新型コロナウイルス感染症の第一波流行期に院内感染した看護師の職場復帰に関する葛藤と使命感

Conflict and a Sense of Responsibility in Regard to the Decision to Return to Work among Nurses Infected with COVID-19 in the Workplace in the Early Stages of the Pandemic in Japan

要旨

　目的：新興感染症に院内感染した看護師の職場復帰と就労継続に必要な支援の示唆を得るために，第一波流行期にCOVID-19に院内感染して職場復帰した看護師の職場復帰前後の思いと，思いに影響した要因を考察する．

　方法：A病院でCOVID-19に院内感染し，研究に同意した看護師13名に半構造化面接法によるインタビューを行い質的帰納的に分析した．

　結果：職場復帰前は復帰をためらう思いと復帰したい思いの両方を抱いて［復帰に向けての葛藤］があった．復帰後は［復帰後も続く不安と病院の対応への不満］と同時に［復帰後の充実感］も抱いていた．復帰をためらう思いの持続は復帰後の不安と不満を強める要因の一つであった．感染症病棟看護師は感染した体験を今後に活かそうとしていた．

　結論：復帰前は復帰に向けての葛藤があった．感染の辛さの理解，職場環境の改善など看護師としての使命感を持ち続けられる病院からの支援は職場復帰と就労継続への支援につながることが示唆された．

　Objective: To clarify the thoughts of nurses before and after returning to work following infection with coronavirus disease 2019 (COVID-19) in the early stages of the pandemic, as well as the factors affecting these thoughts, and obtain suggestions regarding return-to-work support for nurses infected with newly emerging infectious diseases.

　Methods: Semi-structured interviews were conducted with 13 nurses who had been infected with COVID-19 while working at Hospital A and consented to participate in this study. The data obtained were qualitatively and inductively analyzed.

　Results: Before returning to work, the nurses experienced “conflicts about returning to work” between hesitation and anticipation. After returning to work, they had “a sense of fulfillment” while experiencing “continuing anxiety even after returning and dissatisfaction with the hospital's responses.” The persistence of hesitation before returning to work was a factor that reinforced their anxiety and dissatisfaction after returning. The nurses working on an infectious disease ward were willing to apply their experience of being infected to the care of their patients.

　Conclusions: Before returning to work, nurses experienced conflicts, and after returning to work, they experienced contradictory feelings of a sense of fulfillment and anxiety and dissatisfaction. These findings suggest that hospitals can help nurses maintain a sense of responsibility by understanding their suffering and improving their working environment, and that such support can help nurses to not only return to work, but also continue working.