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大学病院において看護師長が体験する倫理的問題
岩本, 幹子;溝部, 佳代;高波, 澄子
Permalink : http://hdl.handle.net/2115/36097
JaLCDOI : 10.14943/34178
KEYWORDS : nursing ethics;ethical issues;questionnaire;nursing administration;nursing practice;看護倫理;倫理的問題;質問紙法;看護管理;看護実践
Abstract
本研究の目的は、高度医療を担う大学病院において看護師長が遭遇する倫理的問題の実態と、その対応や教育ニーズへの認識を明らかにすることである。研究方法は、入院病棟を管理する看護師長46名を対象とし、「ETHICS and HUMAN RIGHTS in NURSING PRACTICE」 (S.T. FRY & NEN. 1997) を用いた質問紙法である。この結果、多くの看護師長が体験し、悩んでいる問題として「看護師の充足状況」の問題が挙げられた。診療報酬制度によって定められた看護配置と大学病院という急性期病棟のスタッフナースがおかれている多忙な状況の間で、看護師長の独力では解決出来ない問題に苦悩していた。また、倫理的問題の対処の際には、主治医との協力が有効であると認識しているが、同時に医師との対立があることも頻繁に体験しており、問題解決へ向けての十分な相互理解をはかる必要性が示唆された。長い臨床経験の中で看護師長は倫理に関して学習し知識を深めながらも、倫理に関する教育の必要性に高い認識を示した。以上の結果から、看護師長は倫理的問題の解決は困難であるが、その重要性を認識し、努力を続けていることが示された。
The aims of the present study were to identify the ethical issues that head nurses have encountered in practice at university hospitals that provide technologically advanced medical treatment, to clarify how the nurses handled these ethical issues, and to determine the extent to which they require ethics education. Survey instrument; a questionnaire was used. It was based on the survey tool, "Ethics and Human Rights in Nursing Practice" (Fry ST & NEN. 1997). Respondents included 46 head nurses who managed inpatient wards at three university hospitals. The following results were obtained. Respondents most frequently experienced and have been most deeply troubled with "insufficient nursing staff". Therefore, respondents were troubled by ethical issues that could not be solved by themselves between the staff nurses' situation and the health care system. Many respondents recognized that nurses and physicians have to be cooperative in solving ethical issues, however the respondents also experienced frequently "conflicts in the nurse-physician relationship". From these results, it is said that nurses and physicians are required to understand mutually in order to solve ethical issues. Although head nurses have learned nursing ethics throughout their careers, they believe that they require ethics education more. These findings also suggest that, despite the inherent difficulty, it is important to solve ethical issues.
The aims of the present study were to identify the ethical issues that head nurses have encountered in practice at university hospitals that provide technologically advanced medical treatment, to clarify how the nurses handled these ethical issues, and to determine the extent to which they require ethics education. Survey instrument; a questionnaire was used. It was based on the survey tool, "Ethics and Human Rights in Nursing Practice" (Fry ST & NEN. 1997). Respondents included 46 head nurses who managed inpatient wards at three university hospitals. The following results were obtained. Respondents most frequently experienced and have been most deeply troubled with "insufficient nursing staff". Therefore, respondents were troubled by ethical issues that could not be solved by themselves between the staff nurses' situation and the health care system. Many respondents recognized that nurses and physicians have to be cooperative in solving ethical issues, however the respondents also experienced frequently "conflicts in the nurse-physician relationship". From these results, it is said that nurses and physicians are required to understand mutually in order to solve ethical issues. Although head nurses have learned nursing ethics throughout their careers, they believe that they require ethics education more. These findings also suggest that, despite the inherent difficulty, it is important to solve ethical issues.
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