Acquisition and sharing of knowledge and skills of visiting nurses in Japan

Abstract: The purpose of this study is to clarify, through ethnographic research, how nurses acquire and share their knowledge and skills of home nursing in clinical settings. The field research took place at a visiting nurse station in Nagoya, Japan between 2013 and November 2021. Research method used were participant observations and interviews at visiting nurse station and patients’ homes. One of the authors is an assistant professor of nursing at a university’s Nurse and Health department who also leads students in the clinical training at the visiting nurse station. The research data were acquired from periodical nurse station visits and from accompanying nurses in their activities.visiting nurses considered patients and family as partners, and they explored the preferred care together with the patient to create tailored care. We showed the following in a paper at AHFE-HSSE conference in 2021: the visiting nurses read into the patient’s societal background, life and beliefs, and visiting nurses analyzed the living style patients wish for, in order to propose the method which materialize this kind of living. The value co-created by the nurses and patient formulated the “normal living style” wished to be sustained by the patient (Otani and Ito 2021).Incidentally, in nursing education in Japan, universities nursing faculties and nursing schools educate students in basic knowledge and skills of nursing in wards to home nursing in Japan. The co-creative practices and techniques of visiting nursing care need to be learned while working in a clinical setting after the nurse is licensed.　The paper revealed the following: The visiting nurse "co-created" with the patient to produce a nursing technique that fit the patient's needs　based on the "sticky information" (von Hippel 1994) obtained in the patient's home. At the visiting nurse station, the nurses reported new information obtained at the patient's home or communicated to the patient during daily conferences. The nurse illustrated and demonstrated the nursing techniques that fit the patient to colleague nurses.In addition, the nurses had a joint conference with physical, occupational, and speech therapists working in the same station. The participants reported to each other the new information the patient during their stay at the patient's home, and described the techniques of each specialist that fit the patients. The information revealed in the conference was recorded into the patient's medical chart each time. The nursing skills created in the patient's home through co-creation with the patient are sticky information that is difficult to transfer, but they are shared and accumulated through gestural demonstrations at conferences by the health professionals.

Keywords: visiting nurse, ethnography, co-creation, knowledge sharing

DOI: 10.54941/ahfe1002554

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