護理人員超時工作與疲勞之相關性分析

The Correlation between Overtime Work and Burnout of Nurses

黃薇瑄(Wei-Hsuan Huang)

指導教授 ： 黃麗玲

中臺科技大學/管理學院/健康產業管理研究所/碩士(2012年)

摘要

勞動基準法(勞基法)對勞工工時有所規定，但醫療機構中護理人員超時工作的情形普遍，甚至有「血汗醫院」等看法。過去文獻多指出護理人員的高離職率，係因工作壓力、超時工作、工作量大等特性，但醫護人員超時工作原因相當複雜，若又導致疲勞而產生醫療疏失之後果嚴重。因此，本研究目的有：調查目前護理人員超時工作現況、測量其職場疲勞狀態，及探討護理人員超時工作與其疲勞狀態間之關聯與影響。
本研究以台中市某區域教學醫院之全體護理人員為對象，利用「護理人員工時現況與疲勞之相關調查」問卷為工具，問卷內容包括基本資料、超時工作情形與認知、職場疲勞三大單元，共得有效樣本310份，回收率79.5%。
結果發現本研究樣本分布以女性(98.4%)、30歲以下(57.1%)、大學學歷(61.9%)、單身無子女(51.0%)、護理師(82.9%)、年資2-10年(49.4%)、N2專業層級(46.5%)、三班輪班者(70.0%)、騎機車(50.3%)、通車時間在15分鐘以內(50.0%)居多；七成以上的護理人員有超時工作情形，以每月超時7天內(52.6%)、每次超時30-60分鐘者居多(47.7%)，且病人量突增是造成超時工作的主因，49.3%的護理人員希望超時工作能給付加班費。職場疲勞的四個構面平均得分為48.26到69.41之間，而控制其他變項後，年齡、護理專業進階層級、通車時間、勞基法保障範圍、加班費機制、每次超時工作時數、單位超時天數與單位超時時數會影響職場疲勞程度。
護理人員超時工作與疲勞的情形嚴重，尚須利用下班與休假的時間進行在職教育，長久累積的疲勞若未獲得適當的紓發，可能使護理人員離職率升高，甚至影響照護品質。因此本研究建議醫院管理者加強人力訓練以因應病人突增的狀況，並且彈性的應用人力，必要時各單位應互相支援；建議醫院將非護理的照顧工作交由照顧服務員執行，並且簡化繁雜的文書作業，針對超時工作建立適當的補償機制；政府相關單位應針對護理人員的訓練結構，研發其他工作量的替代方案，讓護理人員有充足的休息時間，以延展護理人員的職涯生命。

關鍵字

護理人員 ； 職場疲勞 ； 職場疲勞量表 ； 超時工作

並列摘要

The working hours were stipulated in Taiwan’s labor standards. Most of past literatures pointed out that higher turnover rate of nurse should be caused from working pressure, working overtime, and overload working. The reasons of overtime working in medical facilities are complex, and they’re not only caused of burnout but also medical negligences. The purposes of this study are to investigate the situation of nurses’ overtime working in the hospitals, and to measure the relations and impacts of overtime working and burnout.
This study utilized a stractured questionnaire of "The Correlation between Overtime the Work, and Burnout of the Nurses" to be study tool. All questionnaire data collected from 310 valid samples who were working at a regional teaching hospital in Taichung.
The most of these samples women, below ages of 30, college graduates, single and no child, RN, 2-10 years of seniority, N2, motorcyclists, whom could arrived hospital within 15 minutes. Furthermore, there’re over 70% of nurses were work overtime, most of them are 7 days per month (52.6%), and generally work overtime in 30-60 minutes (47.7%). Moreover, the sudden increase of patients was the main reason for the overtime work. 49.3% of nurses hope their overtime could be a wage surplus. About the occupational burnout scores, can be average from 48.26 to 69.41. After controlling the other factors, age, professional clinical hierarchal ladder, commuting time, the guaranteed coverage extracted from the Taiwan labor standards act, hours of overworking, the number of overtime days and the number of overtime hours could affect the situation of burnout.
The overtime work problems of nurses are very serious. They must obtain on-job education training at off hours or during vacation. In which the usage of personal hours might cause a high turnover rate for nurses, even to affect the quality of health care. This study impressed the importance of personal on-job training to enhance their professional abilities. Moreover, adjustments of human structure should be flexible. Due to the sudden increase of patients, so a certain amount of assistance should be requested and acquired. This study suggests that nurse-aids manpower could be need to support the nursing works. Furthermore, paperwork should be simplified in order to compensate for the extra hours put into the work. We suggeste to the managers of healthcare facility to change their training structure be amended – perhaps using alternative ways in exchange of the deduction of educational training hours and investigation. So that the resting hours of nurses is sufficient in order to guarantee an extension of their nursing careers.

並列關鍵字

occupational burnout ； occupational burnout inventory ； nurse ； overtime work

參考文獻

蕭桂榮(2009)。輪班護理人員的睡眠品質、壓力、疲勞與相關生理指標之探討(未出版之碩士論文)。私立長榮大學，台南市。

陳美珠(2006)。不同作業環境對護理人員疲勞狀態之影響(未出版之碩士論文)。私立中山醫學大學，台中市。

張晏蓉(2005)。工作特質、疲勞與急性心肌梗塞之相關(未出版之碩士論文)。國立台灣大學，台北市。

林育如(2009)。醫務社會工作者職場疲勞之調查研究(未出版之碩士論文)。國立台灣大學，台北市。

蔡依倫(2009)。急診醫師疲勞相關因素探討及其對離職意願之影響(未出版之碩士論文)。國立台灣大學，台北市。