Report of “the School Health Education” from the Newsletter of “School Health” by JSSH
第 325 号
P8-9
シリーズ 63

Series 63「健康教育をささえる」〜保健主事の現場から〜“Supporting health education” – From the position of a School Health
Coordinator

養護教諭の立場からの保健主事の職務
大阪市立茨田中学校

保健主事・指導養護教諭

The duties of a Health Coordinator from the perspective of a nursing teacher
宮本 幸子(YOGO teacher)
Sachiko Miyamoto, Health Coordinator/Tutoring Staff of School Nursing,
Matta Municipal Junior High School, Osaka

私は中学校の養護教諭と保健主事を兼務している立場です。そのため子どもの健康課題についていつも直面している立場であり、また自身がMy standpoint is that of a person dually appointed as a nursing teacher

保健主事であるということを常に念頭におきその重要さを感じていま(YOGO teacher) and Health Coordinator of a junior high school.

す。以下自分が保健主事の職務を通して感じたことを述べます。

For this reason, I am in the direct line of the health challenges children face,and have a sense of the importance of the fact that I am a Health Coordinator.
Below I will outline some of my impressions from my work duties as Health
Coordinator.

１．兼務することによるメリットとデメリット
保健主事として兼務していることのメリットは子どもたちの心身の健1. There are advantages and disadvantages of dual appointments

康状態に敏感であり、意識が高いということが挙げられると思います。

One of the advantages of being a Health Coordinator is being able to see the

また、学校医や学校歯科医、学校薬剤師等との連携もしやすいというこ

delicate nature of the mental and physical health status of children. It alsoともあります。養護教諭は元々、学校や学年全体を視野に入れ仕事を進means that it is easy to maintain ties with school doctors, school dentists and

めないと上手くいかないことは多々あります。そのためいろいろな連絡

school pharmacists. Duties of nursing teachers (YOGO teachers) originally1

や調整など保健主事の職務まで果たしていることもあります。一般的にwould not, in many cases, proceed well unless these took in school or school

保健主事は学校保健と学校教育全体への活動に関する調整を行うことがyear as a whole. For this reason, there are cases when nursing teachers

第一の仕事ですので、養護教諭の気づきを含め密に相互連携し、自校の(YOGO teachers) complete the duties of a Health Coordinator, such as

学校保健活動をどのように動かしていくのか、そして教職員の理解ととliaising and coordination. Generally, as the Health Coordinator has as their

もに組織的に展開するにはどうすればよいのか等が問われます。非常にprimary duty coordination relating to activities for school health and school

大切な役割です。兼務が良いか悪いかは養護教諭によってもいろいろ意

instruction as a whole, they cooperate closely on how to proceed with school

見の分かれるところですし、各校の実情により違うことは承知です。

health activities for their appointed school. This includes the requirement totake account of the nursing teacher (YOGO teacher), and how best to deploy
them organizationally, with the input of educators. It is an extremely
important role. There are various opinions on the merits and demerits of dual
appointments depending on the nursing teacher (YOGO teacher), and it isalso a given that there will be differences depending on the particular
circumstances of respective schools.
2. Thinking about nursing teachers (YOGO teachers) and Health
Coordinators
Why then is there not a deeper understanding of “the particular standpoint of

２．養護教諭と保健主事を考える

a Health Coordinator” or “a Health Coordinator’s work duties”? How can we

しかしながら、どうして「保健主事という立場がどういうものなのか」 facilitate further understanding of these as well as an understanding of theや「職務は何なのか」についての理解は深まらないのでしょうか。浸透

difference between nursing teachers (YOGO teachers) and Health

しないのでしょうか。養護教諭と保健主事の違いについては理解されてCoordinators? (For junior high schools, there are persons in charge of career

いるでしょうか。
（中学校の場合、進路や生活指導においてはそれぞれ主

courses or lifestyle instruction, and both educators and guardians have an

事が存在し職務内容については教職員も保護者も理解していると思いま

understanding of the content of such duties). I think that one way to addressす。）学校保健に思い入れのある養護教諭が、そのメリットを生かして保these issues is using advantages afforded by a dual appointment of a nursing

2

健主事を兼務することも一つの手段だと思っています。ただし、そのた

teacher (YOGO teacher) to Health Coordinator and employing a YOGO

めには一人で勝手に突っ走るのではなく、総合的に全体をみるよう努め

teacher’s strong affinities for school health. However, in the context of a lack

ることが必要です。しかし、私の場合、たまに少し思い入れが強くなっof understanding, it is difficult to get cooperation and for this to happen it isているかもしれないのかな…と感じて空しくなることもあり、学校保健

important to strive to see the integrated whole rather than forging ahead onと学校教育全体とのバランスを振り返る時もあります。教職員にいかに

one’s own. In my case, I sometimes feel that I am overly invested in my work

受け入れられ、より良い方法で共に活動していけるかという課題はいつ

and can be left feeling somewhat bereft. There are also times when I am

も感じています。それぞれ校種の違いや学校状況によって違うとは思い

prompted to reflect on the balance between school health and school

ますが、“理解”という視点から考えると保健主事についての理解度は低

instruction as a whole. Challenges of which I am constantly aware are how to

いのではないでしょうか。都道府県・市が年度当初に実施する小・中・be best received by educators and superior methods of working together.

