看護婦の労働と意識

-半専門職の専門職化に関する事例研究-

抄録

The main purpose of this article is to elucidate the process by which the occupations in the modern society are professionalized, through a case study of the nurse in Japan.
The nurse is still considered as a semi-profession in Japan.
Why is it ? In conclusion, it is due to the fact that there still remains a big distance between the nurse and “full-fledged professions” in that the nurse lack autonomy or a wide range of freedom as individuals and groups' and speciality to guarantee the autonomy or a system of highly professionalized knowledge and technology, both of which constitute a basic requirement of professions. In other words, the central questions in professionalization of the nurse are : firstly, how to establish their “speciality” based on the systematized knowledge and technology, and secondly, how to free themselves from subordination to medical doctors amidst the rapidly bureaucratizing organization of hospitals and thus to establish their “speciality”.
The answers to these two questions have so far been sought in the improvement of training and certification system of the nurse and in the movements for obtaining rights as laborers.
This article, however, intends to examine the structure of attitudes and opinion of nurses toward the situations and meaning of the occupation in which they are engaged, as a preliminary task before attempting to identify the tendency toward professionalization in the policy or in the movement. It seems essential if we are to consider the possibility that the nurse may be professionalized.
The survey used in this paper was administered to 296 nurses holding certificates under the new system in seven hospitals in Tokyo. Contrasting the results of this survey, I also used parts of the results of the survey administered to 246 students in their final year enrolled in nine nursing junior colleges or higher institutes.
The following points have been revealed by the surveys :
Reflected strongly in the opinion and attitude of nurses are the difficult situations for the professionalization such as unsatisfactory system and content of education, immature science of nursing, subordinate relation to medical doctors, gap between what they are originally expected to do and what they are actually doing, and weak Japan Nursing Association, which should play a central role in the efforts toward the professionalization of the nurse.
This fact implies that the nurse has not yet reached even the level of semi-profession, the typical example of which are the elementary and lower secondary school teacher. In spite of this low level of professionalization, they are quite satisfied with the present level of specialization and autonomy and optimistic about the future of their occupation. The nurse still remains to establish itself as a semi-profession. Its full-fledged professionalization will begin when it has attained speciality and autonomy as a semi-profession. But, it is quite dubious if they will show the confidence and optimistic perspectives about the level of professionalization of their occupation and its future possibility as they do today, even when they have established as a semi-profession.