中山管理評論

  期刊全文閱覽

中山管理評論  2018/6

第26卷第2期  p.211-238

DOI:10.6160/SYSMR.201806_26(2).0003


題目
探討新進護理人員職場導師制度之負面經驗
Exploring the Negative Experience of Mentoring Programs among New Nurses
(139_M5b2c54f732a39_Full.pdf(檔案不存在))

作者
黃靖媛、吳宗晉、翁瑞宏、蔡育真/樹德科技大學國際企業與貿易系、台南市立醫院管理部及嘉南藥理大學醫務管理系、國立金門大學長期照護學系、台南市立醫院護理部
Ching-Yuan Huang, Tsung-Chin Wu, Rhay-Hung Weng, Yu-Chen Tsai/

Department of International Business and Trade, Shu-Te University; Department of Administration, Tainan Municipal Hospital & Department of Hospital and Health Care Management, Chia Nan University of Pharmacy and Science; Department of Long Term Care,


摘要(中文)

背景:職場導師制度對於新進護理人員是一個非常重要的制度,此制度可使新進護理人員降低角色轉換及對新環境的不適應,然此制度亦可能會產生負面經驗,但國內卻甚少針對此議題進行研究。目的:探討新進護理人員職場導師制度會產生的負面經驗,並將結果建立完整之職場導師負面經驗理論。方法:以兩家區域醫院服務未滿一年之20位新進護理人員為訪談對象,並採用紮根理論進行資料分析。結果:研究結果經由20位受訪者逐字稿,從開放性編碼的160個負面經驗語幹中,經由主軸編碼編成12個類別,最後從主軸編碼的12個類別,經過選擇編碼發展成五大構面「制度構面」、「導師構面」、「護理主管構面」、「其他醫療人員構面」、「導生構面」。結論與建議:當負面經驗產生後,對職場導生所造成的影響結果為離職、主管介入處理、更換導師、自己忍耐下來或造成導生陰影;職場導師制度負面經驗建議可分別從職場導師的配置、職場導師制度指導時間、職場導師的任用資格等面向來進行改善。

(139_M5b2c54f732a39_Abs.pdf(檔案不存在))

關鍵字(中文)

職場導師制度、負面經驗、導師、導生、護理人員


摘要(英文)

Background: Mentoring program is crucial for the newly employed nurses in Taiwan. This program can facilitate to reduce the maladjustment of newly employed nurses during role transformation from one position to another and their discomfort toward new environments. However, mentoring program can also bring negative experiences. There has not been any domestic investigation on this issue yet. Objectives: This research was aimed to investigate the negative experiences generated in the implementation of mentoring program to the newly employed nurses. The results will be established as a theory of negative experiences in the mentoring program at workplace. The findings are provided as a reference to help the development of mentoring program in nursing sectors. Methods: The subjects of this research were twenty newly employed nurses servicing at their positions for less than one year at two regional hospitals in southern Taiwan. We used had a thirty to sixty minutes to make in-depth interview with each nurse, utilized semi-structure questionnaire as the way for data collection, and adopted grounded theory for data analysis. Results: Based on the data collected from the interviews of the twenty subjects, the results of this research were derived from the 160 negative thematic experiences and were compiled into 12 categories through axial coding. The twelve categories can be further developed into five main dimensions through selected encoding scheme. The five main dimensions are Institutional Dimension, Mentor Dimension, Nursing Supervisor Dimension, Other Medical Staff Dimension, and Mentee Dimension. Institutional Dimension includes Hospital System, Factor of the Mentoring Program, and Factor of Education System. Conclusion and Suggestion: The negative experience occurred to the mentee at workplace can result in leaving from the job position, manager intervention, mentor replacement, self-suffering and shadow upon the mentee. Negative experiences of mentoring program include five main dimensions (Institutional Dimension, Mentor Dimension, Mentee Dimension, Nursing Supervisor Dimension and Other Medical Staff Dimension). It is suggested that the negative experience in mentorship can be reduced by improving mentor assignment at workplace, mentor guidance time, and the qualification and competence of the mentor.

(139_M5b2c54f732a39_Abs.pdf(檔案不存在))

關鍵字(英文)

