Process of Returning to Work for Mid-Career Nurses Who Continue Working After a Sabbatical or Leaving Work Due to Mental Health Disorders

Abstract

本研究は,キャリア発達の視点を踏まえた支援体制構築のために,メンタルヘルス不調による休職・離職を経て復帰し看護師として働き続けるプロセスを明らかにすることを目的とした.3 年以上の職務経験の後にメンタルヘルス不調による休職もしくは離職を経験し,看護職に復帰した看護師 9 名に半構造化面接を行い,複線径路・等至性アプローチを用いて分析した.その結果,「見通しをもって看護師を続けていく」という等至点に至るまでのプロセスにおいて,「心身に強く仕事の負担がのしかかる」「現状と先行きへの不安に職業継続意思が揺らぐ」「何もしていない焦りと不安を抱え葛藤する」「看護師としての自分を立て直す」という 4 つの分岐点(BFP)が見出された.また,キャリアを中断するまでの時期では,<看護を担う専門職者としての信念>がキャリア発達の促進要因かつ阻害要因として働いていることが明らかとなった.本研究の結果から,メンタルヘルス不調による休職・離職経験のある看護師へのキャリア発達支援には,何らかの迷いや複線性が生じる分岐点に着目し,経験に応じた細やかな支援が必要であるとともに,様々な予期せぬ出来事をキャリア発達のチャンスとして捉えるスキルを培い伸ばせるような支援が望ましい.さらに,組織が期待する役割と看護師個人が大切にしている信念が大きくかけ離れないことも大切である.This research was designed to determine the process of support system construction by nurses returning to work after taking a sabbatical or leaving work due to mental health disorders from the viewpoint of career development. Semi-structured interviews were conducted with nine nurses that had left their jobs due to mental health disorders after more than 3 years of employment and then returned to the profession. These interviews were then analyzed using the trajectory equifinality approach. The results indicated four bifurcation points (BFP) on the process of reaching equifinality so they could continue their nursing careers with prospects: “The burdens of work weigh heavily on both the body and mind,” “The willingness to continue working changes due to current conditions and anxiety about the future,” “Experiencing tension from the frustration and anxiety of not doing anything,” and “Gearing oneself toward being a nurse.” In addition, the results indicated that up to the point where they discontinued their careers, “Belief of being an expert who has assumed a nursing career” worked to both promote and obstruct career development. The results of this study indicated the necessity of career development support for nurses. To provide career development support to nurses that have taken sabbaticals or left work due to mental health disorders, it is necessary to pay attention to their BFP, which may cause some ambivalence and develop multiple possibilities, and provide detailed support appropriate to the person’ s experiences. In addition, support is preferable to provide opportunities for nurses to see various unexpected incidents as chances to develop their careers and nurture their skills to overcome problems. The roles that the organizations for which they work expect nurses to adopt and the beliefs that nurses value should generally be in accordance with each other

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