高すべての新任教諭研修の際に、保健主事に関する内容を盛り込むこと

While I believe there are variations depending on the various school types

により、今後誰が保健主事になろうと保健主事の職務理解につながる一and school circumstances, when we contemplate the perspective of

つの方法ではないかという意見もあります。

“understanding,” I wonder if there is in fact a lack of understanding towards
Health Coordinators. One idea to improve this situation would be toincorporate the content of Health Coordinators in the training for all
newly-recruited instructors for elementary/junior high/high schools
implemented at the start of each fiscal year by the prefectural and municipal
authorities. It might be a way to invite a better understanding of the duties ofa Health Coordinator and allow any nursing teacher (YOGO teacher)considering becoming a Health Coordinator to best fulfill their duties.
3. The importance of school health and the role of a Health Coordinator
So just how much importance is being placed on school health? Are healthissues being positioned in the objectives in the running of the school? Whileacademic ability and lifestyle instruction are of course important, the3３．学校保健の重要性と保健主事の役割について
では、学校保健についてはどれだけ重んじられているでしょうか。学
校運営の目標に健康課題は位置づけられているでしょうか。学力・生活

foundation of learning and exercise is health. I believe that it will be difficult
to formulate an in-school organizational structure for school health in thecontext of poor understanding of the duties of a Health Coordinator.

指導はもちろん大事ですが、学習や運動の基本は健康です。保健主事のA January 2008 report of the Central Council for Education states

職務理解度が低い状況で学校保健の校内組織体制は成立しにくいと考え“Health Coordinators will give instructional advice so that all educators takeます。平成 20 年１月の中央教育審議会答申において「保健主事はすべ

an interest in school health activities so they can seamlessly perform theirての教職員が学校保健活動に関心を持ち、それぞれの役割を円滑に遂行

various roles.” I feel that there is extreme significance in these several

できるよう指導助言する」とあります。とても意味深い内容だと思いま

essential points of “all educators” having “an interest in school health

す。
“すべての教職員”“学校保健活動に関心を持つ”“それぞれの役割を

activities” in order for them to “smoothly perform their various roles.” In

円滑に遂行”このいくつかのポイントに非常に大きな意味を感じます。

fact, while it would be wonderful if all such objectives could be fulfilled, the

実際、この内容が全うできれば素晴らしいことですが、なかなか現場は

reality on the ground is that this is not what is happening. What kind of

そうはいきません。すべての教職員に関心を持ってもらうためにはどの

approach should be taken in order to have all educators take an interest in

ような働きかけをすれば良いのか、これは大きな課題です。それを左右

school health? This is the major challenge. The most significant influence on

する一番大きなポイントは、管理職が学校保健を重んじ、健康に関する

this is the importance placed on school health by administrators. This

危機管理意識を高める意識があるかないかということです。これによっtranslates to whether or not there is an acknowledgment of the necessity ofて大きな違いがあり、教職員全体の意識レベルが左右される影響がある

raising the crisis management awareness relating to health. This makes aと感じています。私自身今までの経験上、それを強く感じます。危機管

large difference, and I feel that this has an impact in dictating the level of

理意識を高めるためにも教職員の保健関係の研修会を、計画的に実施しawareness of educators as a whole. My own experience to date gives me aていくことが必要だと思いますが日程や時間的調整が厳しいことも課題

strong sense of this.

です。少しずつ理解を求め、広げていくしかありません。そのためにもIn order to heighten crisis management awareness, I believe it is also

保健主事が発言する機会をきちんと確保することが大切だと思います。

necessary to strategically implement training seminars relating to school

本校では、週に一度、「主任・主事会」が設定されており、もちろん管理

health for educators. A challenge in this is the tightness of schedules and

職もメンバーに入っています。その場で保健主事が報告、連絡、相談しcoordination of timeframes. The only option is to gradually aim for

調整につなげる効果的な場となっています。組織体制を整えるためにもunderstanding and disseminate such understanding. The important factor for4このような話し合いの場への参加が必要だと思います。
「保健主事と養護

this is scrupulously securing opportunities for Health Coordinators to

教諭は両輪の如く…」という表現が良く用いられます。最近では新任やcommunicate. We have instituted a weekly “Staff and Directors Meeting” at

