從後現代主義反思新手護理師之留任

Reflecting on Intention to Stay of New Nurses from Postmodernism

護理人力短缺的年代，新進人員能否留任成為重要的關鍵點，新手護理師進入臨床後，面臨一連串現實休克震撼(reality shock)，因應前所未有的壓力與角色轉換過程，傳統的帶領新人制度備受質疑與挑戰，新進人員離職率若持續居高不下，進一步加劇低落的工作氣氛與離職的惡性循環。現今護理管理中強調「以學員為中心」的「夥伴關係」，身為護理主管必須改變，並認清夥伴關係的意涵。本文試圖以後現代主義「去中心(decentralization)」、「多元(multiplicity)」、「互為主體性(inter-subjectivity)」、「解構(deconstruction)」的中心概念，反思新人面臨現實休克階段之留任管理模式，藉由觀念改變、角色改變、方法改變，協助新人走過休克期(shock)、拒絕期(rejection)及恢復期(resolution)三階段，期能提供管理者思考與改革新人留任措施，共創「優質執業環境」，以補足護理人力的缺口。

The intention to of new nurses to stay in their position is an important issue for manpower shortages nowadays. New nurses have to confront a series of reality shocks, heavy stress, and role-change process. This is the reason that traditional training systems receive much criticism and face many challenges. When staff turnover rate is high, work ambiance will become worse and result in more nurses leaving hospitals. As nursing management implies emphasizing member-center partnership, managers must make changes and realize the meaning of this partnership. This article uses postmodernism concepts such as decentralization, multiplicity, inter-subjectivity and deconstruction to reflect the new nurses management system during their reality shock period. Moreover, the article aims to help new nurses overcome crises from three stages including the shock period, rejection period, and resolution period through changing notions, roles and methods. This article also serves as a reference for managers to reform retaining measures for new nurses and establish (more) positive work environments.