Mentoring Program, Negative Experience, Mentor, Mentee, Nurse


政策與管理意涵

過去國內管理領域研究大多著重在如何職場導師制度功能的發揮,甚少深入探討在此制度實施的過程中,對於新進護理人員所造成的負面經驗。因此,本研究結果不僅可以做為未來改善醫院職場導師制度之重要依據,亦可強化國內人力資源管理、組織行為以及教育訓練實務與理論之完整性。 近來國內新進護理人員離職率偏高,本研究發現當新進護理人員對職場導師制度產生負面經驗後,對其所造成的影響為離職、自己忍耐下來或造成導生陰影,因此研究結果不僅可協助管理者了解職場導師制度負面經驗內涵及其對於新進護理人員的影響,更得以讓管理者得以充分掌握後續職場導師制度改善的方向,降低新進護理人員離職率。此外,本研究結果從原因條件、介入條件到產生負面經驗,及負面經驗對於職場導生的後續影響,建立出一套完整且可供後續驗證的理論,亦可作為未來醫務管理、人力資源管理與組織行為學者進行職場導師制度負面經驗量表發展與實證架構建立之重要參考。 本研究發現職場導師制度產生的負面經驗包含制度構面、導師構面、導生構面、護理主管構面、其他醫療人員等五大構面,而後續職場導師制度可改進的方向包含職場導師的配置、職場導師制度指導時間、職場導師的任用資格等面向。在職場導師的配置方面建議在指導時間內,導生與導師的班別盡量安排在同一個班別,才不會造成導生要適應過多職場導師的教導方式;在職場導師指導時間方面:建議指導時間至少要三個月,但如果已有經驗的導生,可視導生學習情況而定;在導師任用資格方面,建議職場導師應任用N2以上護理師較為恰當,此外也建議至少應經過教育訓練才能擔任職場導師這個角色,在進行導師教育訓練時,除了告知導師如何教導導生外,亦可舉辦溝通議題相關的演講讓導師了解與導生如何溝通,最後,導師除教導護理技術外,亦須教導導生參與醫療團隊的注意事項,找出與醫療團隊成員相處方式。


