以「最後一哩」選習制度方式應聘新進人員及留任之歷程

The Course of 'Last mile' Concept in Preceptorship Programs for the Recruitment and Retention of New Nursing Staff

據全聯會2012年調查，90.58%醫院表示護理人員招募困難，造成醫院運作危機。護理學校畢業生是護理人員召募的最大來源，顯示學校教育、醫院人資管理上需一密切合作之接軌。本研究為了解學生在學選習期間即開始準備就業及實際至臨床工作的經驗歷程，作為未來護理人力資源應用之參考。本研究對象之新進護理人員是在學時以本院為畢業前最後一站選習單位，且畢業後選擇留任本院者，採質性研究之深入訪談，以內容分析法分析資料，結果發現：（1）學校課程規劃就業學程，有助於應屆畢業生提早適應就業環境；（2）完善的教育訓練計畫，可提供完整的教學與評值過程；（3）新進人員留任，需全院所有人員努力營造友善的工作環境。本研究認為若輔導員及學生皆以就業為前提進行教與學，確認個別性的學習需求，提早熟悉單位有助於增加適應，減少畢業後現實衝擊。另建議醫院亦可提供選習時之部份薪資，有助於增加學生選習單位選擇之動機，亦提高留任之可能性。

According to the survey results of National Union of Nurses Associations 2012, 90.58% of the hospitals in Taiwan showed difficulty in recruiting new nurses. This further resulted in the crisis of regular hospital operation. New graduates from nursing schools are the largest workforce source. The importance of close collaboration between school education and workforce management in hospitals has been addressed. This study aims to explore senior nursing students' experiences in job preparation after graduation during the last semester of clinical practicum, and it is intended for use as a reference for nurse recruitment in the future. The study subjects were senior nursing students whom were employed by the same medical college hospital where they completed their clinical practicum. Data were collected in this qualitative study through in-depth interviews with the participants and content analysis. The research results revealed that (1) the course design, including job preparation after graduation from school, helped the students adapt to a new work environment; (2) a comprehensive education and training plan provided a complete teaching and evaluation process; and (3) retention of new nurses depended on a friendly work environment that was cultivated through efforts of all personnel. This study concluded that if the preceptors and students use a job-driven teaching/learning model and identify individual learning needs, their adaptation to the workplace would be enhanced through familiarity of the work environment at an early time; this would further reduce the impact of reality after graduation from school. It also recommended that the partial salary for senior students during clinical practicum may motivate them in the selection of units for practicum and increase the possibility of job retention.