若い年齢層の先生方が増えてきている中、保健主事、養護教諭の関係性

our school, and administrative staff also naturally attend this. This is an

は経験値も含め、どちらか経験深い方がリードし相互に上手く連携がでeffective platform for Health Coordinator to report, liaise, consult and

きればいいと思います。保健主事が中心になって作成する「学校保健計

coordinate. Participation in these kinds of platforms for dialogue is needed to画」、養護教諭が作成する「保健室経営計画」が教職員に周知されるよう、 consolidate an organizational structure.
職員会議で提案する時間を確保する等も学校保健推進に効果的です。養

“The Health Coordinator and nursing teachers (YOGO teachers) are like

護教諭の目線は常に学校、学年全体を見据えながら仕事をすすめていま

two wheels of a bike” is an expression which is often used. With the recent

す。そのため知らない間に保健主事の職務まで行っていることもあり、increase in new appointees or teachers in younger age tiers, I hope that they

一度整理することも必要かもしれません。

will be led by persons with deep experience including the experience values
from the relationship of Health Coordinators and nursing teachers (YOGO
teachers) with deep experience, and that mutual ties are achieved. Securing
time to plan staff meetings is effective in promotion of school health so that
educators can be kept up to date on the School Health Plan drafted by the
Health Coordinator and the Health Center Management Plan, drafted bynursing teachers (YOGO teachers). Nursing teachers (YOGO teachers) carryout their work with a firm eye fixed on school and school year as a whole at
all times. For this reason, before they know it they may also be carrying out
the duties of Health Coordinator, and it may be necessary to coordinate thisinitially.
4. About the School Health Coordinators Committee, Osaka City
To consolidate organizational systems, ideally Health Coordinators should
maintain close ties with nursing teachers (YOGO teachers); educators

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involved in duties allocation; and homeroom teachers. However, Health
Coordinators are often swapped every one to three years, meaning that this
４．大阪市学校保健主事会について
保健主事に求められることは、養護教諭との連携を密にし、また分掌

will be an ongoing challenge. There is an organizational structure in place at
the Junior High Schools Health Coordinators Committee for Osaka City,

関係教職員や学級担任等との連携を図り、組織体制が整えば良いのですwhereby managing officers are placed in charge of eight respective blocks as

が、保健主事は、１年～３年で交代する場合が多く、引き継ぎも課題にblock managers, and positions are rotated annually. Block managers receive

なります。大阪市の中学校保健主事会では、８つある各ブロックに幹事

information from board officers and deliver this to Health Coordinators forを設け（毎年輪番交代）、会役員からブロック幹事へ、そこから各ブロッ

respective blocks. An executives and management meeting is also of course

ク内の保健主事へという連絡体制を整えました。もちろん定期的に役

periodically convened. A successors file is prepared and deployed for the員・幹事会も実施します。各校での校内引き継ぎ用ファイル、またブロ

school and block managers. A managing officer’s file is also prepared andック幹事が次の幹事に引き継ぐ幹事用ファイルを用意し活用していま

deployed for succession of duties at every school. The New Appointees

す。新任保健主事研修会も昨年度よりスタートし、たくさんの先生方にSchool Health Coordinators Seminar also began last year, and enjoyed the

参加いただいています。毎回事後アンケートから感じることは「知らなparticipation of many teachers. In a post-seminar questionnaire survey whatい」「わからない」ではなく「知りたい」「こうやってみようと思った」

is striking are the many opinions saying: “I want to know more,” or “this is「具体的な実践内容も知りたい」という意見が多く、新任保健主事研修

how I thought it should be done” or “I want to know the specific details of

会の意義を深く感じ、よりいっそう充実させていくことが必要だと考え

practice”, rather than “I don’t know,” or “I don’t understand.” This imparts aます。また保健主事同士がお互いに交流し意見交換できるような研修会

strong sense of the significance of the New Appointees School Healthや校種連携もできればいいと思います。

Coordinators Seminar, and I believe that it is necessary to further enrich andconsolidate this activity. Seminars and school ties for health coordinatorcolleagues to mutually exchange and share opinions are also desirable.
5. Future expectations of Health Coordinators
The necessity of a “School Health Board” has been sought for some time.
However this should not be pushed forward after the sudden intention and6desire for a School Health Board has been expressed, and this has been asource of anxiety for many teachers. The various stakeholders in school
health gather for the School Health Board, making this an organizational
５．これからの保健主事に望むこと

undertaking with, I believe, genuine significance. While we cannot place all

少し前より「学校保健委員会」の必要性が求められています。でも、our expectations on administrative staff, a primary imperative is achieving

