The objective of this study is to elucidate nursing care for patients and their families in general wards that supports patients in the end-of-life phase of their disease in line with their wills. An interview survey was conducted with nine nurses based on the narrative approach. Nine cases were reconstructed from the narratives of each participant, and a thematic narrative analysis was conducted. The nine cases showed a process that does not involve simply listening to the patient’s wills and fulfilling them, but also overcomes various barriers to do so while exploring better strategies in accordance with the patient’s medical condition, the family’s situation, and the patient-family relationship. Interpreting these, the following five characteristics were revealed as constituting nursing care that significantly impacted supporting the patient’s will. 1) Ascertaining the underlying meaning of the patient’s will, 2) Gaining a closer understanding of the family’s circumstances to connect patient and family, 3) Continuing to engage in care that values the individual, 4) Performing care as part of a nursing team, and 5) Utilizing the characteristics of general wards in care. These findings demonstrate some aspects of excellence in end-of-life nursing in general wards and indicate end-of-life nursing specific to general wards.

Objective: To clarify how second-year nurses practice nursing as a member of a team through interactions with team members, including those in other professions.

Method: A qualitative descriptive study of seven nurses in their second year of clinical experience. This study uses both participatory observation and semi-structured interviews.

Results: A total of three major themes were identified with respect to nursing practice: “self-centered thinking and behavior have changed to team-oriented thinking and behavior,” “struggling to fulfill the roles expected of them,” and “searching for their own nursing style.”

Conclusion: Second-year nurses have more free time because they have become used to their daily duties. Therefore, their approach has changed in such a way that they now think and act in accordance with their position and situation as a member of the team. Additionally, they struggle and try hard on a daily basis to engage in duties that involve many difficulties. The presence of senior nurses is believed to be important for second-year nurses to complete their learning cycle.

Midwives are expected to be able to construct helping relationships. This requires accurately identifying the needs of the people they are helping. To improve this ability, we conducted an educational intervention comprising case conferences focusing on emotions. The intervention was based on a theory of helping relationships, and participants were four midwives working in a perinatal unit. Interviews and questionnaires were administered before and after the intervention. Data were analyzed using qualitative synthesis method (KJ method) to identify the structure of learning in this educational intervention. We identified a three-stage learning process: understanding the use of emotions, a shift in mindset, and the expectation that utilizing emotions will lead to improved quality of care. We also identified three aspects that supported this learning process and three difficulties that arose during the learning process. These difficulties could be overcome through a series of educational interventions, practices, and supports, which were found to lead to deeper learning and retention. The findings suggest that case conferences focusing on emotions are effective as a continuing education method to improve midwives’ performance in perinatal wards which contain patients with complex physical and psychosocial problems.

Purpose: To clarify the “Quantum Leap Experience” of professors and associate professors with more than 10 years of educational experience who are faculty members at nursing universities.

Methods: Semi-structured interviews were conducted with six university professors and associate professors specializing in nursing education. All interviewees had over 10 years of teaching experience in basic nursing education. The interview data were analyzed using both qualitative and descriptive methods.

Results: Nursing faculty members experienced significant quantum leap moments triggered by career crises such as research-related distress, work pressure, graduate suicides, and multiple tasks. Although they identified career crises as agonizing events, they reflected on them and faced these crises with a determined attitude. The common factor in the crises among these five teachers was research, with three experiencing it during their new term.

Conclusion: Nursing faculty identified to do both research and teaching duties during a new term as equivalent to a career crisis. However, the publication of their research and recognition from society increased their confidence as nursing faculty, strengthened their educational abilities, and fostered the next generation. Therefore, the findings of this study suggest that the publication of research results is important for the career development of nursing faculty and requires systematic support.

Objectives: The present study was conducted to investigate the utilization of nursing assistants by top managers of the nursing divisions at acute care hospitals.

Methods: Using a qualitative descriptive design, semi-structured interviews were conducted of three top nursing division managers of acute care hospitals.

Results: The responses of the three top managers of the nursing divisions of acute care hospitals in regard to utilization of nursing assistants were classified into four categories: clear definition of objectives/goals, collaboration system establishment, collaboration processes by assignment to the chief nurse, and direct relationship with the assistants.

Discussion: The top managers of the nursing divisions viewed utilization of nursing assistants as collaboration with nurses and practiced dynamic management that moved the entire organization through establishing an organizational structure (including manpower management). An open issue with utilization of nursing assistants was the difficulty in securing nursing assistants. The top nursing division managers were attempting facilitation of recruitment and continued retention of nursing assistants within the framework of the policy of the medical facility they belonged to. In addition, the study suggested that a positive feedback be given to the chief nurse, who is the key to the utilization of nursing assistants.

Purpose: This study aims to describe how nurses engaged in outpatient care at a general hospital assess the significance and experience of outpatient settings, and how the experience of the nurses contributes to the setting.

