訪問看護事業所に非常勤として就労した看護師の適応に関する経験：質的研究

Exploring the Adaptive Experience of Part-time Home Visit Nurses: A Qualitative Study

要旨

　目的：訪問看護分野に非常勤として就労した看護師の訪問看護への適応に関する経験を明らかにすること．

　方法：首都圏の訪問看護事業所に非常勤として1年以上勤務し，かつ医療施設などでの看護師経験を1年以上有する者17名に半構造化インタビューを行った．データはConventional content analysis の手法で分析した．

　結果：協力者は〈病院で身に着けた看護ケアの常識が通用しない〉，〈できていたはずの自分と今の自分との乖離〉といった【訪問看護への適応の前にたちはだかる困難】を経験していた．それに対して〈出来事の意味を考える〉ことや〈業務遂行を改善する打開策を見つける〉ことといった【訪問看護への適応を促した対処】が取られることで，【訪問看護へ適応した姿】を実感することに繋がっていた．

　結論：非常勤訪問看護師の訪問看護への適応のためには，準備性を高めるオリエンテーションや，能力を鑑みた訪問業務の采配が重要であると考えられた．

　Objective: This study described the adaptive experiences of part-time home-visit nurses.

　Methods: Semi-structured interviews were conducted with 17 nurses who had more than one year of experience and had worked part-time for home-visit nursing agencies in the metropolitan area for over a year. Data were analyzed using the conventional content analysis method.

　Results: The study participants indicated that some experiences, such as “common sense of nursing care acquired through experience in hospitals that does not work” and “difference from the self that I should have been able to be,” led to “difficulties in adapting to home-visit nursing.” In order to “cope with adaptation to home-visit nursing,” the participants took measures such as “thinking about the meaning of events” and “finding ways to improve my work” in order to create “a sense of adaptation to home-visit nursing.”

　Conclusion: Helping nurses adapt to home-visit nursing may require hosting an orientation that enhances their readiness and offering work arrangements that take the nurses' capabilities into consideration.