フライトナースの職務遂行の構造

Structure of Nursing Practice of Flight Nurses

要旨

　目的：病院前救急医療におけるフライトナースの職務遂行の構造を明らかにすることである．

　方法：東海・近畿圏のフライトナース6名を対象に半構造化面接を行い，KJ法を用いて分析した．

　結果：職務遂行は，【周囲の関係者の力をもらうために自ら協働を仕掛ける】，【医師とのディスカッションを通して精度の高い臨床推論を引き出す】，【臨機応変な対応と工夫を凝らす】，【特殊で厳しい医療環境のなかで最大の効果を上げるために努力する】【振り返りを行い，個人の経験を知識に変換しチーム内で共有する】，【フライトナースの看護の独自性を明らかにしたい】，【経験で得た知識を活用したOJTによる新人の育成】の7つのシンボルマークで説明された．

　結論：職務遂行は，「中核としての経験の蓄積」を基盤として「経験をブラッシュアップ」する過程を経て「さらなる展望へ」へと至る段階的な三層構造となった．

　Objective: The present study involved flight nurses who provide emergency medical care while transporting patients to hospitals, and aimed to examine the structure of their practice.

　Method: Semi-structured interviews with six flight nurses in the Tokai and Kinki regions were conducted, and the results were analyzed using the KJ method.

　Results: The flight nurses' practice was classified into the following 7 categories: [Cooperation suggested by themselves to work in collaboration with surrounding health care staff], [Accurate clinical inferences extracted through discussions with physicians], [Flexible responses and ideas], [Efforts to achieve the maximum effect in special and severe health care environments], [Reflection to convert the experiences of individuals into knowledge and share it within the team], [Paying attention to the uniqueness of nursing care provided by flight nurses], and [On-the-job-based training for new flight nurses utilizing knowledge acquired through experience].

　Conclusion: The nursing practice of flight nurses has a tri-layer structure: It is based on “the accumulation of core experience” and develops into “future visions” through the process of “brushing up skills learned from experience”.