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未来の保健医療従事者となる聖路加国際大学の学生へ:学長メッセージ

2020年04月10日

未来の保健医療従事者となる聖路加国際大学の学生へ

学長 堀内成子

COVID-19の世界的流行の中で、あなたは何を学んでいますか?

 いつもであれば新学期が始まるこの時期、多くの学生のみなさんが毎日の授業で勉学に励みつつ、アルバイトや夏休みの旅行計画を立てるなどして、心躍る季節を過ごされていたことと思います。
 今年、この季節を同じような心持で過ごされている方がいたら、今すぐに立ち止まって考えて欲しいことがあります。自分の今日と明日の計画ではなく、日本の、世界の今日と明日の見通しに目を向けてください。4月7日に緊急事態宣言が発令され、今この感染症流行の爆発をいかに防止するかを考え行動する時期です。
 あなたは、今健康であるかもしれないけれど、目に見えないウィルスを持っているかもしれない。それを、誰かに渡してその人を死に追いやるかもしれないことを考えてください。将来、医療従事者となる人の行動は、DO NO HARM !これを忘れてはなりません。
 あなたにできることは”家で過ごす“(Stay Home!)こと。静かに蓄える時間です。皆さんには想像力があります。

 この病に苦しんでいる患者さんのことを想像してください。患者さんのほとんどが、健康であった状態から一転して、発熱、喉の違和感などの体調不良が起こり、呼吸苦を体験しています。息をするたびに、ガラスを吸い込むような痛みであると病床から知らせてくれた患者さんもいます。患者さんの苦痛がどれほどのものか想像できますか。 従来の肺炎とは異なり治療法が確立していない、回復する見込みが見えない暗闇にいる不安は、言葉で言い表せない怖さでしょう。面会が制限されているため、家族は大切な人が苦しんでいる傍らに近寄ることもできない。手を握り、抱きしめることさえできない、そんな無念や悲しみをどう乗り越えたらいいのでしょう。

 次に、COVID-19の最前線で治療にあたっている保健医療従事者のことを想像してください。保健所では昼夜を問わず増え続ける電話相談に対応し、濃厚接触者の特定や感染者の追跡、検体採取や病床の調整を行っています。医療機関では、検査法、治療法の確立が不鮮明な中で、命を救うために最善の方法を探り治療やケアを行っています。身体的な苦痛と孤独に耐えている患者さんをどう支援するのか。医師、看護師、薬剤師、臨床工学技士、臨床検査技師、放射線技師等の様々な医療職種、給食担当者、物品管理部、医療連携相談室、事務職、組織内のすべての部署が協力し合ってチームとして働いています。
 COVID-19受け入れ医療機関が限られていることから、平時の医療体制とは異なる緊急時対応に追われます。例えばひとりでも多くの患者さんの命を救うために、効果的に治療するために、病棟の再編成が突然起こります。慣れた環境から未知の部署の人々と協働しなければなりません。様々なストレスが加わります。そして保健医療従事者も、勤務が終われば家族やこどものいる場所へ帰宅します。自分をはじめ家族の感染予防に努めます。また、医療の現場以外でも、食料品の提供やライフラインの維持など、人々の生活を支えるために、感染の不安を抱えながら業務を続けている人たちがいます。

 社会では医療従事者に対する感謝の気持ちを表す運動がある一方、病院や地域で働く保健医療従事者に対して誹謗中傷や不条理な要求を求める声も聞かれます。将来、保健医療従事者となる聖路加国際大学の学生の皆さんは、何を考えどんな行動をとるのでしょうか。この感染症が終息した後の楽しいことを夢見る時間も必要です。でも、この疫病災害に学ぶ時間だと考えてみてください。

  • ・ペストやスペイン風邪など感染症パンデミックの歴史から、収束の要因は何か?
  • ・ウィルスと人類との闘い、細菌と人類との闘いその違いは何か?
  • ・総合医学雑誌“ビッグ5”のひとつThe Lancet に掲載されたCOVID-19論文は世界に何を伝えたのか?
     https://www.thelancet.com/coronavirus
  • ・WHOのCOVID-19ポスターの特徴は、日本の啓発ポスターとどう違うのか?
  • ・感染症による偏見や差別をなくすには、どう行動することが重要なのか?
  • ・看護倫理学会は、なぜ「医療従事者への感謝」の声明をだしたのか?
  • ・PCR検査法の感度・特異度は? 日本や世界の検査体制の現状は?
  • ・人工呼吸管理ECMOの原理は?多職種で管理が必要な理由は?
  • ・感染症や呼吸器系疾患の専門看護師・認定看護師は、一般看護師とどこが違うのか?
  • ・専門職学会(日本公衆衛生学会、日本感染症学会、日本小児科学会等)は、市民向けにどんな情報やサービスをしているのか?