いきなり「学校保健委員会をやります、やりたいです」と言ったところ

the understanding of such staff. I believe this should then be followed by

で進むはずもなく、苦労されておられる先生方がたくさんいらっしゃい

approaches to educators and the organs of the PTA. At this school too weます。学校保健委員会はそれぞれの学校保健関係者が集まり、本当に意

have newly established a “School Health Board of Management and Steering

味のある組織活動だと思います。なんでもかんでも管理職に求めてはいCommittee” among the other school committees. I concluded that there is a

けないもしれませんが、まずは管理職に理解があるといいと思います。

need for such a committee which includes the administrative staff or the

そして次は教職員への働きかけと PTA 組織への働きかけだと思います。 persons responsible for respective school year, and those in charge of
地盤固めが必要なのです。本校でも教職員の校内委員会の中に「学校保educational affairs, rather than leaving this in the charge of the duties

健委員会運営委員会」を新たに設置しました。分掌部会がその代りを担

allocation section.

うのではなく、管理職や各学年主任、教務主任等も含めた委員会が必要

Another thing which surprised me when I assumed my post was thatと思いました。また、私が転勤してきて驚いたことに、本校の PTA 組織

there were no specifications for “health” within the organs of the PTA. Alongに「保健」という名称がありませんでした。その必要性とともに学校保with the need for this, the objectives of a School Health Board were

健委員会の目的について役員の方々に説明し、昨年度より１年、２年、explained to the various executives, and the designation of “School Year,

３年それぞれ「学年保健給食委員会」という名称で発足し、学校保健委

Health and Meals Committee” was inaugurated for years 1, 2, and 3 and a

員会も開催しました。新たに委員会を作ることは厳しいですが、今までSchool Health Board has been convened, since the previous year. While it isの「学年委員会」に「保健給食」という名称が加わり、その役員の方々

difficult to establish new committees, the “Health and Meals” designation

を中心に子どもたちの健康、安全等について活動していく組織として位

was added to that of the “School Year Committee.” This addition positioned

置づけられました。学校保健委員会当日、アドバイザーとして参加してactivities for the health of school children within the organizational structure

くださった学校医、学校歯科医、学校薬剤師の専門的立場からのお話にof the school, around the focus of the members of this committee. In response

対し、保護者の方々はもっとお話を聞きたかったとの感想もいただき、

to the specialist perspectives provided by input from the school doctors,

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生徒保健委員も出席し意義のある会となりました。子どもたちが健康的

school dentists and school pharmacists in attendance on the day of the Schoolな生活を実践していくためには家庭との連携がとても重要です。そのた

Health Board, feedback was received from guardians which indicated that

めにも日ごろから家庭に学校保健活動についての情報を伝え、子どもたthey would like to hear more about this undertaking, making it a meaningful

ちの様子や健康情報を発信し、課題を共有し、学校保健委員会が活性化

meeting to be attended by members of Student Health Committee.

できればいいと思います。

Ties with households are vital to put into practice healthy lifestyles for

最近は子どもたちの心の健康等がとても気になる課題のひとつです。

children. For this it would also be desirable to routinely provide information

兼務ではない保健主事の先生方はさらに養護教諭と連携を密にしていた

about school health activities to households and disseminate information on

だくことをお勧めします。また生活指導やスクールカウンセラー等とのthe status of children and health, share challenges and that the School Health

連携も大切にし、チーム学校として組織体制を充実していくことが必要

Board be activated.

だと思います。中学校の場合、小学校との連携は保健指導等を行うにしRecently, the mental health of children has been an issue of extremeても、健康情報を把握して指導につなげるためにも重要であり効果的でconcern. We recommend that teachers maintain ever-closer ties with nursing

す。実施されている地域もあるかと思いますが、小中合同の学校保健委

teachers (YOGO teachers) who are not dual-appointed Health Coordinators. I

員会や地域全体の学校保健委員会も開催できればいいなと思っていま

think it is also necessary to emphasize ties with lifestyle guidance and school

す。今後も私自身、養護教諭との兼務のメリットを生かしながら、PDCA

counsellors, among others, and to consolidate and enhance organizational

サイクルに則り、学校での健康づくりをすすめていきたいと思います。

structures as a collaboration of school staff named Team school. Ties withelementary schools are important for junior high schools, as students caneffectively use health information from their elementary school days, andthese ties can be facilitated by health instruction. While I believe there areregions which are implementing this already, I think that it would be
excellent to hold a combined elementary and junior high school health board
or have a school health board for regions as a whole. From now on I would
like to continue recommending further promotion of health in schools in linewith PDCA cycles, using the advantages of being a dual-appointed Health
Coordinator and nursing teacher (YOGO teacher).

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[End]

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