精神衛生護理人力現況調查

A Survey of the Psychiatric Mental Health Nursing Workforce

謝淑貞(Shu-Jen Hsieh) ； 黃瑞媛(Jui-Yuan Huang) ； 蕭淑貞(Shu-Jen Shiau)

《精神衛生護理雜誌》 1卷2期 (2006/09) Pp. 5-16

https://doi.org/10.6847/TJPMHN.200609_1(2).0001

摘要

本研究乃中華民國精神衛生護理學會接受衛生署委託辦理「台灣精神衛生護理人力現況調查」之部份成果報告，內容包括精神衛生護理人數及其基本資料、醫院床數與護理人力比、薪資福利、離職率及需改善之問題與對策等。
研究方法為94年8月至11月間，針對地區醫院以上的精神科及精神專科醫院寄發問卷調查表，共發出132份問卷，回收81份，有效問卷79份，有效回收率60%。回覆問卷的醫院包括醫學中心等79家共15163床，佔台灣全部精神病床之51%；精神衛生護理人員共2626人，佔台灣全部精神護理人員總數之66.9%。
ICU、急性病房、精神專科教學醫院之慢性病房及日間病房的護理人力，均低於94年度評鑑標準。精神護理人員大學畢業以上者佔34.7%，具護理師證書者81.6%，護理人員專業能力分級N1以下者佔20.7%、完成N1者23%、完成N2者28.8%、完成N3者11.8%、完成N4者4.6%。護理人員薪資各院差異非常大，與醫院屬性、規模、所在地區有關。93年度離職率超過20%的醫院比92年度增加將近3倍。目前問題依序為護理人力不足、工作量多薪資低、工作壓力大身心疲潰、專業角色定位不明未受尊重、無一致性的精神科進階培訓制度。問題解決策略的建議有：爭取合理的人力配置標準、因公受傷要給予慰問、公會與學會團結聲援提高約用人員薪資、學會舉辦減壓課程以紓解壓力、實施精神衛生護理師專業能力認證、學會統一精神科進階培訓制度供各醫院參考等六項。本調查結果可作為主管機關制訂有關精神醫療與護理政策，及精神衛生護理學會推展專業能力認證與教育訓練之參考。

關鍵字

精神衛生護理 ； 護理人力

並列摘要

The Psychiatric Mental Health Nurses' Association (PMHNA) of Taiwan was commissioned by Taiwan's Department of Health to complete a survey of the psychiatric nursing workforce in Taiwan. The purposes of the survey were to understand the geographic distribution of psychiatric nurses, their work conditions, their pay, turnover rates and causes, the problems that they face, and the strategies that they suggest to solve such problems.
A structured questionnaire was used to collect data from 79 hospitals (a response rate of 60%) with 1516 psychiatric beds (51% of Taiwan's total) and 2626 psychiatric nurses (66.9% of Taiwan's total). We identified a nurse-patient staffing ratio in ICUs, acute wards, chronic wards and day wards, below the standard recommended by the Taiwan Joint Commission on Hospital Accreditation in 2005. We found that 34.7% of nurses had a bachelor's degree, and 81.6% had RN licenses. As far as professional grade was concerned, 20.7% were below N1, 23% had finished N1 requirement courses, 28.8% had finished N2, 11.8% had finished N3, and 4.6% had finished N4. Remuneration of psychiatric nurses varied with hospital level, size and location. In 2004, the staff turnover rate was three times higher than in 2003. The problems faced by psychiatric nurses were staff shortages, heavy workloads and low remuneration, high stress and feelings of burnout, feelings of being held in low esteem by hospital administrators, and a lack of systematic training programs. Suggested strategies for solving such problems included the following six ideas: striving for reasonable staffing standards, to given support and comfort when injured by a patient, for public and professional associations to call for increased remuneration, for professional associations to provide stress management courses to facilitate stress relief, the realization of clinical competence examinations and credentialing models, and for professional associations to provide standardized, progressive training programs, for each hospital to consider.
These findings may serve as a reference for the Department of Health, the Psychiatric Mental Health Nurses Association, and hospital administrators concerned with policy making or problem solving.

並列關鍵字

psychiatric mental health nursing ； nursing workforce