Hagiwara Tomoko, Yamaguchi Kyohei
Department of Clinical Nursing, School of Health Sciences, University of Occupational and Environmental Health, Japan.
J UOEH. 2022;44(3):313-319. doi: 10.7888/juoeh.44.313.
Before the outbreak of COVID-19, "Clinical Practice in Adult Nursing (Chronic Care)", a professional course to acquire basic nursing practice skills for the care of adult patients with chronic diseases, was conducted on site in the wards of internal medicine, outpatient departments, and the admissions support office for a total of three weeks. Due to the spread of the COVID-19 epidemic, however, clinical practice was carried out online from May 2020, and was resumed on site at our university hospital in October 2020. A restriction was placed on the length of time spent at the hospital for on-site training, referring to the training standards based on our university's new coronavirus response manual, and a training program was developed for hospital ward training, consisting mainly of shadowing practice performed without speaking or coming into contact with patients. In principle, two students were assigned to one patient: one in the morning and the other in the afternoon. In addition, for practicing the acquisition of patient information through conversation and the provision of nursing assistance, the perspectives used in the process of shadowing were clearly defined so that students could maintain active attitudes in clinical practice, and support was provided so that students could have the experience of engaging with patients, using nurses as mediators. In the results, the students evaluated the contents of the prepared assistance based on their own nursing plan in reference to the practice of the nurse as a mediator, and compared that with the assistance practiced by the nurse based on clinical judgment, which contributed to acquiring practical learning supported by the grounds for clinical judgment. However, the students could not experience the process of building supportive relationships and the implementation of nursing skills, which remained an issue.
在新冠疫情爆发前,“成人护理临床实践(慢性病护理)”这门专业课程,旨在让学生掌握照顾成年慢性病患者的基本护理实践技能,在内科病房、门诊科室以及入院支持办公室进行为期三周的现场实践。然而,由于新冠疫情的蔓延,从2020年5月起临床实践改为线上进行,并于2020年10月在我校附属医院恢复现场实践。参照我校新冠应对手册中的培训标准,对现场培训在医院的时长进行了限制,并制定了医院病房培训计划,主要包括不与患者交谈或接触的跟班实践。原则上,两名学生负责一名患者,一名上午负责,另一名下午负责。此外,为了通过对话获取患者信息并提供护理协助进行实践,明确了跟班过程中所采用的视角,以便学生在临床实践中保持积极态度,并提供支持,使学生能够以护士为媒介体验与患者接触的经历。结果,学生们参照护士作为媒介的实践,根据自己的护理计划对准备好的协助内容进行评估,并将其与护士基于临床判断所实施的协助进行比较,这有助于获得基于临床判断依据的实践学习。然而,学生们无法体验建立支持性人际关系的过程以及护理技能的实施,这仍是一个问题。