中小規模病院に継続勤務する看護師のキャリアアップに関する認識

Career-Building Awareness of Nurses Who Continue Working at Small and Medium-sized Hospitals

要旨

　本研究は、中小規模病院の看護師のキャリアアップに対する認識を明らかにすることを目的に半構成的面接を行った。研究対象は、500床未満の中小規模病院5施設に継続勤務している看護師14名である。その結果、看護師のキャリアアップに対する認識として9つのカテゴリーを得た。看護師は【キャリアアップのための経済的・時間的自己投資】をしながら、【各々の職場におけるキャリアアップ】をしていた。最終的には【自己成長のためのキャリアアップ】に向かって努力していた。また、看護実践能力の評価プログラムとして導入されている【キャリア開発ラダーの課題】を挙げていた。しかし、中小規模病院で勤務する看護師は、病床数や看護師の人員が少ない点、対象施設が大都市から遠隔地にある点等により、【学習環境としての状況的不利】を感じていた。看護師は【誰にも潜む仕事継続の危機】に直面するが、【ワークライフバランスの重視】をしながら、【看護職としての職務満足感】や【“やめられない”という消極的意思】が仕事継続の動機づけになっていた。

　以上より、中小規模病院の看護師は、自己成長のためにキャリアアップをしていきたいと認識しているものの、学習環境として不利を感じていることが明らかになった。中小規模病院の学習環境の充実のために、病院と大学が連携して、研修や研究に取り組んでいく必要がある。また、中小規模病院間で連携できるよう大学がコーディネイト役割を発揮していくことが重要になると示唆された。

　In this study, a semi-structured interview was conducted with the aim of identifying career-building awareness of nurses at small and medium-sized hospitals. The 14 interview subjects were nurses who have been continuously employed at five small and medium-sized hospitals (fewer than 500 beds) since starting their careers. Nine categories regarding career-building awareness were extracted. As a result, it was revealed that the nurses were making efforts for “career-building at their respective workplaces” by “investing money and time in career-building.” Accordingly, they were working hard toward “career-building for their own growth.” In addition, they cited “issues associated with the career development ladder” introduced as a program to evaluate nursing competency. Nurses working at small and medium-sized hospitals felt that they were at “a disadvantage in terms of learning environment” because the numbers of beds and nurses were small and their hospitals were located far away from large cities. All of them acknowledged “a shared sense of crisis regarding continuing their present jobs.” However, while putting “emphasis on work-life balance,” they were motivated to continue working by the “satisfaction the nursing job offers” and the fact that “they will not be able to quit anyway.” Based on the above findings, it was revealed that nurses who work for small and medium-sized hospitals are aware of the need to build their careers for personal growth, but feel that they are at a disadvantage in terms of learning environment. To improve learning environment in small and mediumsized hospitals, hospitals and universities need to work together in implementing training and research. Moreover, it was suggested that in order for inter-hospital cooperation to take place, it is important for a university to play the role of a coordinator.