賦權於公共衛生實務

Empowerment in the Public Health Practice

公衛護士是預防保健及醫療服務的第一線工作者，面對社會型態及人口組成遽變，賦權及在職訓練成為提升護理人員職能的重要方法。衛生所的角色如同政府的末梢神經，除了在第一線反映社區民眾的需求，也必須將政府傳遞的服務在社區全面推行。雖然衛生所有分布廣闊的優勢，然而人力不足、資訊紊亂則是目前衛生所的弱勢。因此透過賦權及在職訓練可提升公衛護士的知能以因應龐大業務及多角度的發展。本文以臺北縣政府衛生局為例，從四個方向進行衛生所賦權計畫，包括個人培育、組織培育。並加強公衛護士對自我專業價值的認同，而此價值的提升可透過與社區結盟，並建立一種視病猶親的「血緣關係」。最後建議將員工培訓視為機構主管的重要管理工作之一，衛生主管機關應能適時引進組織管理、在職訓練及服務再造等相關企業理念，以適時對人員增能賦權，對事務進行知識盤整，建構符合衛生單位的智慧資本與社會資本，方能創造下個階段的競爭優勢並有效提升公衛護士的知能。

Public health personnel are the first-line workers of preventive care and medical services. In the face of rapid social and demographic changes, empowerment and on-job training have become important approaches to enhance the function of nurses. Health centers act like the “peripheral nerves” of the government healthcare system, as they must both reflect the needs of community residents and fully implement government mandated services. While widely distributed, health centers face manpower shortages and disorderly information collection and distribution systems. Empowerment and on-job training programs can enhance public heath staff knowledge in order to cope with heavy workloads and shift toward multi-dimensional development. This paper examines the experience of the New Taipei City Public Health Bureau in conducting health center empowerment programs from four perspectives, including personal cultivation and organizational cultivation. It was found that public health staff self-recognition of professional values can also be further strengthened through alliances within the community, and that establishing personal relationships with patients by “treating patients as relatives” was effective in realizing health center objectives. This paper also reminds agency supervisors that staff training is a critical management task. Health authorities should thus introduce in a timely manner organizational management, on-job training, service reengineering, and other related corporate philosophies; facilitate staff empowerment; consolidate core professional knowledge; and construct intellectual and social capital that meets health unit needs in order to enhance health center competitiveness and public health staff knowledge.