行政院會議通過「醫療保建及照顧服務業發展綱領及行動方案」,導致各醫療院所均朝社區健康照護發展。在此趨勢發展下,各醫療院所護理人力不足現象,有愈來愈明顯的情況。 長期以來,護理人員工作壓力大,流動率高。護理人員的高離職率,直接和間接降低整體醫療品質。因此,各醫院努力創造一個讓護理人員留職的環境。但是良好的環境,除了需擁有足夠的資金外,滿足護理人員真正的需求,更是重要關鍵。 本研究依據社會交換理論的概念,探討臺灣地區護理人員,在認知投資員工成長 (perceived investment in employee development) 與離職意圖間的關聯。此外,在人力資源管理研究文獻,發現認知投資員工成長與程序正義有關。因此本研究探討程序正義認知的干擾角色與組織承諾、工作滿足的中介效果。 經文獻探討及問卷實證分析後,確認投資員工成長對組織承諾與工作滿意具正向關係,但對離職意圖是負向關係。組織承諾與工作滿意於投資員工成長與離職意圖間具有中介效果。而程序正義認知在投資員工成長對組織承諾與工作滿意具有干擾作用。這結果有利於組織調配有限資源投資員工成長,以有效降低員工離職。
In the wake of the passage of the “Guidelines and Action Plans for Medical and Healthcare Service Industry Development” by Executive Yuan, almost all medical institutions have begun to develop toward providing community-based health care services. Under this trend, insufficiency of nursing staff has become more and more evident in all levels of medical institutions. For long, nursing staff has been characterized by high job pressure and high turnover rate. The high turnover rate of nursing staff will directly and indirectly reduce the overall medical service quality. Therefore, all hospitals should endeavor to create an amiable environment that can retain their nursing staff. This environment should be built on the basis of sufficient funds and, more importantly, satisfaction of employees’ needs. Based on the social exchange theory, this study investigated the correlation between perceived investment in employee development and intent to leave among nurses in Taiwan. Previous literature of human resource management has shown that perceived investment in employee development correlates to procedural justice. Thus, this study further discussed the moderating role of procedural justice perceptions and examined the mediating effects of organizational commitment and job satisfaction. Through literature review and empirical analysis of survey results, this study confirmed that perceived investment in employee development positively affects organizational commitment and job satisfaction but negatively affects intent to leave; organizational commitment and job satisfaction mediate the relationship between perceived investment in employee development and intent to leave; procedural justice perceptions have moderating effects on the relationship between perceived investment in employee development and organizational commitment or job satisfaction. The above findings could help medical organizations allocate limited resources to employee development to effectively reduce employees’ intent to leave.