護理人員工作時間之研究

The Research on Working Time of Nurses

黃品尊(PIN-TSUN HUANG)

指導教授 ： 郭玲惠

國立臺北大學/法律學院/法律學系法律專業組/碩士(2016年)

摘要

我國護理執業環境目前存在高離職率與低執業率的現象，造成原因在於護理人力配置不當、照顧病人數過多、工作負荷過重、薪資及福利過低、經常超時工作等，如果護理執業環境持續惡化，使護理人員不願就業，則我國的醫療照護品質將大為下降，病患無法獲得良好照顧，因此應正視護理執業環境崩壞問題。本文以工時制度作為切入角度，此因其為勞資關係之核心，亦影響勞工身心健康與家庭生活的平衡，且護理人員的工作時間存有許多爭議，因此將分析現況，探討現行法制是否合宜，以期改善護理執業環境。

首先將說明我國醫療機構的人力現況、護理人力配置、護理人員工作特性及工時現況，藉此了解其工作負荷和勞動條件。其次，將介紹護理人員在工時各方面所適用之法律規定，而後帶入護理人員在工時上所遇到的爭議，即On Call制度、正式工作之前後與訓練時間是否屬工作時間、醫院給予護理人員的加班補償是否合理、休息時間不足以及目前輪班制度是否適當等，並以相關法律規定、學說及實務見解作分析，最後引入德國工作時間之立法例，思考其帶給我國之啟示。

結論部分，本文認為護理人員的On Call待命時間、點班、交班及填寫護理紀錄皆屬工時，至於訓練時間，則依個案認定是否屬工時；另外，本文參考德國工作時間法，針對輪班、加班、休息、待命和夜間工作等工時制度提出應如何修法之見解；除法制面，政策面亦應努力，制定合護病比、明訂護理人員工作內容、落實勞動檢查及加強勞雇雙方勞動權益意識，方能更順利解決護理人員的工時問題。

關鍵字

護理人員 ； 工作時間 ； 待命時間

並列摘要

The current nursing care environment in Taiwan is imbued with high turn-over rate and low practice rate, and can be attributed to factors such as inadequate manpower allocation, mass patient load, heavy workload, low pay and benefits, and frequent overtime. If the practice environment continues worsening, in time fewer nursing personnel will be available, and as a consequence, patients won’t receive good care, and our health care quality will suffer drastically. This is an important issue that needs to be addressed accordingly. Therefore, this article investigates the issue of nurse practice environment from the perspective of working hours, which constitutes the core of employer-employee relationship and greatly influences employees’ work-life balance and mental/physical health. As the working hours of nursing personnel is under considerable controversy, this article attempts to analyze the status quo and investigate the suitability of current legislatures, in order to improve the current environment.
The article first addresses the current status quo of manpower in healthcare institutions, allocation of nursing personnel, job characteristics and working hours in Taiwan, which illustrates workload status and labor conditions. Secondly, this article introduces the legislatures and regulations regarding work hours that are applicable to nursing personnel, then followed by drawing the controversy on working hours faced by nursing personnel – the “On call” policy, whether the time before/after work and training hours are considered working hours, whether the overtime compensation for nursing personnel is reasonable, insufficient break hours, whether the current shift policy is appropriate, etc. Moreover, discussion on these issues is supplemented with analyses of legislative regulations, academic theories and courts' opinions, and summarized by introducing the example of German legislatures on work hours and how such policies may inspire our own policy making.
In summary, this article considers that the hours spent on call, shift inventory, shift transfer and completion of nursing records can be deemed as working hours, while training hours should be determined on a case-by-case basis. Furthermore, the article also provides insights on legislature reforms for work shifts, overtime, time break, stand-by time and night shifts, based on the German legislatures for working hours. Despite the regulations, the aspect of policy is important as well; only with appropriate nursing/patient ratio, clear nursing work objectives, frequent labor auditing and strong awareness of labor rights for both the employers and employees can the issue of nursing work hours be properly settled.

並列關鍵字

Nurse ； On Call

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