緊張しすぎて失敗を繰り返す新人【円滑に仕事をさせるための手段は】

※ 日経ヘルスケア 2012年1月号 掲載 ブログにするにあたり株式会社日本経済新聞出版社より許可を頂いております。

緊張しすぎて失敗を繰り返す新人 円滑に仕事をさせるための手段は

 

前回紹介した、緊張しすぎて業務をスムーズに行えない新人看護師A子。
輸液ポンプの操作なども、一人で練習しているときはできるのだが、
同僚や先輩が隣で見ていると、緊張が強くなり操作を誤ってしまう。
ちょっと注意するだけで泣き出すため、周囲のスタッフは扱いに苦慮していた。

筆者が看護学校の教員を務めていたころ、
マイペースで他者に学ぶのが苦手な学生が増えていると感じることが多かった。
今回指導に当たった新人看護師A子も、まさにそんなタイプの若者だ。

しかもA子は、看護学校で教官から厳しい指導を受け、
余計に萎縮するようになっていた。
実技テストで失敗したときに言われた
「あなたって本当は看護師にならない方がいいと思うよ」
という言葉が忘れられないとA子は泣いて訴えた。
そんなA子の指導に当たっていた教育係のB子が心身の不調を来してしまったのは、
前回、紹介した通りだ。

トラウマを解消して未来へ進む。TNサクセスのコーチング

うれしかった経験を思い出させる

 

そこで筆者は、
①過去の嫌な経験を克服する
②仕事を体で覚えさせる
ことを目標に、A子への指導に当たることにした。

①に関しては、B子の協力も得て次のようなやり取りをした。
まずA子にいすに腰掛けてもらい、
B子と筆者がA子を挟んで向かい合って座った。

奥山
奥山
今から、A子さんが言われた嫌な言葉のダメージを和らげるお手伝いを、私とB子さんでやってみますね。
ええっ、そんなことができるんですか。ぜひ、お願いします。
A子
A子
奥山
奥山
前に言われた
「あなたって本当は看護師にならない方がいいと思うよ」
という言葉を思い出してください。
そのときの先生の表情やA子さんが味わった嫌な気分も一緒に思い出してみてくださいね。
思い出しました……。
A子
A子
奥山
奥山
じゃあ今度はね、人から言われてうれしかったなぁっていうことを思い出してみてください。
……はい。初めて受け持った患者さんから「あなたみたいな人が、いい看護師さんになるんだよな」って言われたことです。
A子
A子
奥山
奥山
それは、うれしいですよね! もっとその話を聞かせてください。

(A子はひとしきり話して、すっかり楽しそうな表情に)

奥山
奥山
今度は目を閉じて、目の前に大きなスピーカーをイメージしてみてください。
そこから「あなたって本当は看護師にならない方がいいと思うよ」という先生の声が聞こえてきます。
でもA子さんは、その言葉が聞こえてきたら電源を切るジェスチャーをしてください。
私とB子さんがある言葉をかけると、その嫌な言葉は、電源が切れるのと同時にスピーカーの中にすっと消えていきます。

そのイメージを頭の中に描きながら、何度か同じことを続けてみましょう。

(A子は目を閉じ、しばらくすると電源を切るジェスチャーをした)

奥山
奥山
あなたみたいな人が、いい看護師さんになるんだよな。
B子
B子
あなたみたいな人が、いい看護師さんになるんだよな。

(スピーカーをイメージするところから、この声かけまでの手 できないできる 順を3回ほど繰り返す)

こうしたやり取りを繰り返すことで、過去の嫌な経験が頭をよぎっても、
うれしかった経験を同時に思い出し、
次第につらい思いを和らげられるようになる。

その効果は着実に表れ、A子は
「あれっ? 嫌な先生の言葉を思い出しても、以前のようにつらくはなくなりました」
などと話してくれるようになった。

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写真をクリックで日経ヘルスケアのサイトにいきます。

 

単一の課題を反復させるのがコツ

もう一つの「仕事を体で覚えさせる」ことを目指したのは、
以下のような理由からだ。

看護師などが仕事を身につける際、図1の四つの段階で習熟していくことになる。
例えば、ある看護師が新しい体位変換の方法を学ぶため研修会に参加したとする。
研修を受ける前は、まだ図1の①の「無意識で、できない」段階。
実際に研修で体位変換を習い、その場でやってみても、
なかなか講師のようにうまくいかない。
これは、②の「意識してもできない」状態だ。

次に、研修会場で休憩時間にペアで10回ほど練習すると、
手順を思い浮かべれば何とかできるようになり、
③の「意識したらできる」状態に達する。
研修を終えて職場に戻り、何度も練習を繰り返すと、
手順を考えなくても自然にできるようになる。
これが④の「意識しなくてもできる」状態だ。

A子は③の段階に達しており、ここから④に引き上げれば、
近くに人がいても緊張せずに行えるようになると思われた。
④のレベルを目指すには、
輸液ポンプの操作などの単一課題を反復させることが有効だ。
筆者はB子に、
「A子さんのように他人の存在を気にするタイプの人には、
通常の3倍くらい一人で練習させてほしい」と話した。

この反復練習を終えた後、筆者はB子に対し、
A子が輸液ポンプを操作している最中に、
あえて本人に話しかけるよう依頼した。
それでもミスなく実施できれば、4の段階に至ったことになる。
A子はこれをクリアし、ほかの新人より数カ月遅れはしたものの、
輸液ポンプの操作を問題なくこなせるようになった。

なお、A子のようなタイプに限らず、技術を身につけさせる上では、
反復練習を続けて無意識のうちにできるようにすることが大切だ。
近年、看護教育の現場で、技術を覚える前にエビデンスを教え込む傾向があるが、
あまり強調しすぎると本人があれこれ考えたり緊張してしまい、
かえって逆効果になり得ることに留意したい。

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・スタッフの状況を考えないで、「ハンコ押して下さい」「チェックまだですか?」と言われる
・技術チェックを受ける際、学生が自分で患者選定ができない
・バイタルサインが異常値でも、すぐ報告に来ない
・患者さんと仲良くなると言葉使いが敬語ではなくなる
・スタッフが言ったことが、行動記録にそのまま書かれている。学生の考えが記入されていない
・指導しても返答がない言い訳をする。など。
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お知らせ

2020年2月1日(土) 東京ビックサイトにて
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こちらの記事もおすすめです!

新人が育たない【教育係の心理的負担を軽減させる妙手とは】

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