The Radiological Nursing Society of Japan
andThe Fukushima nuclear accident
日本放射線看護学会と福島原子力事故
Emiko Konishi, RN, PhD, Kagoshima University Faculty of Medicine
小西恵美子 鹿児島大学医学部客員研究員
Yoshiko Fukushima, RN, MHSH, Graduate School of Health Sciences, Hirosaki
University
福島芳子 弘前大学大学院保健学研究科
Koji Yoshida, RN, MSN, Education Center for Disaster Medicine, Fukushima
Medical University
吉田浩二 福島県立医科大学災害医療総合学習センター

The Radiological Nursing Society of Japan
日本放射線看護学会
Aim: to lead best practice and increase knowledge inradiological nursing across clinical, community, andindustrial settings in daily as well as in emergency
situations
目的: 臨床-地域-産業を横断、平常時および事故・異常・緊急時の放射線・原子力に関わる看護実践と知の集積を目指す

Knowledge skill on Radiation health effects is key forpractice 実践の要は放射線健康影響の知識

The Fukushima nuclear accident and radiological nursing
福島原発事故と放射線看護• Triple disasters in Fukushima: earthquake,tsunami & Nuclear Power Plant accident
複合災害・・・地震、津波、原発事故/放射線• Scarcely any disaster specialist nurses toFukushima （within nuclear evacuation zone）
警戒区域内へのDMATナースの派遣殆どなし• Active involvement of radiological nurses tosupport Fukushima
放射線看護師の福島支援活動

Radiological nursing activities in the Initial Phase緊急期の放射線看護活動★We cared for: Plant workers & Fukushima residents
ケア対象:作業員と福島住民★We worked at: 活動場所:• Offsite Center オフサイトセンター(原発から5km)• ER of nuclear power plant 事故原発の救急室• Temporary Medical Center in J-village
J-Village内仮設医療センター• Hospital of the Radiation Emergency Medicine
緊急被ばく医療指定病院• Evacuation centers 避難所

Radiation Emergency Medical Assistance Team(REMAT®)
緊急被ばく医療チーム
Fukushima Daiichi NPP（福島第一原子力発電所）

Ns
Medicines

Dosimeters

Ns
Ns

2011 March 12 8:10 am (17 hr after the earthquake)
REMAT was dispatched from NIRS, Chiba, to the off-sitecenter of Fukushima by a helicopter.
震災直後に緊急被ばく医療チームは現地に向かった。

Activities of REMAT® nurse in emergency phase
超急性期におけるREMATの活動

Ns

Ns
Ns
Ns

Establishment of a temporary
medical center（at J-Village）
医療施設の設営

Ns

Health and radiation exposure
management of the Plant workers
原発へ向かう復旧作業員の被ばく管理

Ns

Health care, first aid, teaching forevacuees’ temporary house visit
住民の一時帰宅の健康管理 6

Transport of a wounded worker
患者搬送
We rushed to the worker for an emergency care and then transported the worker backto our Hospital by helicopter.
福島第一原子力発電所から福島医大附属病院への傷病者搬送

16th MarchFMU
Hiroshima Uni

FNPP
Nagasaki Uni

20km
The reactors were unstable and therefore the situation was scary. But we measured
radiation during the work, executed the mission with a sense of security and confidence.
原発が不安定で不安であった。しかし、携行した測定器で線量を確認し、安心感を得た。

On-site activities
緊急被ばく医療機関、サイト内救護室での活動＜Advanced Trauma Life Support＞
初期診療＜Setup＞
受け入れ準備Ns
Ns＜Education＞
教育

Ns

•
•

＜Training＞
シミュレーション訓練

Ns

My colleague nurses and I coordinated the set-up of a system to radiation
emergency medicine and advanced trauma life support.
We also trained the medical staff for the treatment and decontamination ofcontaminated patients.

Radiological nursing in the Recovery Phase
復旧期の放射線看護活動
Situations in Fukushima;福島の状況• Radiation level decreasing but fears
Spreading 放射線レベル低下、しかし不安は拡大• UNSCEAR 2013 Fukushima Report : The mostimportant health effect is on mental and social wellbeing, related to the fear and stigma from theperceived risk of radiation exposure
国連科学委員会2013福島レポート: 事故の最も重要な
影響は放射線そのものの生物影響ではなく、三重災害による精神的社会的な苦痛、および各人の放射線リスクの感じ方に起因する恐れと偏見であるFace to face interactional lectures
多職種協働の現地での対話

Share daily life concerns 日常生活の心配の共有<Question>– Tap water?
水道水は？

– Garden vegetables?
自家製の野菜？

– Wild mushrooms?
野生のキノコは？
– Parks in town

We listen, tell stories/対話• Healthy life style
健康生活スタイル• Radiation data
放射線の情報公園は？
10

Effects of interactions
車座対話がもたらしているもの• “Oh, it is ok to regain normal life! Will tell
today’s knowledge to my family and neighbors”
もう普通に生活していいんだ! 夫にも近所にも話す• Also, this approach, by working with the local
PHNs, has served as a practical radiation
education for those nurses
保健師との協働⇒保健師の実践困難の共有、放射線の学び• Empowerment of resident/PHNs/researchers
住民/保健師/研究者のエンパワーメント

Most important agenda: Authorization of theCertified Nurse Specialist in radiation nursing
重要課題: 放射線看護専門看護師の分野特定促進＜In the initial phase＞
急性期＜In the recovery phase＞
復旧期

Graduate degree program inradiological nursing has been
establishedin
3
universities.
CNSof radiation nursing＜Practical education ＞
実践的な教育放射線看護専門看護師

Hirosaki Uni＜Clinical site＞
臨床現場

Nagasaki Uni

Preparation for emergency through daily practice and education
平常時から有事に備える

It is utmost important
to authorize
the program as the JapaneseKagoshima
Uni
Nursing Association defined Certified Nurse Specialist course.

Radiological nursing education
放射線看護教育Can you deal with residents anxieties about radiation
health effects?
放射線の不安を抱く住民に寄り添うことが出来るか？

Do you know about the character of radiation?
放射線について知ってる？

After the accident, confusion happened by the lack ofknowledge about radiation health effects.
Basic nursing education should include contents about
radiation and its health effects
事故後、放射線健康影響の知識不足から混乱が起こった。
災害の備えと対処のために看護基礎教育に放射線を!

Preparation for emergency through daily
practice and education
平常時から有事に備える

Thank you !!