二十一世紀台灣護理面對的挑戰

The Challenges the Nursing Profession in Taiwan in facing the 21st Century

面對總額預算實施以來，醫療院所在健保給付壓力下，大幅縮減護理人力，加上整體護理人力供需失衡，讓護理人員的薪酬與工作壓力不成比例，一連串嚴重的醫療疏失與新興傳染病的肆虐，讓護理人員的執業風險受到前所未有的衝擊。如果危機就是轉機，我們可以從幾個層面來討論，藉由回顧過去、檢視現在、放眼未來，再創造護理專業的價值：(1)護理教育問題：培養具備對生命尊重的價值觀與高尚的職業倫理道德，以及主動關懷社會與志工服務的精神。(2)護理人力供需問題：以護理專業角色為基礎，促進人力資源政策與計畫，收集資料與監控護理人力供需狀況。(3)護理人員對政治的意識不足：主動爭取讓護理界有權參與制訂有關護理薪酬、福利的諮詢及決策權，還要有權參與分配有關醫療資源與參與制訂有關護理的教育及服務的政策。(4)護理專業能力的提升：改善及增加繼續教育的品質與機會，建立一個對護理人員實行臨床工作審核的系統管制、採取適當的督導、監察及評估措施，以促進護理的發展和提高護理素質。(5)護理專業的不可取代性：思考我們的核心價值是哪些？以新思維拓展專業角色與功能。

Since the implementation of the national budget-based reimbursement plan by Taiwan's NationalHealth Insurance, nursing manpower has largely reduced across all medical facilities. Theproblem was further exacerbated by the fact that there had been an oversupply of nurses in thelabor market. As a result, nurses in Taiwan today are facing a situation where the salary scale andthe workload are disproportionate. In addition, recent highly publicized malpractice incidents anddeliberate epidemics of emerging infectious diseases have made the nurse's job risk subject tounprecedented impact.The most important question that nurses face now is how to turn this crisis into an opportunity.This paper will discuss how to recreate the professional value of nursing for the 21st century byreviewing the past, examining the current situation, and visualize the future. The author addressesfive major issues that the nursing profession needs to tackle and provides insights into strategiesthat can help deal with these issues.The five major issues are: (1) the nursing education problem, (2) the supply and demandproblem of nursing manpower, (3) the lack of political sensitivity among nurses, (4) increasing theprofessional capability of nurses, and (5) the irreplaceability of the nursing profession.