助産師資格のない看護師等の内診が意味すること（第一報） : 助産師不足とその背景
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概要
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日本において，看護師等による産婦への内診を含む助産行為は，2002年，2004年，2007年に出された行政通知によって禁じられている。本研究は，助産師の社会的需要はますます増大しているという観点から，以下について論じる。1. 医療法指定規則に定めのない助産師の需要は，助産行為を誰が担うのかに依拠する。とくに診療所では助産師を積極的に採用する方策が十分なされてこなかったために，無資格者による助産行為をせざるを得ない状況となった。2. 未就業助産師のなかで就業を希望する者は一定数存在する。3. 助産師の偏在は就労環境に依拠し，単に勤務条件，労働条件のみならず，継続教育の保証，助産師としての専門性が発揮できる環境，安全に助産業務が遂行できる人的環境，医師，看護師との役割分担とパートナーシップが重要である。4.現在，医療化された出産現場において助産師は，専門職としてのアイデンティティを取り戻し， 実践能力を高める努力が必要とされる。In Japan, the practice of midwifery, including pelvic examination, by registered nurses, licensed practical nurses, and nursing assistants is prohibited under administrative notifications issued in 2002, 2004, and 2007. This study addresses the following issues in the light of increasing social demand for midwifery. 1. As the Medical Practice Act does not designate the roles and regulations for nurse-midwives, the demands for these professionals depend on who has been charged with the responsibility for delivery. There has not been effective strategies to employ nurse-midwivesactively at matemal clinics; as a result, unlicensed persons have had to assist with deliveries. 2. There is a constant number of qualified nurse-midwives who are not currently working, but wish to start practicing. 3. The structure of the current work environment is responsible for the uneven distribution of nurse-midwives. Therefore, it is important to provide a clinical environment in which nurse-midwives can use the full extent of their training and a personal environment in which they can safely accomplish their statutory duty at delivery. It is also important to guarantee continuous education and training, clearly defining the roles of physicians and registered nurse under these conditions will help establish a partnership among them and improve employment and labor conditions. 4. Currently, nurse-midwives are routinely confronted by hospitals at delivery as to their function and responsibilities. Nurse-midwives need to regain an acknowledgement of the role of their profession in childbirth and continue to enhance their practical abilities to fulfill that role effectively.
- 2007-12-31