The Scope of Practice of Nurses and Midwives ─On Whether Clinics Need Registered Nurses

我國專科護理師除了可執行包含醫療輔助行為的一般護理人員執業範圍，及專科護理師之執業範圍外，並得於醫師監督下執行醫療業務，也就是說專科護理師目前已合法取得醫療主要行為權。

依照衛生福利部民國65年6月14日衛署醫字第116053號函解釋：醫療工作之診斷、處方、手術、病歷記載、執行麻醉等醫療行為，應由醫師親自執行，其餘醫療工作得在醫師親自指導下，由輔助人員為之，但該行為所產生之責任，應由指導醫師負責。所謂醫師之輔助人員，係指在醫師指導下協助醫師為醫療行為之人員，其資格尚無特別限制。但民國77年1月29日衛署醫字第708878號函釋：依民國75年12月26日修正公布之醫師法第28條但書之新規定，所謂醫師之輔助人員，應以具有護士、助產士或其他醫事人員資格者為限，從而非醫事人員，包括助理護士即不得執行任何醫療輔助行為。

一般開業診所需不需要登記護理人員？若診所只有1名醫師，又未接生，又未設門診手術室，也不作人工流產手術者，按法規是可以不必登記護產人員，可由助理護士從事單純的掛號、收費、跟診等行政工作；惟仍應符合護理人員專業法規或有關法令之規定，否則任由「未取得護理人員資格，執行護理人員業務者，本人及其雇主各處新台幣一萬五千元以上十五萬元以下罰鍰。」

In addition to performing assist medical practices traditionally sanctioned for nurses and for its own profession, nurse practitioners in Taiwan can now perform additional main medical practices under physician supervision. That is, they have acquired the legal right to perform main medical practices.

In accordance with the Department of Health’s 1976 regulation, medical diagnosis, prescription writing, surgery, completing medical records, and anesthesia should be performed by physicians personally. Other medical work may be performed by assistants under the supervision of physicians. Liability arising from these acts should be borne by the physician in charge. Physician assistants support physicians’ medical practice and do not have special qualification requirements.

In 1988, the Department of Health issued new regulations in accordance with the newly amended Physicians Act Article 28 and defined physician assistants as qualified nurses, midwives or other medically qualified personnel, so non-medical personnel, including nurse assistants, cannot perform any medical support work.

Are medical clinics required to employ registered nurses? According to regulations, clinics that have only one physician, do not perform deliveries or abortions, and do not have outpatient operating rooms are not required to register nursing staff. Having nursing assistants who only perform the tasks of registration, payment, and other administrative work is in compliance with professional nursing or related laws and regulations. Performing nursing services without adequate qualification, however, may result in a fine of NT$15,000 to NT$150,000 each on the nurse and employer.