從醫療職場工作特質探討醫院護理長與臨床護理人員之工作壓力源

Exploring Job Stressors for Head Nurses and Clinical Nurses from the Perspective of Their Job Characteristics

林瑜雯(Yu-Wen Lin) ； 莊子萱(Tzu-Hsuen Chuang) ； 劉曦宸(His-Chen Liu) ； 陳韻柔(Yun-Jou Chen) ； 陳富莉(Fu-Li Chen)

《台灣公共衛生雜誌》 30卷3期 (2011/06) Pp. 245-256

https://doi.org/10.6288/TJPH2011-30-03-05

摘要

目標：本研究以醫療職場的工作特質，分析不同職位護理人員之工作壓力源。方法：採質性訪談方式，共訪問九位護理長及十七位臨床護理人員，訪談資料經轉譯、編碼形成類組，發展概念。結果：研究發現護理長的工作壓力源來自於處理許多單位內及醫院所交付的行政工作，但欠缺管理上自主權又難獲得同事間的社會支持；而臨床護理人員來自於短時間內劇增病人量或輪班交班延長工作時數的負荷，且缺乏病人照護的技能及決定自主權，並面對無法控制的危害暴露及病人或同事間溝通不良的問題。結論：醫院護理長及護理人員之工作壓力源雖不盡相同，但均來自於工作環境因素及個人因應能力。故建議護理長可參與醫院政策制定過程，以降低主管與基層單位的想法差異；並調整臨床護理人員排班制度及改善行政作業流程。另外，為提升護理長領導技能及新進護理人員醫療照護技能提供相關訓練。醫院亦可以提供一些健康促進活動，增進醫療人員互動，強化社會支持。

關鍵字

工作負荷 ； 危害暴露 ； 工作壓力源 ； 質性研究 ； 護理人員

並列摘要

Objectives: The aim of this study was to explore the job stressors for head nurses and clinical nurses from the perspective of their job characteristics. Methods: Nine head nurses and 17 clinical nurses participated in this study. All interview contents were transcribed and coded. Matrices were constructed to identify themes and evolving concepts. Results: Execution of administrative tasks without sufficient decision-making authority and lack of colleagues' social support were the major stressors for head nurses. The clinical nurses' stress levels were raised by an overwhelming workload such as a large number of patients checking in within a short time period or work-hour extension due to task transfer between shifts, inadequate professional skills in patient care and a lack of decision-making authority. Involuntary exposure to hazardous materials and poor communication with patients or coworkers were also job stressors. Conclusions: Head nurses and clinical nurses experienced different job stressors. Most came from the work environment and poor personal coping strategies. We suggest that head nurses be involved in hospital policy making processes and that the work-shift arrangements for clinical nurses be adjusted. Optimizing administrative procedure is also recommended. Skill-based training courses that promote leadership skills for head nurses and patient care skills for newly hired nurses are needed. Hospitals might also offer health promotion activities to improve employee interaction and encourage social support.

並列關鍵字

Job demand ； Hazard exposure ； Job stressor ； Qualitative research ； Nurse

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