護理師在第一線接觸病人,擔任醫病關係中的溝通協調者,在醫療體系中扮演非常重要的角色。然而,我國國民在享受聞名全球的全民健保服務時,醫護人員卻承受過重的工作壓力,2018年臺灣護理產業工會調查顯示,勞基法二修後工時反而加長,護理師白班平均工時9.65小時,而醫學中心白班平均9.91小時,意謂超時工作2小時被當作功德(沒有加班費)。嚴苛的工作環境促使護理師出走,致使各醫療院所面臨嚴重的護理師短缺,根據中華民國護理師護士公會,護理師執業率僅為58.4%,平均工作壽命不到七年(來源:衛生福利部)。工作壓力對護理師身心造成影響,高達37%的護理師因壓力過大必須尋求治療(來源:臺灣護師醫療產業工會)。 本文以臺灣護理師與一般國民的健康比較為研究目標,希冀結果可供政府及相關單位參考,以提升護理師的健康及留職率,確保我國醫療體系的永續經營。本文使用全民健保資料庫2005年百萬人抽樣檔,以2011至2013年資料為代表,聚焦於護理師與一般國民之住院等醫療利用,作為衡量健康的依據。分析發現每年約有6%的女性護理師離職,其中離職率以25至34歲最高,且工作壽命不長,約20%在取得執照後一年便離職,且離職率與工作地區、醫療院所層級有關,39歲以前離職多與生產後有個人生涯規劃,而40歲後離職可能並非與身體狀況較差有關。雖然護理師的健康狀況可能並未較一般國民來得差,但某些疾病的發生率較高。另外,女性護理師因為妊娠、分娩和產後合併症等住院的可能性高於一般國人,背後可能代表女性護理師的生育率較高。
Professional nurses contact patients on the front line and act as communication coordinators in the doctor-patient relationship, playing a very important role in the health care system. However, while people enjoying the quality service of National Health Insurance (NHI) system, health care workers are under excessive work stress. A 2018 survey by the Taiwan Nurses Union showed that the working hours of nurses increased despite passing the second revision of the Labor Standards Act. The harsh working environment has prompted professional nurses to leave, causing medical care institutions to face a severe shortage of nurses. Working pressure also has an impact on their physical and mental health, and up to 37% of nurses seek treatment due to excessive stress. In this study, we used data from the NHI Research Database from 2011 to 2013 to compare the health of professional nurses and ordinary people in Taiwan. The results show that about 6% of female nurses leave each year and the turnover rate of those aged 25-34 is the highest indicating that their working life is not long. We found that the high turnover rate is related to the working environment, including the location and the level of medical care institutions. The reasons of resignation may not be restricted to poor physical condition, for example, leaving before the age of 39 is related to family planning (e.g., giving birth to newborns). Also, the health of nurses may not be worse than that of general population, but they are more likely to be hospitalized for certain diseases, such as complications of pregnancy, suggesting higher fertility rates for female nurses.