交易型領導、信任與組織公民行為之關係

Relationships of Transactional Leadership, Trust, and Organizational Citizenship

後SARS（severe acute respiratory syndrome）時期，醫院經營面臨健保政策之制約管理，包括全面推行總額預算與各項品質指標，迫使醫院從擴張發展轉變為額度控管與成本控制之策略。各單位遇缺不補、人力縮減，但留任員工卻得負起更多的績效表現。因應內外環境的改變，醫院員額數最多的護理部門，責任上更是不惶多讓。因此，各病房護理單位直接或間接地承受了這些重責大任。如何讓病房單位護理人員，在有限的資源下，發揮組織公民行為，使組織有效運作，是有其迫切性的需要。本文希望透過文獻整理，探討護理長與護理人員之間交易型領導與信任特質對於護理單位組織公民行為之影響。查證發現，護理長如能善用領導型態與護理人員建立信任關係，將能增進護理人員從事組織公民行為之意願，使護理單位展現出良好的功能，進而達成醫院管理所設立的目標。

Under the health-care insurance system in Taiwan, hospital management has not only to challenge the impacts of the post-SARS era, but also has to conquer the system change brought about by the National Health-Insurance Bureau. By global budget and various quality-control indicators, the hospital confronts pressure on restriction measures, including, on the one hand, reducing manpower, while on the other, pushing remaining employees to achieve more. The nursing department, comprising the highest percentage of faculty in the hospital, cannot but burden itself by accepting more duties. A ward nursing unit (WNU) therefore, has taken on the fundamental role of attaining the goals set by the hospital. This review is concerned with how the WNU functions and what kind of relationships exist between head nurses and staff nurses. An approach was adopted of exploring the impact of transactional leadership and trust on Organizational-Citizenship Behavior (OCB) between head nurse and staff nurses, with the aim of clarifying the present situation and proposing some suggestions for future modifications.