專科護理師角色認同之關聯探討- 以某醫院為例

Discussing The Role of Nurse Practitioners and Related factors —An Exploratory study

徐慧美(Hui-Mei Hsu)

指導教授 ： 陳家祥

元智大學/管理學院/管理碩士在職專班/碩士(2012年)

https://doi.org/10.6838/YZU.2012.00188

摘要

健保給付得緊縮，醫院為控制成本及外科醫師缺乏下，因應而生的專科護理師逐漸取代住院醫師的工作，但也造成角色認同不清。2007年5月，專科護理師正式走向制度化，筆者此研究以關懷角度切入，探討某地區教學醫院的專科護理師對自身角色認同之看法，以及內心衝突。因為工作環境中常因角色定位不明而產生困擾，影響工作表現及醫療品質，甚至會萌生離職之意。
本研究採質性深度訪談，收集南桃園某家地區教學醫院五位主治醫師及五位現職專科護理師，再輔以兩位病患之看法。本研究主要目的在探討影響專科護理師對自身角色認同看法的因素、?解醫師、病人對於專科護?師之角色認同的想法是否有差?，可針對有不同處加以調整、 期望協助專科護理師新進同仁之角色調適及認同、及清楚釐清專科護理師工作內容範圍，執業有所依據。
研究結果發現，專科護理師的制度是提供一個想在專業有所成長之護理人員另一揮灑的空間，有助於護理界吸引人才固守崗位，善用人力資源，並提供醫院更好的醫療品質。然有幾點建議：(1)成立專科護理部，對於員工關懷、職涯規劃與醫院人力資源訂定一套合理標準、(2)提供足夠在職訓練及進修管道、(3) 訂定明確工作規範、(4)實行之臨床警訊呼叫系統(Clinical Alert System)及緊急應變方案，以早期發現病情惡化的病人、(5)發展專科護理師能力進階制度。

關鍵字

專科護理師 ； 主治醫師 ； 角色認同 ； 衝突

並列摘要

The DRG assignment determines the payment level the hospital will receive. Because of cost control and shortage of surgeons at the hospital, nurse practitioners were initially introduced to address the shortage of residency positions and resulted in undefined role identification. In May 2007, they have now become institutionalized in many academic health science centers. In this study the role of the nurse practitioners at a regional teaching hospital and mind control are discussed. Due to undefined roles problems developing may influence work performance, quality of medical care, and intention of resignation.
This research is a qualitative in-depth interview-based. The point of view from five physicians and five nurse practitioners serving at a district teaching hospital in southern Taoyuan as well as two patients are analyzed. The main purpose of this study was to investigate the impact of nurse practitioners’ self-identification, factors of their roles, understanding the opinions of physicians and patients to them for any differences so that they can make adjustments and help other new nurse practitioners clearly define their authority, responsibility and accountability at work.
This study found that the system of the nurse practitioners is to provide educational
opportunities to professional nurses learning knowledge, contributing the nursing profession, to fully utilize human resources, and to deliver a better medical quality and care. However, there are a few suggestions including (1) The establishment of a specialist care department, a set of reasonable standards for the care of employees, career planning and standards of human resources, (2) Adequate job training and education pipeline, (3) Well-written job specification, (4) The Clinical Alert Call System and Emergency Response Program, early detection of patients with deteriorating diseases, (5) The skill development in Nurse Practitioner Clinical Education.

並列關鍵字

nurse practitioner ； physician ； role identification ； conflict

參考文獻

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