安寧緩和醫療團隊督導制度之探討與應用

Discussion and Application of Supervisory System for Palliative Care

蔡佩真(Pei-Jen Tsai) ； 蔡佩渝(Pei-Yu Tsai) ； 鄭適芬(Syi-Fen Chang)

《安寧療護雜誌》 14卷1期 (2009/03) Pp. 62-69

https://doi.org/10.6537/TJHPC.2009.14(1).6

摘要

安寧療護是高度專業、高度接觸的醫療服務，醫療團隊的情緒負荷高，若未處理得當，容易造成情緒的耗竭，因此安寧病房的教育訓練與人力維護制度更顯得重要與急迫。督導制度是組織中的在職教育與人力發展上的重要機制，透過機構內部或外聘督導者以個別督導或是集體督導的方式來協助受督導者確保服務的品質。對安寧病房而言，督導的短期目標可以促進工作者擁有高效率的工作能力，協助醫療團隊在專業的成長和發展，提供一個能提昇工作效率的環境，支持和鼓舞醫療團隊執行任務的動機。關於督導制度如何實際應用在安寧醫療團隊，本文將以中部某醫院安寧病房的經驗爲例，說明外聘督導制度實施時須考慮之事項與細節，包括評估需求、尋找適當督導者、設定適合的督導框架、督導技術的實施與反省。一個團隊的成長需要有一些元素的配合與滋養，包括院方願意投資於人力資源的維護、團隊領導者的理念與堅持、外來資源的妥善選擇與運用、醫療人員謙卑受教的心。任何醫院若是希望推動督導制度，也可以在這些條件中預作準備，按著各家醫院的獨特體質，發展人力資源維護的制度。

關鍵字

督導 ； 訓練 ； 醫療團隊

並列摘要

Palliative care is the medial care that's not only highly specialized but also loaded with patient-and-caregiver contacts and as a result it consumes a great deal of caregivers' emotional energy. If emotional burdens weren't managed properly, it is easy to turn emotional consumption into emotional exhaustion. Therefore, it is a matter of importance and urgency to have educational training and human resource system in place. In additional, supervisory system ensures quality job training and talents development whether it is conducted through inner staffs or contractors in a one-by-one or group setting. Specifically for palliative care, short-term supervised job training program can boost caregivers' performance, facilitate team growth, and provide a work environment that supports and motivates caregivers. The question then remains: ＜||＞How to practically apply supervisory system in palliative care?＜||＞ This article will use the example from a palliative care hospital in Taichung to answer this question with details, including assessing the caregivers' needs, finding the right supervisor, and establishing proper supervisory boundaries, and evaluating on the execution of the system. There are also several factors contributing to the team growth-hospital's investment in maintaining palliative care human resource, team leader's vision, resource management, and caregiver's willingness to learn. This report hopes to better prepare any palliative care hospital that wants to implement supervisory system tailored to its unique environment and infrastructure.

並列關鍵字

supervision ； training ； medical team