病棟看護師長が認定看護師を有効活用するために実行している関わり方や工夫

How Head Nurses Are Involved and Creative: Making Effective Use of a Certified Nurse

要旨

　目的：病棟看護師長が，他病棟に勤務する兼任の認定看護師（Certified Nurse，以下，「CN」と略）を有効活用するために実行している関わり方や工夫を明らかにする．

　方法：病棟に勤務する師長で経験年数5年以上，兼任のCNと働いた経験を有するもの．半構造化面接にて兼任のCNを活用するために「師長が実行している関わり方や工夫」について尋ね，質的記述的分析をした．

　結果：10名の協力が得られた．師長は兼任のCNを有効活用するため【CNとのコミュニケーションの駆使】【CNとのメタ・コミュニケーションの駆使】を様々な場面で工夫する等，【CNの豊かな人間性を尊重】して信頼関係を築いていた．また，師長は【CNとスタッフの双方の円滑な関係構築】に配慮し，兼任のCNを病棟の研修会の講師としケアに介入させ【スタッフ自らがCNへ依頼をするための動機づけ】を行い，【CNの介入による高度な看護実践の定着】を意図した関わりをしていた．

　Purpose: This study aimed to describe the management practices utilized by Japanese head nurses (HNs) to most effectively employ a kenmu (“joint assignment”) certified nurse (CN) while they were assigned to their wards.

　Methods: Semi-structured interviews were conducted with 10 female head nurses with a minimum of five years of experience, regarding how they treated the CN and attempted to make the best managerial use of these individuals. The results showed that the HNs exercised their human relations skills and built relationships of trust by showing respect for the practical skills and humanity of the CNs, communicating with them fully, and making full use of meta-communication. Additionally, they took care that smooth relations existed between the staff and CN and motivated the nursing staff to ask the CN for help when required. HNs were also purposefully involved in finding ways to ensure that, through the interventions that the CN performed, the nursing staff learned more advanced nursing practices themselves. The study showed that HN managerial practices were the accumulation and demonstration of knowledge resulting from intentionally using the CN with the provision of the best possible patient care in mind.