女性已婚臨床護理人員工作、家庭與參與進修生活經驗之探討

Married women in clinical nursing staff to explore the experience of family life and participate education

阮竫育(Ching-Yu Ruan)

指導教授 ： 徐敏雄

國立暨南國際大學/教育學院/終身學習與人力資源發展碩士學位學程碩士在職專班/碩士(2016年)

摘要

本研究係以質性研究法，深入探討臨床護理人員輪班工作與家庭、進修間之影響。研究對象的選取是採方便取樣，以深度訪談法收集資料，以半結構性的訪談，以 Noddings 提出關懷倫理之理論內涵，撰寫訪談大綱，進行一次一對一的錄音訪談，時間約 60-90 分鐘，將訪談過程中個案所表達的語言與非語言轉為記錄。共收集十位中部地區已婚女性臨床護理人員做為訪談對象。將訪談內容進行分析、歸納與整理，最後分析出已婚女性臨床護理人員於工作、家庭與進修間的情形。經過資料的歸納分析，最後萃取出三項有意義的主題：
一、繁忙的臨床護理工作型態：臨床護理工作概況、協助其他業務工作、護理工作延長工時。
二、臨床護理人員輪班概況與家庭生活影響：臨床護理人員輪班概況、臨床護理人員輪班困境、護理輪班工作與家庭照顧間的影響。
三、護理人員參與相關進修學習之概況與家庭生活影響：參與在職教育課程壓縮護理人員休假時間、護理人員參與繼續教育影響家庭生活與休假之時間、輪班工作對於護理人員參與進修教育之困境、自假參與護理相關證照訓練作為轉職之機會。
最後獲致主要結論如下：
一、高工作量延長護理工時，壓縮臨床護理人員自由時間，卻無法得到應有的重視與關懷，改善目前護理工作型態。
二、臨床護理人員承擔多重角色工作內容，模糊專業地位，護理專業無法得到認同，淪為輔佐醫療團隊。
三、護理人員輪班工作不僅影響生理層面問題，更對護理人員在母職角色、親子互動與家務處理等家庭生活的衝擊。
四、臨床護理人員參與相關進修教育，壓縮護理人員休假與休息時間，進而影響其進修品質與家庭生活。
根據上述研究結果，分別對政府政策、醫療院所與研究限制提出下列建議：
一、對政府政策的建議：醫療評鑑制度的檢討與改善、醫療人員教育績分政策檢討與改善、協助導正護理專業與形象認同、以關懷倫理為出發的政策制定。
二、對醫療院所的建議：配合參與評鑑制度的必要性、合理化的輪班制度、臨床護理工作單純化、在職教育及會議參與補助與獎勵。

關鍵字

臨床護理人員 ； 關懷倫理 ； 輪班工作

並列摘要

The purpose of this qualitative study was to explore the effect of shift work on the families of, and the advanced studies of, clinical nurses. Study participants were selected by convenience sampling. In-depth interviews were used for data collection. A semi-structured interview was employed, incorporating the ethics of care theory proposed by Noddings. The interview outline was first composed and then one-on-one recorded interviews (60-90 minutes in length) were conducted. During the interview process, all verbal and non-verbal behaviours expressed by the interviewees were recorded. A total of 10 married female clinical nurses, each from the central region, were recruited as interviewees. Results of the interviews were analysed, summarised, and organized. Work, family, and advanced studies status of the married female clinical nurses were also analysed. Finally, by summarising and analysing the data, the following three significant themes were extracted:
1. Busy clinical nursing work patterns: clinical nursing work overview, assistance with other operations, and extended nursing work hours.
2. Overview of shift work in nurses and its effect on family life: overview of clinical nurse shift work, dilemmas of shift work for clinical nurses, and the effect of nursing shift work on family care.
3. Overview of nurses participating in related advanced studies and its effect on family life: participation in professional education courses reduces the free time of nurses, nurses’ participation in continuing education affects family life and free time, shift work causes dilemmas for nurses participating in advanced studies and also affects personal leave for participation in nursing-related licensing training to obtain opportunities to change professions.
Finally, the main conclusions are as follows:
1. High work volume extends nursing work time and reduces the free time of clinical nurses but They cannot receive due attention and care, so the current nursing work pattern should be improved.
2. Clinical nurses undertake multiple roles, thus blurring their professional status. The nursing profession does not have an identity and is reduced to assisting the medical team.
3. Shift work not only causes problems on the physiological level, but also negatively impacts aspects of nurses’ family lives; these include their roles as mothers, in parent-child interaction and in household management.
4. Clinical nurses participating in related advanced studies have reduced vacation and rest time, affecting the quality of their studies, and affecting their family lives.
Based on the above results, the following recommendations, with limitations of the study, are made to government policy makers and medical institutions:
1. Recommendations to government policy makers: review and improve the medical evaluation systems, review and improve the educational grading of medical personnel, provide assistance and guidance for both the profession and its identity, and develop policies built around the ethics of care.
2. Recommendations to medical institutions: match evaluation system participation with necessity, develop rational shift work systems, simplify clinical nursing work, and provide subsidies and awards to allow for on-the-job education and participation in conferences.

並列關鍵字

clinical nurses ； ethics of care ； shift work

參考文獻

黃美華、郭倩琳（2009）。女性護理人員生涯阻礙與因應策略之相關性研究。護理暨健康照護研究，5(2)，91-99。

林佳靜、曾翠華、蕭淑貞、王淑怡、盧美秀、鍾聿琳（2008）。臺灣護理教育專業人才培育的現況。醫護科技學刊，10（3），145-158。

洪瑜嬬、林佩蓁、潘純媚、陳秋蓉、何啟功、吳明蒼（2006）。護理人員的輪班工作與睡眠品質、身心健康及家庭功能之間的相關性。勞工安全衛生研究季刊，15（1），17-30。

游惠瑜（2005）。諾丁的關懷倫理學及其問題。哲學與文化，32（3），95-109。

謝淑芬（2001）。已婚職業婦女與全職家庭主婦對休閒活動參與阻礙與阻礙協商策略差異之研究。戶外遊憩研究，14（2），63-84。