臺灣專科護理師在臨床實務上面臨的困境與挑戰

Difficulties and Challenges of Nurse Practitioners in Clinical Practices in Taiwan

洪翠蓮(Tsui-Lian Hung) ； 齊偉先(Wei-Hsian Chi)

《台灣專科護理師學刊》 6卷1期 (2019/03) Pp. 12-21

摘要

背景：專科護理師在人力短缺的環境下擔負部分住院醫師的工作，面臨諸多角色定位、多元心理壓力及專業認同的問題。目的：探討台灣專科護理師在臨床實務上遭遇的困境以及現行專師培訓制度的缺失，藉以說明專師專科化的重要性。方法：本研究採質性研究法，透過滾雪球方式與十一位專科護理師進行深度訪談，分析訪談逐字稿，透過分類找出主題。結果：本研究的分析歸納有三個主題：第一個主題為臨床業務權責不清，其中包括三個次主題：（1）工作業務內容模糊；（2）專業界線不明確造成專師心理壓力；（3）工作分配未依專業性。第二個主題是專業能力培訓與成長發展不完整，此主題包括三個次主題：（1）培訓制度的缺失；（2）缺少專師實務訓練之專屬模式；（3）專業角色發展受限因而引發挫折感。第三個主題則是主責部門歸屬與權責混淆。結論：專科護理師目前面臨的問題，應朝專師專業化及專科化的方向尋求解決之道，不僅應提升專科護理師的職能及功能，且應改變現行醫護共管的專師管理模式。

關鍵字

專科護理師 ； 質性研究 ； 專師訓練 ； 專業認同

並列摘要

Background: Nurse practitioners were created to meet the shortfall of residents. However, there are still a lot of issues that exist, such as unclear role orientation, multiple pressures, and the professional identity of nurse practitioners. Purpose: This paper explored the difficulties and problems nurse practitioners are facing, with emphasis on the importance of professionalism for solving these problems. Methods: This is a qualitative research based on in-depth interviews with eleven nurse practitioners through snowball sampling. Researchers analyzed the transcripts and categorized the themes. Results: The analysis resulted in the following findings, which were grouped into three themes. The first one included three subthemes: (1) ambiguous demarcation of nurse practitioners' works, (2) pressure due to the problems with work demarcation, and (3) human resource allocation being unaligned with professional considerations. The second theme was related to the problems with nurse practitioner training program and professional development. This included (1) the flaws of the current training program, (2) lack of specialized training for nurse practitioners, and (3) the feeling of frustration due to the lack of professional ability. The third theme was the crisis of affiliation identity. Conclusion: The problems nurse practitioners are facing can be tackled through developing their professionalism and specialization. This can improve the professional capability and function of nurse practitioners. The current management model, governed by both the medical and nursing department, should be replaced.

並列關鍵字

nurse practitioner ； qualitative research ； training of nurse practitioner ； professional identity

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