台灣臨床護理人員交班經驗之現象學研究

A Phenomenological Study of the Shift Change Experiences of Clinical Nurses in Taiwan

背景：交班是護理人員間的工作溝通及互動。然而，這個每天在世界各角落發生的護理職場現象，卻鮮少獲得學界或業界的關注，究竟護理人員如何詮釋交班經驗意義，迄今仍無法從文獻獲知。目的：探討臨床護理人員交班經驗的意涵。方法：本研究採用詮釋現象學，依詮釋循環分析以尋求護理人員交班經驗意義。研究方法包括深度訪談、參與觀察及田野紀錄等資料收集方法。採徵求自願者及滾雪球方式進行收案，總共26位受訪者均是目前在醫院從事臨床工作，並與護理同事有交班互動經驗的護理師。結果：交班經驗呈顯台灣護理人員在單位中自我轉化、適應及自我安頓的生存奮鬥樣貌。台灣護理人員交班經驗意涵可以用三個主題來說明：(1)接力完成團體照顧任務、(2)共同承擔連帶責任、(3)既是經驗傳承也是權力展演。結論／實務應用：台灣臨床護理人員交班經驗之知識可提供護理人員理解交班互動現象，並做為擬定在職教育或解決臨床交班互動問題之參考。

Background: The process of changing shifts requires that clinical nurses engage in critical communication and interaction activities. Little research has examined the shift-change phenomenon. How Taiwanese nurses interpret their lived shift-change experiences deserves further exploration. Purpose: This study explores the meaning of the shift-change experiences of nurses in Taiwan. Methods: A hermeneutic phenomenological design was used. Data from interviews, participant observations, and field notes were analyzed. Twenty-six nurses with shift-change experience volunteered in a snowball sampling process. Data were collected using in-depth interviews. Hermeneutical analysis was used to explain the meaning of the nursing shift-change experience. Results: The shift-change experiences of participants revealed their existential meaning and struggles toward self-transformation, adaptation, and self-settlement for survival. The meaning of the shift-change experience of clinical nurses in Taiwan are characterized by three themes: (a) 'A relay for accomplishing collective nursing goals', (b) 'An associated duties to be carried out jointly', and (c) ‘An experience transmission as well as power practice'. Conclusion/Implications for Practice: Our study highlights the cultural implications and existential meaning of the clinical shift change experience to nurses in hospitals in Taiwan. These findings provide a better understanding of the nursing shift-change experience in terms of both practical issues and nurses' perceptions. Findings may be used to improve in-service training programs and to suggest solutions to problems encountered during the shift-change period.