由我國『專科護理師』制度之推行展望護理人員職涯發展

The Influence of Accreditation of Career Development of Clinical Nurse Specialist on Nursing

台灣地區於1986年馬偕醫院創設「專科護理師」制度以來，截至1988年統計約近四十餘家醫療院所或以「專科護理師」、或以不同職稱進行類似性的醫療或護理照護服務；2000年立法院通過「護理人員法」中有關「專科護理師」證照、分科、甄審等相關規定，使得我國「專科護理師」制度邁入另一個新紀元。護理人員於過往的職涯發展，多由護士、護理師，組員、組長、（副）護理長、督導及主任的單線式職涯發展；然而『專業』與『管理』兩項職能發展，不論在現代醫療專業分工與個人職涯規劃自主意識興起，皆存在著思辨的空間。本研究於2002年針對台灣地區之地區教學醫院等級以上之護理人員以分層抽樣方式進行問卷調查，研究結果發現：1. 在職務別分類上，護理人員對於「專科護理師」證照制度的認知上呈現顯著差異。2. 在「專科護理師」證照制度之法令知悉有顯著的差異，並顯示「專科護理師」證照制度對護理人員具有正面意義；在職涯途徑上的選擇，有更明確的未來。

There were tremendous increasing numbers of hospitals to adopt Clinical Nurse Spcialist (CNS) to assist health care delivery from 1986 to 1988. In year 2000, The Legislative Yuan of Taiwan approved the laws of accreditation and licensure of CNS. However, what are the recognition and impression of the accreditation of clinical nurse specialist form nursing? This study examines the associations among recognition, job characteristic, job satisfaction, and job commitment related to the CNS. This study used self-developed survey research to ask 386 nurses, including 43 nursing directors, 45 nursing supervisors, 134 nurse managers, 52 PAs and NSPs, and 115 registered nurses. The survey period was from March 10 to April 31 of 2002. The overall alpha of the instrument was 0.97. Descriptive analysis and ANOVA were used to attain the purposes of this study. The major findings from this study :The perception of CNS is positively associated with the constructs of job characteristics, job satisfaction, as well as organizational commitment. It suggests that the promotion to the CNS path will assist the nursing turnover in the future.