專科護理師的角色功能與人資管理之展望

Outlooks for the nurse practitioners' role functions and human resource management

台灣人口老化情況日益嚴重，對高品質的健康照護需求殷切，再加上醫療給付制度與醫學教育的變革，致使住院醫師人力不足、工時超長等過勞現象。而醫師人力需求難以短時間供給，各醫院管理階層為符合評鑑基準、解決醫師人力缺口及節省醫療成本之考量，大量招聘及培訓專科護理師作為臨床醫療之替代人力。因應上述醫療環境的變化，衛生福利部於2016年1月1日公告施行「專科護理師於醫師監督下執行醫療業務辦法」，拓展專科護理師之執業範疇，使專科護理師能在規範下合法執行醫療業務。隨著專科護理師角色功能與執業範疇的拓展，醫療院所對稱職專科護理師的需求日益殷切，專科護理師的執業人數也隨之快速成長，逐漸成為各醫療院所不可或缺的專業人才。然而目前專科護理師的執業現況仍有許多困境與挑戰有待進一步改善與解決，因此，筆者分別就專科護理的角色定位、醫護領域對專科護理師角色功能期待之差異、醫護共管模式之困境與挑戰、以及合理合法的執業內涵與工作負荷進行剖析，期能藉由本文提升讀者對專科護理師的角色功能與人資管理現況與展望的了解與正視，進而創造專科護理師更優質的工作環境，使能全力發揮此一進階護理角色功能以符合各界之殷切期待。

The need for high quality healthcare has been increasing due to an aging population in Taiwan. Moreover, reforms in healthcare insurance policies and the medical education system have resulted in a staffing shortage and a work overload for resident physicians. The demand for physicians cannot be fulfilled in such a short period to come; therefore, a great number of nurse practitioners were recruited by medical centers as temporary workforce substitutes to meet the standards of the medical survey, solve the insufficiency of resident physicians, and save healthcare costs. Due to current changes in the healthcare environment, the Ministry of Health and Welfare has developed and enacted the regulation “Nurse Practitioners Performing Medical Practice under Supervision of Physicians' on January 1, 2016. This regulation expands the scope of practice for nurse practitioners and allows them to perform medical practice legitimately. The expansion of scope of practice and role function of nurse practitioners result in a rapid increase in the demand of nurse practitioners. Currently, existing difficulties and challenges in the daily practice of nurse practitioners still need to be resolved. Therefore, the author attempts to address and analyze the following subjects: roles of nurse practitioner, variance of role function between medical clinicians and nursing practitioners, difficulties and challenges of a dual management model, and the reasonable legitimate workload and scope of practice for nurse practitioners. We hope to bring them up for readers' understanding and attention to the current situation, as well as for the outlook of the role function of nurse practitioners in Taiwan. Furthermore, we can create a better work environment for nurse practitioners to perform their expected role functions and broaden the scope of practice in their specialties.