 2011.3.11東日本大震災の時、世界中の人々が大切な命について考えました。祈りました。今まさに、COVID-19という疫病災害で世界中の人々が闘っています。聖路加国際病院の職員も、皆さんの先輩・同窓生も、昼夜を問わずCOVID-19の治療とケアに献身しています。あなたも同じ聖路加に学ぶものとして、チームとして存在してください。世界で今何が起きているのかを看護・公衆衛生の学生として考え、自分なりの答えのもとで行動し、今しかできない学びに向き合うことを願います。
 将来、医療従事者となる人は、DO NO HARM !これを忘れてはなりません。

To the students and future health care professionals of St. Luke’s International University

Shigeko Horiuchi
President

What are you learning from the COVID-19 global epidemic?

Normally, this time of year when the new semester begins is an exciting season with many of you working on your studies every day in class, working part-time jobs, and planning trips for summer vacation.
This year, if there is anyone spending this season with a similar feeling, there is something about which I want you to stop and think. Turn your attention not to your own plans for today and tomorrow, but instead to the outlook of today and tomorrow for Japan and the world. With the declaration of the state of emergency ordered on April 7th, now is the time to think about how you can prevent a pandemic explosion and act.
While you may be healthy now, you might be carrying an invisible virus. Think about the possibility of passing that to someone and causing their death. The actions of future medical professionals are those that DO NO HARM! You must not forget this.
What you can do now is stay home. It is time to quietly grow. All of you have imagination.

Imagine the patients suffering from this disease. Most of the patients completely changed from being healthy, to then feeling unwell with fevers and strange sensations in their throats, to now experiencing difficulty breathing. There are even patients that informed us from their beds of pain as if they were inhaling glass every time they took a breath. Can you imagine just how much patients suffer? Different from the common pneumonia, there is no established cure, and the uncertainty in the dark with the outlook for recovery being unknown is a fear inexpressible by words. Because visitations are limited, families cannot even be at the side of those important to them who are suffering. Consider how they can overcome the kind of frustration and sadness of not being able to even hold hands with or hug each other.

Next, imagine the health care professionals looking for a cure on the front lines of COVID-19. At the health centers, they are responding to continuously increasing phone consultations both day and night, determining people in close contact with the disease and tracing infected people, collecting samples and organizing hospital beds. At medical institutions, they are conducting treatment and care all while the establishment of testing and treatment methods remain unclear, searching for the best methods to save lives. How do we support patients dealing with physical suffering and loneliness? Physicians, nurses, pharmacists, clinical engineers, clinical laboratory engineers, radiologists, those of other various medical positions, the people in charge of food services, Property Management, Medical Liaison Office, administrative workers, and all departments within this organization are cooperating and working as a team.
Because medical institutions accepting COVID-19 patients are limited, they are pressed by emergency responses differing from the usual medical system. For example, in order to save even one more patient life or give effective treatment, wards are suddenly rearranged. People have to go from environments to which they are accustomed and work together with people from unknown departments. Various stress is added. Health care professionals then also return home after work where their family and children are. Starting with themselves, they work to prevent their family from becoming infected. In addition, even outside of medical practice, there are people in food provision, life-line maintenance, and other areas anxious of infection continuing to work to support the lives of everyone.

Within society, while there are movements expressing appreciation to medical professionals, there is also voices of abuse and calls for unreasonable requests towards health care professionals. What will you, the students of St. Luke’s International University and future health care professionals, think and what kind of actions will you take? Time to dream of the fun things after this infection is over is also needed. However, I want you to think of this epidemic disaster as a time to learn.

  • ・What have been the main factors responsible for ending infection pandemics throughout history such as the plague and Spanish flu?
  • ・What are the differences between the fights between viruses and humanity and germs and humanity?
  • ・What have the articles about COVID-19 published in The Lancet, one of the “big 5” medical journals, told the world? https://www.thelancet.com/coronavirus
  • ・How do the characteristics of the WHO’s COVID-19 posters differ from the social awareness posters in Japan?
  • ・What actions are important to ridding the world of bias and discrimination due to infectious diseases?
  • ・Why did the Nursing Ethics Association release their “appreciation to medical professionals” statement?
  • ・What are the detection and specificity ranges of the PCR testing method? What is the current condition of the testing systems in Japan and around the world?
  • ・What is the basis for ECMO respiratory management? What are the reasons that management requires efforts from various disciplines?
  • ・How are specialized nurses in infectious and respiratory diseases and registered nurses different from general nurses?
  • ・What kind of information and services are professional organizations (Japanese Society of Public Health, The Japanese Association for Infectious Diseases, Japan Pediatric Society, etc.) providing to the general public?

During the Great East Japan Earthquake on March 11, 2011, people all over the world thought about the importance of life. They prayed. The time has come when people all around the world are fighting the epidemic disaster known as COVID-19. The staff of St. Luke’s International Hospital, your superiors and classmates, are devoting themselves to treatment and care against COVID-19 both day and night. I ask that you too, as someone learning from that same St. Luke’s, exist as a team. I hope that you think about what is happening in the world right now as students of nursing and public health, act based on the answers you find, and face the lessons available to you now.
Those to become future medical professional shall DO NO HARM! You must not forget this.