A case of small intestinal ileus caused by migration of gastric bezoars, which was successfully treated by dissolution therapy with cola through an ileus tube.

A 60-year-old woman with a history of distal gastrectomy for gastric cancer presented with a chief complaint of epigastric pain. Duodenal ileus due to the migration of a gastric bezoar was diagnosed, and she was hospitalized. We performed endoscopic lithotripsy and injection of cola, but the bezoar migrated toward the anus. Her abdominal pain worsened the following day, and she was diagnosed with ileus induced by the gastric bezoar. After decompression with an ileus tube, 1000ml/day of cola was injected via the ileus tube, and the ileus resolved on the 5th day of therapy. Based on this experience, we believe that dissolution therapy with cola via an ileus tube is effective in the treatment of bezoar-induced small bowel ileus.

Five reasons for the lack of nursing students' motivation to learn public health.

Prevention is better than cure. Public health plays an important role in promoting prevent medicine. To obtain the abilities to provide appropriate nursing services, learning public health is necessary for students who want to become registered nurses. When teachers teach public health to nursing students, it is important to motivate them to learn it. Therefore, we investigated the reasons for the lack of motivation to learn public health by conducting a questionnaire survey. The subjects were female nursing students in 29 vocational schools in Kanagawa and Chiba prefectures of Japan that allow graduation after a 3-year study period. We asked the students whether or not they had completed the subject of public health and analyzed those students who answered affirmatively. We analyzed 1,553 respondents whose average age was 22.6 ± 5.2 years (range, 18 to 45). Using factor analysis, we discovered the 5 reasons that lead to the lack of nursing students' motivation to learn public health: "Difficulties acquiring knowledge of public health," "Inappropriate attitudes of public health teachers," "Thinking lightly about the national examination in the field of public health," "Lack of understanding the importance of learning public health," and "Future plans that do not specialize in public health." Using multiple linear regression analysis, these 5 reasons were significant predictors for the lack of students' motivation. Older students also had significantly less motivation to learn public health than did younger students. When teachers instruct their students, they should teach public health better with the present knowledge.

Nursing students' learning motivation toward technical knowledge and their ethics regarding patients' rights.

Nursing students must develop their abilities to provide appropriate nursing services. They need to acquire the level of nursing knowledge to pass the national examination according to Japanese law. Moreover, even if the awareness of the rights of people who receive nursing services increases, students must not have a sense of resistance toward those rights. Therefore, we investigated the factors associated with students' motivation to pass their examination and such a sense of resistance. We produced items related to reasons students wanted to become registered nurses with reference to job satisfaction and their learning environment (e.g., teachers' manners and school events unrelated to the examination). There were 3,417 female nursing students analyzed in 29 vocational schools that allow graduation after a 3-year study period (average age, 21.93 years [standard deviation, 5.44]). Older and third-year students had a stronger motivation to pass the examination and a weaker sense of resistance to people's rights compared with younger and first- to second-year students. Students who answered a "Lack of enthusiasm for becoming a registered nurse" had a weakened motivation and a strengthened sense of resistance. Factors enhancing students' motivation to pass their examination were "Professional commitment," "Desire for companionship," and "School events unrelated to the national examination." Factors strengthening students' sense of resistance to people's rights were "Living stability" and "Social appraisal." Teachers must develop methods to teach ethics so that their students respect the rights of people who receive nursing services and to ensure that they acquire the necessary nursing knowledge.

Japanese professional nurses spend unnecessarily long time doing nursing assistants' tasks.

In environments in which professional nurses do simple tasks, e.g., laundry, cleaning, and waste disposal, they cannot concentrate on technical jobs by utilizing their expertise to its fullest benefit. Particularly, in Japan, the nursing shortage is a serious problem. If professional nurses take their time to do any of these simple tasks, the tasks should be preferentially allocated to nursing assistants. Because there has been no descriptive study to investigate the amount of time Japanese professional nurses spent doing such simple tasks during their working time, their actual conditions remain unclear. Professional nurses recorded their total working time and the time they spent doing such simple tasks during the week of the survey period. The time an individual respondent spent doing one or more simple tasks during that week was summed up, as was their working time. Subsequently, the percentage of the summed time he or she spent doing any of those tasks in his or her summed working time was calculated. A total of 1,086 respondents in 19 hospitals that had 87 to 376 beds were analyzed (response rate: 53.3%). The average time (SD) that respondents spent doing those simple tasks and their total working time were 2.24 (3.35) hours and 37.48 (10.88) hours, respectively. The average percentage (SD) of the time they spent doing the simple tasks in their working time was 6.00% (8.39). Hospital administrators must decrease this percentage. Proper working environments in which professional nurses can concentrate more on their technical jobs must be created.

Work motivation for Japanese nursing assistants in small- to medium-sized hospitals.

Nursing assistants can work without a professional certification to help registered nurses and licensed practical nurses. Nursing assistants engage in various tasks, e.g., washing laundry, cleaning up, and clerk tasks regarding nursing. Enhancing work motivation among nursing assistants is essential for every hospital, because when nursing assistants do their jobs well, it allows registered nurses and licensed practical nurses to complete their own specialized jobs. We examined the predictors significantly associated with nursing assistants' work motivation. For those predictors, we produced items to examine job satisfaction. Those items are classified into intrinsic and extrinsic facets. The subjects for this study were Japanese nursing assistants working in 26 hospitals with 62-376 beds (4 public and 22 private hospitals). A total of 516 nursing assistants were analyzed, with the average age and standard deviation of 42.7 ± 12.9 years; the age of 456 female subjects was 43.8 ± 12.7 years and that of 60 male subjects was 34.3 ± 11.0 years. Our results show that "work motivation" is significantly associated with "free time to do one's own things," "nursing assistants as important partners on the job," "feeling helpful to patients," "participating in decision making," and "job-skill improvement." Free time to do one's own things is an extrinsic item. Hospital administrators must monitor the workload and their quality of life among nursing assistants. All the other significant items are intrinsic. Nursing assistants are not only motivated by money. They highly value the intrinsic nature and experience of their jobs.