護理督導理想角色之初探
A Preliminary Study of the Role of Nursing Supervisor
中文摘要
論文名稱：護理督導理想角色之初探 研究所名稱：臺北醫學大學護理學研究所 研究生姓名：黃素珍
畢業時間：九十一學年度第一學期 指導教授：盧美秀 臺北醫學大學教授 魏玲玲 臺北醫學大學助理教授
21 世紀是個充滿挑戰之三 C 時代，醫院在組織扁平化精簡人事過程 中，護理督導成為首要之扁平對象，對護理界造成重大衝擊！故護理督 導角色之存廢與否，成為極重要的議題。因此，本研究之目的乃在瞭解 護理主管與非護理主管對護理督導理想角色之看法，探討是否為護理主 管與對護理督導理想角色看法之差異情形，並建構護理督導的理想角色 與功能。本研究以橫斷面調查的研究方式，採立意取樣，以同意接受本 研究之臺北市公私立區域醫院之護理部主任、督導、護理長等護理主管 與醫院院長、副院長、醫療科及一般行政科室主任等非護理主管為研究 對象，並以SSIZE 統計軟體設定 α=0.05，檢力為 95%，估算出樣本數為 350 人。採自擬之結構性問卷並配合深度訪談收集資料，研究工具包括：
對護理督導理想角色之認同程度問卷和個人屬性二部份；共發出問卷464
份，回收問卷387 份，有效問卷 378 份，有效回收率 81.5%。
研究結果發現：護理主管與非護理主管共同認為有20 項主要的與 27 項次要的
理想角色功能為護理督導應具備的角色與功能，總平均值3.948。此外，性別、
職稱、有無接受教育訓練及醫院屬性等四個因素與對督導理想角色之認同度有關 經進一步將該四個因素考慮後，「職稱即是否為護理主管與醫院屬性」仍與認同 有關。
本研究的結果，能提供醫院決策者進行組織再造、職位再造與制訂由護理督導改 任師(二)級護理師之角色功能及人力資源整合時的參考。
建議相關單位可據此爭取恢復並保留護理行政組織分級中之「督導」職位，以及 醫院仍應設立固定比例之具有督導功能之師（二）級護理師人員擔任督導角色，
並建議此護理督導之理想角色可由台北市政府衛生局所屬各市立醫療院先試行，
依成效再逐步推廣，但每位督導需先接受相關之行政管理在職教育訓練，強化 應具備之「業務運作、團隊合作與促進組織及自我成長等」核心能力，提昇競爭
力，方能扮演好此一21 世紀所需之理想督導角色，以發揮應有之獨特功能。
關鍵字：護理督導、角色功能、核心能力 英文摘要
Title of thesis : A preliminary study of the role of nursing supervisor Institution: Graduate Institute of Nursing, Taipei Medical University Author : Huang, Su-Chen
Thesis directed by : Lu, Meei-Shiow Professor Wei, Ling- Ling Assistant Professor
The 21st century heralds the challenging three-C era. The significance of supervising positions in the nursing world has become the subject of scrutiny. This study therefore seeks to understand nurse managers’ and non-nurse managers’ views on the ideal role of nursing supervisors, and explore any differences between these views, in order to define the ideal role and function of nursing supervisors. This cross-sectional study applied purposive sampling to select subjects from public and private regional
hospitals in Taipei that agreed to cooperate with the researchers. Subjects consisted of the heads of nursing departments, nursing supervisors, head nurses and non-nurse supervisors such as hospital directors, assistant hospital directors, heads of health departments and heads of administrative departments. The study’s alpha-coefficient and power were calculated using SSIZE statistical software (respectively α=0.05, power of the test=95%), while the sample size was 350. Self-evaluation structured questionnaires were used and in-depth interviews taken to collect data. Study tools included an “Ideal Role of Nursing Supervisors Identification Questionnaire” and a Demographic Data Form. A total of 464 questionnaires were distributed, of which 387 were returned and 378 found valid. The valid response rate was 81.5%.
The results of this study found that both nurse managers and non- nurse managers regard 20 main types of ideal roles and functions and 27 sub-types as described in 47 questions on the questionnaire as prerequisites of nursing supervisors, total mean is 3.948. In addition, it was found that there is a correlation between identification of the ideal role of nursing supervisors and four factors (gender, hospital association, job title and received educational training). Even after further control of these four factors (to determine whether the job title was nurse manager), a correlation was still found.
The results of this study can be used by hospital decision makers as a reference for reorganization, repositioning and re-appointment of nursing supervisors as second- level nurse practitioners, as well as for the integration of human resources and so on.
In view of this study, we suggest that the relevant authorities reinstate and/or maintain supervising positions as part of the organizational structure of medical facilities.
Municipal medical centers that fall under the Department of Health - Taipei City Government should start introducing a fixed ratio of second-level nurse practitioners with supervising authority, after which gradual implementation in other areas should be considered, depending on the level of success of the first stage of introduction.
However, anyone in a supervising role should first receive relevant training in
administrative management to improve required core competence (with regard to general operations, team collaboration, organizational and personal development, etc.) and increase competitiveness, in order to be able to function in an ideal supervising role and exhibit a distinctive function within the organization, as is required in the 21st century.
Key words: nursing supervisors, role function, core competence
