談最後一哩與新進護理人員臨床教育之銜接

Implementing the 'Last Mile' Program in New Nurse Clinical Education

在檢討護理人力短缺的一片聲浪中，新進護理人員的之高離職率，一向備受重視。工作壓力大、超時工作、工作量負荷重、職場環境中之人際互動不佳、未感受到主管的支持和經驗／技術及學理的準備度不足，往往是導致新進護理人員不留任的原因。學校端為強化學生實作能力，於學生畢業前夕推動「最後一哩」計畫，期望提升新進護理人員「留任率」。本文將先介紹目前學校護理之「最後一哩」、新進護理人員臨床教育、與「護理臨床教師」之現況，並探討「最後一哩」與新進護理人員臨床教育銜接上所面臨的挑戰，最後再針對如何強化兩者的銜接，提出進行建議的策略：如進行相關技能檢定、聘用角色典範型之護理人員擔任護理臨床教師、適切調整專款經費之運用、培養情緒管理的能力及學界與業界形成夥伴關係，將最後一哩納入護理職前訓練等因應策略，期許學界與業界能攜手合作，共同培育高留任率且具紮實專業知能與敬業樂群之護理人員。

The shortage of working nurses has made Taiwan's low nursing retention rate a critical issue in domestic healthcare. Main reasons for new nurses leaving their jobs include high pressure, overtime work, heavy workload, interpersonal relationship problems with colleagues, and inadequate support from administrators. In response, nursing educators designed the ”last mile” program to improve the hands-on competence of nursing students with the goal of increasing post-graduation retention rates. This article introduces the last mile program in its present form and discusses the challenges faced in transitioning the program from the classroom into the clinical training environment. The authors suggest establishing a challenge test prior to implementing the last mile program, recruiting role-model preceptors, adjusting training program / project budgets, and developing partnerships between nursing educators and clinicians to enhance the clinical competence of new nurses and ultimately increase professional nurse retention rates, competence, and accountability.