Methods: Unstructured interviews were conducted with two nurses engaged in outpatient care at a general hospital. Sets of transcribed data were descriptively analyzed from a phenomenological perspective.

Results: The outpatient care was experienced by the participants as a “place where they identify patients who may be in trouble” and a “place where they pay attention to patients even if only for a short period of time.” Their experience was supported by the intentionality of each participant who “wished to provide discharge planning” and “wished to accommodate the feelings of patients by being attentively involved with the patients.”

Discussion: The participants were deeply involved in the lives of individual patients on an ongoing basis in the outpatient care. They were oriented toward each individual patient based on their interest in that person, and through dialogue, they were able to identify events that stood out in the person’s situation and practice support tailored to that person’s life. Despite the prevailing notion of outpatient nursing as task-oriented and demanding, this study illuminates this aspect of nursing practice.

To improve the infection control skills of nursing home staff, two illustration-focused videos, “Standard Precautions” and “Transmission-based Precautions,” were created and the effectiveness of video viewing was examined among staff at four facilities. We assigned two facilities to watch videos on standard precautions (Group A) and two to watch videos on transmission-based precautions (Group B). A questionnaire was administered after watching the video.

Differences in mean questionnaire scores among the two viewing groups and by occupation were analyzed using two-way analysis of variance (ANOVA). Additionally, the percentage of correct answers for each question by each group was analyzed separately between occupations using the chi-square test or Fisher’s exact test. Transmission-based precautions scores were significantly higher in Group B than in Group A (p<0.001). By item, the percentage of correct answers among nurses for “airborne pathogens” was significantly higher in Group B than Group A (p=0.026). Among nursing care workers, the rate of correct answers to questions regarding “characteristics of contact infection and airborne infection” and “application of N95 masks” was higher in Group B than Group A (p<0.001 to 0.048), and that for questions related to the “definition of standard precaution and airborne infection control and pathogens” and “application of N95 masks” was significantly higher in Group B. The results indicate that watching videos with a focus on illustrations may contribute toward improving nursing home staff’s infection control skills. Additionally, the results suggest that viewing videos on transmission-based precautions may be particularly useful.

This study aimed to investigate how visiting nurses comprehend and cater to the needs of patients with Totally Locked-In Syndrome (TLS) who are unable to communicate effectively due to amyotrophic lateral sclerosis. Four nurses caring for two TLS patients were surveyed by participant observation and semi-structured interviews. The results revealed the following categories related to understanding the wishes of a patient: “looking carefully at the expressions of the patient’s eyes to gauge their condition,” “ascertaining the patient’s condition based on their physical signs,” and “empathizing with the patient’s suffering through a personal connection with the patient from before the onset of TLS,” as well as the categories related to care respecting the patient’s wishes: “providing care that makes them feel comfortable,” “talking with the patient to help them feel the ‘present’ and ‘themselves’,” “acknowledging and conveying the patient’s uniqueness,” and “looking after the health of the patient’s family.” Nurses provide care by interpreting patients’ conditions and feelings based on their expression of eyes.

Objective: The present study elucidates thoughts on associate nurse education as perceived by chief academic officers of associate nurse training Institute.

Method: A qualitative descriptive study was conducted using semi-structured interviews with three chief academic officers who had at least three years of experience working in associate nurse training institute.

Results: The analysis of 202 codes yielded 8 subcategories and 3 categories: difficulty in teaching students with diverse backgrounds; feeling caught between the desire to train field-ready assistant nurses and systemic constraints; and despite our efforts, it is difficult to secure a training location and full-time faculty.

Discussion: The findings suggest that chief academic officers face difficulties in educating students due to differences in the incoming students backgrounds and feel conflicted between their educational aspirations and systemic constraints. Therefore, it is necessary to continue discussions on reviewing the content of assistant nurse education to ensure graduates initiate their careers as associate nurses without difficulties.

Objective: To elucidate how expert intensive care unit (ICU) nurses select techniques and content for respiratory auscultation of ventilated patients, along with their experiences with this practice.

Methods: Semi-structured interviews were conducted with nine expert ICU nurses. The interview results were categorized based on the techniques and content used in respiratory auscultation as well as their experiences.

Results: Four categories and 20 subcategories were identified for the respiratory auscultation practices of expert ICU nurses for ventilated patients, including the category “predicting and selectively auscultating respiratory sounds based on multifaceted information aimed at alleviating patient discomfort.” The experiences of the nurses were categorized into four categories and nine subcategories, including the category “understanding how the interpretation of respiratory sounds influences respiratory care and changes in patient condition.”

Conclusion: Expert ICU nurses predicted and confirmed respiratory sounds using multifaceted information to alleviate discomfort in patients receiving ventilation. They tailored auscultation sites and frequencies according to the patient’s condition and position and performing auscultation at appropriate times. These practices were honed through experience, emphasizing the importance of auscultation-based respiratory care in improving patient outcomes.