護理人員願意投入和留任醫院執業之工作條件與彈性制度探討

Abstract

台灣最近數年來出現嚴重的護理人力短缺現象，各醫院護理主管莫不積極研擬有效的解決策略，解決此問題的策略之一，應先瞭解護理人員期望的工作條件和各項彈性制度需求。 本研究旨在探討護理人員在何種工作條件和彈性制度下，願意投入和留任醫院執業。 第一階段以文獻查證，及焦點團體座談方式，廣泛收集應屆畢業生和現職護理人員願意投入和留任醫院執業的意見，擬定「護理人員工作條件與彈性制度調查表」，並經信效度檢定後，進行第二階段採隨機分層抽樣方式，進行全國性醫院抽樣調查。抽中之24家醫院中，有17家醫院同意參與，共發出問卷1,150份，回收1,146份，回收率99.65%。所蒐集之資料以描述性統計、t檢定、線性回歸、因素分析和ANOVA進行統計分析。 統計分析1,146份問卷結果顯示，護理人員願意投入和留任醫院執業的工作條件和彈性制度包含六大因素，分別為職能、數量、區隔、時間、薪資和領導彈性，共有113項，總平均值為4.35(SD = 0.42)，六構面平均值皆在4分以上，表示均具重要性。此外，護理人員之基本屬性中，在醫院層級、醫院所在區域、年齡、學歷、職稱、工作單位和護理總年資與六大構面中之某些構面具有顯著差異。 本研究結果已充分反映護理人員願意投入和留任醫院執業的工作條件和彈性項目，建議醫院高階主管和護理主管能積極創造合適的工作環境、工作條件和彈性制度，期望護理專業團體積極推動本研究結果，並督促政府相關單位提供政策性支持，讓護理人員能有成功的職涯發展，病人也能獲得安全且高品質的照護。The Taiwanese health care system recently faces new challenges with nursing shortage. The nursing managers seek new strategies to retain nurses, and solve the shortage problem. One strategy is to understand the working conditions and the flexible system with nurses are willing to practice in the hospital. The purpose of this study is to explore the nurse’s expectations towards their working conditions and a flexible system in the hospitals. First, a literature review was completed and then focus-group interviews were conducted to collect opinions from new graduates and practical nurses, to develop the questionnaire for the nurses. The focus group interviews were used as foundation for the developed the questionnaire regarding the nurse’s expectations on working conditions and flexible system, and helped strengthen the validity and reliability. Second, we used stratified random sampling to select 24 hospitals in Taiwan. There were 17 hospitals willing to participate in the survey and 1,150 copies of questionnaires were distributed to practical nurses. The valid recovery rate was 99.65% (a total of 1,146 copies were received). The data using descriptive statistics, factor analysis, t-test, linear regression and one-way ANOVA to analyze data. The results showed 113 objectives of nurse’s expectations concerning working conditions and flexible system, which include 6 factors: task, numerical, divisional, temporal, wages and leading flexibility. The total mean was 4.35(SD=0.50). The mean of 6 types of flexibility were above 4.0. It was the highest degree of importance to nurses. Demographic data on type of hospital, work location, age, education level, work position, work unit and total work years, to the 6 types of flexibility had significant differences. The study provides evidences for nursing managers and policy makers about the willingness to join and continue to work for Taiwan practical nurses in the hospital. They expect to have good working conditions and a flexible system. The study suggest all nursing managers to create proper work environments, working conditions and a flexible system, and expect the nursing professional organizations to actively promote the results of this study and urged government to provide policy support, in order to encourage successful careers development among nurses, and provide high quality and safety patient care.