護理人員投入護理專業生涯之歷程經驗

The professional career experiences of clinical nurses – an exploratory qualitative study

賴霈妤(Pei-Yu Lai)

指導教授 ： 周傳姜

長榮大學/健康科學學院/護理學系(所)/碩士(2012年)

https://doi.org/10.6833/CJCU.2012.00056

摘要

護理人員是醫療照護團隊不可或缺的人力資源，也是在醫院工作人數中所佔比例最多的。近年來因健保制度變革導致的成本壓力，機構護理人力配置未能合理化，工作負荷日益加重，工作環境越來越惡化。新進護理人員服務未滿一年即離職者占 22.37﹪，兩年離職者更佔 40﹪，不僅增加訓練成本更影響工作士氣與病人照護品質。然而，當護理專業不斷投注心力在改善護理人員流動率時，推估仍有40％的護理人員選擇持續在工作崗位上服務，其中更有投身護理工作二三十載至退休者。這些護理人員為何能長期留在護理行業直到退休？護理生涯發展的歷程經驗如何？內心有哪些轉化及體悟？值得進一步探討。
目前對於退休臨床護理人員護理生涯歷程之研究非常有限，本研究目的在了解退休護理人員投入護理專業生涯之歷程經驗及其感受。採用深度訪談研究法，共訪問3位國立醫學中心退休護理人員。所有的訪談錄音後轉為文字記錄，並以內容分析法進行分析。結果得到以下五個主題：(1)現實考量入護理(2)護理業務多面向(3)多重角色求平衡(4)護理責任承擔重(5)護理甘苦體會深。本研究結果有助對護理專業生涯經驗的整體性了解，可供護理行政管理及護理教育課程設計之參考。

關鍵字

護理人員 ； 專業生涯 ； 經驗與感受

並列摘要

Nurses which account for the largest proportion of health care human resources in a hospital setting provide indispensable services to patients. Under the cost reduction pressure caused by the health care insurance system change in recent years, the number of health care agencies with deteriorated nursing manpower configuration and failed to rationalize nursing staff’s work load is increasing. Clinical nurses’ work environment has become increasingly worse year after year. Currently, the turnover rate is 22.37% among new nursing staff with the working year less than one and 40 % among the staff with working years between one and two. The high turnover rate not only increase the cost of training but also affect the morale and the quality of patient care. However, with the nursing profession institution’s continued efforts to improve nursing staff’s turnover rate, there are still 40% of nurses keep working in the hospitals. Some of them spent twenty to thirty years for their nursing career until retirement. It is worth to explore: Why these nurses could stay in the nursing profession until retirement? Are there distinctive or specific experiences on their nursing career development? How is the transition and perception of their professional life experiences?
Scant studies focusing on the professional experiences of nurses were found. The aim of this study was to explore the professional experiences of nursing staff devoting into nursing career. The in-depth interview method was used for this study. Three retired nurses from a national medical center were recruited for this research. All interviews were tape recorded and then transcribed. Descriptions were analyzed by using content analysis method.
Themes describing the the professional experiences of nursing staff devoting into nursing career include: (1) Selected nursing profession due to reality concern, (2) Nursing duties go variety, (3) Balancing among multiple roles, (4) Nursing work load became more and more heavy, (5) Perceived the bitterness and sweetness of nursing career. The findings of this is study provide better understanding of the experiences of nursing professional devoted to nursing career. It could also serve as useful reference for better nursing administration and nursing curriculum design.

並列關鍵字

Nursing staff ； professional career ； experiences and feelings.

參考文獻

尹裕君(2005)．新制醫院評鑑與護理品質管理．榮總護理﹐22(2)﹐109-116。[Yin,Y.C.(2005).The New Hospital Accreditation and Nursing Quality Management. VGH Nursing,22(2),109-116.]

王俊文、葉德豐、坤儀(2003)．台灣醫院評鑑趨勢之探討．中山醫學雜誌﹐14(4)﹐513-522。[Wang,J.W., Yeh,T.F ,＆Tseng, K.Y. (2003).The Meta-Analysis for the Trend of Hospital Accreditation in Taiwan.The Chung Shan Medical Journal,14(4),513-522.]

王憲華. (2008). 從新制醫院評鑑談護理照護. 醫療品質雜誌, 2(2), 52-57.

李慧鶯、李選(2004)．在職進修學士學位護理人員生涯定位與生涯發展需求研究．長庚護理﹐15(1)﹐33-43。[Lee,H.I.＆Lee,S.(2004). A Study of the Career Anchor and the Needs of Career Development for the Registered Nurses in BSN Program. Chang Gung Nursing,15(1),33-43.]

李引玉、劉向媛(1994)．護理專業的成長—從生手到臨床專家．護理雜誌﹐41(2)﹐72-76。[Lee,Y.Y.＆Liu,S.Y.(1994).Professional skill development in nursing：from novice to expert.The Journal of Nursing,41(2),72-76.]