrative-based learning program to develop the Certified Nurse Specialist' role of ethical coordination

　本研究の目的は、ナラティヴ学習に基づく専門看護師の倫理調整役割開発プログラムの活用可能性を明らかにすることである。プログラムは5セッションから構成され、4名の参加者のセッションのデータをテーマ分析により分析した。プログラムへの参加は〈自分の実践や考えを安心して語り、聞くことが出来る〉〈先輩も同じような経験をしてきたことに安堵し、悩んでいるのは自分だけではないと勇気づけられる〉と自己肯定感を高めていた。さらに〈先輩CNSの経験を自分に置き換えて考え、とらわれていた自分に気づく〉ことが促され、前提や価値観の批判的な振り返りがなされたと示唆された。このような振り返りは、変容学習において非常に重要な段階であり、〈相手の視点に合わせる柔軟性とぶれない思いをもって、看護の質をあげることが自分に求められている役割とハッとする〉という倫理調整における新たなパースペクティヴをもたらすことが示唆された。

　The purpose of this study is to clarify the possibility of utilizing a Narrative-based Learning Program to develop the Certified Nurse Specialist (CNS)' role of ethical coordination. Data about four participants in the 5-session program was analyzed by the theme analysis method. The participants' self-esteem increased as their participation in the program enabled them to talk about their actions and thoughts and listen to others in a safe environment. They were relieved and encouraged as they realized that the senior CNS had the same experiences, and they were not the only ones who were anxious about their work. In addition, it was suggested that the program helped them to put themselves in the senior CNS' shoes and realize they were slaves to their assumptions and values, which resulted in critical reflection on these. Such reflection is a stage that is extremely important in transformative learning and is believed to bring about a new integrative perspective on ethical coordination as the participants suddenly understood that the role required of them is to improve the quality of nursing care with the flexibility to accommodate the others' viewpoint while also maintaining a strong commitment to their work.