護理人員願意投入和留任醫院執業之工作條件與彈性制度探討

An Exploration of Working Conditions and Flexible System for Hospital Nurses

背景：護理人力短缺一向是台灣臨床照護的重要議題，此議題與護理人員期望的工作條件有關。目的：探討影響護理人員留任的工作條件和彈性制度。方法　第一階段以文獻查證及焦點團體座談，擬定「護理人員工作條件與彈性制度調查表」共113項，第二階段進行抽樣調查，共發出問卷1,150份，回收1,146份，回收率99.65%。結果　本研究顯示，護理人員願意投入和留任醫院執業的工作條件和彈性制度為職能、數量、區隔、時間、薪資和領導彈性六大因素，總平均值為4.35（SD 0.42），六構面平均值皆在4分以上，表示具重要性。護理人員在醫院層級、醫院所在區域、年齡、學歷、職稱、工作單位和護理總年資，與六大構面中之某些構面具有顯著差異。結論／實務應本研究結論為護理人員留任與醫院執業工作條件和彈性制度相關。醫院管理者和護理主管應開創合適之工作條件和彈性制度，以促進護理人員留任與職涯發展。

Background: The lack of sufficient numbers of professional nurses in the healthcare system in Taiwan is an issue that affects the sustainability of this system and that relates closely to working conditions. Purpose: The present study explores the expectations that nurses hold with regard to working conditions and the operation of a flexible system in hospitals. Methods: A literature review and focus-group interviews were used to develop the questionnaire Working Conditions and Flexible System. A total of 1,150 copies of this questionnaire were distributed to practicing nurses using stratified random sampling, with 1,146 valid copies returned for a valid recovery rate of 99.65%. Results: The results show that the expectations of participants concerning working conditions and a flexible system focus on the 6 factors of task, numerical, divisional, temporal, wages, and leading flexibility. The total mean was 4.35 (SD=0.42). The means for the 6 types of flexibility were all greater than 4.0. Participants deemed flexibility to be of high importance. The demographic variables hospital, work location, age, education level, work position, work unit, and total work years all affected the 6 types of flexibility significantly. Conclusions: The present study supports that the retention of nurses is significantly associated with working conditions and the operation of a flexible system. Administrators and mangers must create positive working conditions and a flexible system in order to enhance the retention and career development of nurses.