世紀回眸－－護理執業工作環境之演變與發展

Centennial Retrospective on the Evolution and Development of the Nursing Practice Environment in Taiwan

護理執業環境歷經了百年來的傳承與改變，經由前人篳路藍縷，慘澹經營，始有今日局面。本文依護理執業工作環境的演進，以護理職場人力的改變、醫院評鑑標準、護理職場作業的進展、職場安全、護理職場文化等回顧這一世紀來的變化。本文也陳述了國內外護理界對營造正向護理執業環境所做的努力與各項標準規範。經歷百年的演進，護理惟一沒變的是「視病猶親」的本質。雖然幾度面臨嚴重的護理人員荒，在正面迎戰問題之際，也成功地將危機化為轉機，進而提升了護理人員的待遇與福利，促使專業地位受到社會大眾的高度重視與肯定。面對日新月異的二十一世紀，科技的精進，人口結構的改變等衝擊，都影響著護理執業工作環境之演變與發展。如何運用資訊科技，簡化工作流程，將護理專業融入科技，提供高品質、人性化的護理服務，營造優質安全的護理職場，吸引更多優秀的新南丁格爾投身護理工作，守護全民健康，是我輩對下一個百年所需努力建構的。

The practice environment for nurses has seen tremendous change over the past century due to the dedication and trailblazing work of nursing pioneers. This article describes how the nursing practice environment in Taiwan has evolved over this period. References used include nursing narratives, hospital accreditation standards, standard operating procedures, workplace safety standards, and worksite-related values and expectations. The efforts of the professional nursing community to realize a positive practice environment are further discussed. Over this century of change, the only thing that has remained unchanged is the commitment of nurses to ＂treat patients as one's own family＂. In the current as well as the previous periods of manpower shortages in nursing, the nursing community has managed to turn crisis into opportunity by using the situation to enhance pay and benefits. Nursing professionalism is widely respected and recognized throughout Taiwan society. The rapidly changing needs of the 21st century in aspects such as the advancement of high technology, the rapid growth of the elderly population, and the fast rate of social change seriously impact the development of the nursing profession. How to effectively apply high technology, simplify workflows, provide high quality and humanistic nursing care, build safe and quality workplaces, attract bright nursing students, and provide healthcare for the entire population will remain the responsibilities of nursing for generations to come.