主任看護師が役割を捉えながら変化していくプロセス—昇進前後の役割移行に焦点を当てて

The Process by Which the Chief Nurses Changes while Grasping the Role: Focus on the Transition of Roles before and after Promotion

要旨

　目的：本研究の目的は，主任看護師が昇進を通してどのように役割を移行していくのかを明らかにすることである．

　方法：8名の主任看護師を対象に半構造的面接を行い，データは修正版グラウンデッド・セオリー・アプローチを用いて分析した．

　結果：プロセスは，昇進前の経験に影響を受けて2つに分かれ，一つは主体的，もう一つは消極的であった．前者は，【いずれ管理者になることを決心する】【“主任看護師としての私”を自分とスタッフの両方が認識する】【師長とスタッフの考えをつなぐ方法を探る】，俯瞰して考えることで【立場を活かして組織と個人をつなぐ】であった．後者は，【なんとなく道が決まる】【師長の仕事を助ける】であった．プロセスの特徴は，循環する，引き戻ることであった．

　考察：主任看護師の役割移行に必要なことは，移行に特化した支援，役割を通して学び続けられる支援である．また，役割経験を通して新たな知見を広げる姿勢をスタッフの時期から育んでいく必要性も示唆された．

　Purpose: The purpose of this study is to explore how mid-level nurses shift their roles through promotion from those of team leader nurses to those of chief nurses.

　Method: Semi-structural interviews were conducted with eight chief nurses and obtained data was analyzed by a modified grounded theory approach.

　Results: The process was two-fold, influenced by the experience before promotion: one is an active process and the other is a passive process. The former consisted of four stages: 1) Decision to become a nurse manager eventually, 2) Recognition of “I as the chief nurse” by both a nurse him/herself and his/her staff nurses, 3) Searching for ways to connect the thoughts of nurse managers and those of staff nurses, and 4) Thinking from a bird's point of view and learning to connect organizations and individuals by taking advantage of their position as chief. The latter consisted of two stages: 1) Being passively promoted, and 2) Helping the nurse manager's work, following instructions. The characteristics of those processes were circulation and pullback: nurses in the active process went back and forth between the four stages according to environmental changes, while those in the passive process were pulled back even if they wanted and tried to go into the active process.

　Discussion: The following things are needed to shift the role: a support focused on the transition of roles and a system which enables nurses to continue learning through roles. The study also suggested that nurses should learn to expand new knowledge through role experience before promotion.