特定機能病院の看護師が看護実践を価値づけ，やりがいを獲得し成長していくプロセス

A Detailed Look at How Clinical Nurses at Advanced Treatment Hospitals Discover Worthiness in Their Nursing Practice Leading to Motivation, Fulfillment and Professional Growth

要旨

背景・目的：看護師には看護実践の質向上の責務があるが，困難な状況がある．本研究では，看護専門職の成長を促す教育支援に資するため，特定機能病院の看護師が看護実践を価値づけ，やりがいを獲得し成長していくプロセスを明らかにする．

方法：経験年数5〜10年のA病院の看護師18名を対象に半構造化面接を行い，M-GTAを用いて分析した．

結果：看護師は【どうしたらよいかわからなくて不安な中でもがく】が【試行錯誤し，ひと通りの業務はこなせると感じる】．そして，【自分の看護実践について内省し，次への原動力とする】ことで核となる【看護実践過程の展開とその価値を実感する】に至っていた．さらに【患者の反応やチームメンバーの言動に気づく】【チームの成長に貢献したいと思う】【看護師として成長できていたと気づく】【自分の看護実践について内省し，次への原動力とする】が相互に関連し，【より良い看護を目指し，看護を探究する】に至っていた．

結論：看護師が看護実践を内省し，価値を見出せるようなチームとしての支援が重要である．

Purpose: Nurses have a responsibility to improve the quality of their nursing skills. However, it was reported that this is difficult to achieve. This study was conducted to clarify how nurses who work at advanced treatment hospitals discover worthiness in their nursing practice and to understand the type of support that is needed to develop and foster growth in the nursing profession.

Methods: Data for this study was collected through semi-structured formatted interviews from eighteen nurses with five to ten years of clinical nursing experience at hospital A. The data were then analyzed using modified grounded theory approach.

Results: Early in their careers, nurses reported a struggle to understand their essential duties. However, over time and through trial and error, many said they could dutifully carry out their primary nursing responsibilities. Once nurses genuinely considered their skills and recognized the worthiness of their nursing abilities, that knowledge became a strong motivating factor for the continuation of learning and a deepening of their nursing expertise. Nurses were influenced and supported by a diverse group of patients and team members which eventually led them to reciprocate their influence and support back to the people around them in the workplace. Upon reflection on their work experience, nurses were able to see clear signs of progress in their nursing practices, motivating them to have a deeper understanding of nursing skills to accomplish better nursing practices.

Conclusions: The data suggest the importance of providing team support to assist nurses in reflecting on their work experience and recognizing the worthiness of their nursing practice.