參考文獻

尹裕君,2010,「護理臨床教師制度」,榮總護理,27卷3期:219~224。(Yin, Y. U., 2010, “Preceptorship in Nursing,” VGH Nursing, Vol. 27, No. 3, 219-224.)
王守玉、Carol W、Patsy Yates,2012,「簡介紮根理論研究法」,護理雜誌,59卷1期:90~94。(Wang, S. Y., Carol, W., and Patsy, Y., 2012, “Introduction to Grounded Theory,” The Journal of Nursing, Vol. 59, No. 1, 90-94.)
王桂英、周傳姜、黃瑞蘭,2010,「臨床護理人員工作價值觀、專業承諾與離職傾向及其相關因素之探討」,護理雜誌,57卷1期:22~34。(Wang, K. Y., Chou, C. C., and Huang, J. L., 2010, “A Study of Work Values, Professional Commitment, Turnover Intention and Related Factors among Clinical Nurses,” The Journal of Nursing, Vol. 57, No. 1, 22-34.)
何紀嫻、游金靖、陳晴薇、劉惠瑚,2012,「提升護理臨床教師之教學意願方案」,長庚護理,23卷2期:186~196。 (Ho, C. H., Yu, C. C., Chen, C. W., and Liu, H. H., 2012, “Improving the Teaching Willingness of Preceptors,” Chang Gung Nursing, Vol. 23, No. 2, 186-196.)
吳秀麗、吳美淑、黃惠君、劉力算、林美華,2009,「降低新進護理人員離職率之方案」,安泰醫護雜誌,15卷3期:164~175。(Wu, S. L., Wu, M. S., Huang, H. C., Liuo, L. S., and Lin, M. H., 2009, “Program to Reduce the Turnover Rate of New Nursing Staff,” T.S.M.H Medical & Nursing Journal, Vol. 15, No. 3, 164-175.)
李怡真、高毓秀,2012,「護理臨床教師教育訓練需求評估」,護理暨健康照護研究,8卷2期:27~37。(Lee, Y. C. and Kao, Y. H., 2012, “Clinical Nursing Preceptor Educational Training Needs: An Assessment,” Journal of Nursing and Healthcare Research, Vol. 8, No. 2, 27-37.)
李皎正、鍾聿琳,2012,「談護理臨床教育」,護理雜誌,59卷5期:5~9。(Lee, J. and Chung, L. U., 2012, “Clinical Nursing Education,” The Journal of Nursing, Vol. 59, No. 5, 5-9.)
李選、張婷,2012,「台灣護理專業對教考用失衡議題之省思」,護理雜誌,59卷5期:16~23。(Lee, S. and Chang, T., 2012, “A Taiwan Nursing Perspective on Current Imbalances in Educating, Licensing and Hiring New Nurses,” The Journal of Nursing, Vol. 59, No. 5, 16-23.)
林本炫,2003,「紮根理論研究法評介」,嘉義縣:南華大學教育社會所。(Lin, P. H., 2003, Grounded theory Research, Chiayi County, Department of Applied Sociology & Institute of Sociology.)
林佳暖,2005,師徒關係與組織承諾,國立中央大學人力資源管理研究所碩士論文。(Lin, C. N., 2005, Mentoring Function and Organization Commitment, Master Thesis, National Central University.)
林郁汶、陳玉枝、高毓秀,2012,「護理臨床教師自覺教學效能之探討—以北部某醫學中心為例」,護理暨健康照護研究,8卷1期:70~79。(Lin, Y. W., Chen, Y. C., and Kao, Y. H., 2012, “Effect of Self-Evaluation on Teaching Efficacy in Clinical Nursing Preceptors: An Example of a Medical Center in Northern Taiwan,” Journal of Nursing and Healthcare Research, Vol. 8, No. 1, 70-79.)
林瑜雯、莊子萱、劉曦宸、陳韻柔、陳富莉,2011,「從醫療職場工作特質探討醫院護理長與臨床護理人員之工作壓力源」,臺灣公共衛生雜誌,30卷3期:245~256。(Lin, Y. W., Chuang, T. H., Liu, H. C., and Chen, Y. J., Chen, F. L., 2011, “Exploring Job Stressors for Head Nurses and Clinical Nurses from the Perspective of Their Job Characteristics,” Taiwan Journal of Public Health, Vol. 30, No. 3, 245-256.)
徐木蘭、張國偉、林建江、安寶儀,2009,「《韓非子》與西方人力資源管理內涵之系統性比較」,管理學報,26卷2期:167~188。(Hsu, M. L., Chang, K. W., Lin, C. C., and Ann, B. Y., 2009, “A Holistic Comparison between Han-Fei-Tzu and Western Human Resource Management Thoughts,” Journal of Management, Vol. 26, No. 2, 167-188.)
袁旅芳、盧美秀、徐美玲、陳品玲,2001,「護理長衝突來源及衝突處理型態之探討」,新臺北護理期刊,3卷2期:9~19。(Yuan, L. F., Lu, M. S., Shyu, M. S., and Chen, P. L., 2001, “A Survey of Conflict Sources and Types of Conflict Management among Head Nurses in Taipei,” New Taipei Journal of Nursing, Vol. 3, No. 2, 9-19.)
馬淑清、王秀紅、陳季員,2011,「職場霸凌的概念分析」,護理雜誌,58卷4期:81~86。(Ma, S. C., Wang, H. H., and Chen, J. Y., 2011, “Concept Analysis of Workplace Bullying,” The Journal of Nursing, Vol. 58, No. 4, 81-86.)
張媚、余玉眉,2010,護理人力及專科護理師制度:願景與挑戰,台北市:國家衛生研究院。(Chang, M. and Yu, Y. M., 2010, Nurse Workforce & Nurse Practitioner System: Vision and Challenges, Taipei city, National Health Research Institutes.)
張慧蘭、盧美秀、林秋芬,2010,「應屆畢業新進護理人員離職相關因素之探討」,醫護科技期刊,12卷3期:161~172。(Chang, H. L., Lu M. S., and Lin, C. F., 2010, “Factors Related to New Nursing Staff Turnover Rates,” The Journal of Health Sciences, Vol. 12, No. 3, 161-172.)
陳向明,2009,社會科學的研究,初版,台北市:五南圖書。(Chen, S. M., 2009, The Practice of Social Research, 1st, Taipei city, Wunan.)
陳怡莛,2009,探討轉換型領導與人際互動對新進護理人員職場導師功能之影響。嘉南藥理科技大學醫療資訊管理研究所碩士論文。(Chen, Y. T., 2009, Exploring the Impact of Transformational Leadership and Interpersonal Interaction on Mentoring Function of New Staff Nurses, Master Thesis, Chia Nan University of Pharmacy and Science.)
陳雅玲、許麗齡、謝素英,2012,「Clinical Nurse Preceptor Teaching Competencies: Relationship to Locus of Control and Self-directed Learning」,護理研究,20卷2期:142~151。(Chen, Y. L., Hsu L .L., and Hsieh S. I., 2012, “Clinical Nurse Preceptor Teaching Competencies: Relationship to Locus of Control and Self-directed Learning,” The Journal of Nursing Research, Vol. 20, No. 2, 142-151.)
馮明珠、陳幼梅、吳玲琨、吳鈴珠,2011,「三個月內新進護理人員感受護理臨床工作之壓力與因應經驗」,護理暨健康照護研究,7卷2期:98~107。(Feng, M. C., Chen, Y. M., Wu L. K., and Wu, L. C., 2011, “Perceived Stress and Coping Strategies of Newly Graduated Nurses,” Journal of Nursing and Healthcare Research, Vol. 7, No. 2, 98-107.)
黃靖媛,2008,職場導師制關係效能之前因與成效,國立中正大學企業管理系博士論文。(Huang, C. Y., 2008, Exploring the Antecedents and Consequences of Mentoring Relationship Effectiveness, Ph. D. Dissertation, National Chung Cheng University.)
黃靖媛,2012,為何職場導師制度不成功?探索職場導師關係負面經驗,行政院國家科學委員會專題研究計畫成果報告,計畫編號:NSC 100-2410-H-366-003-。(Huang, C. Y., 2008, Why Mentoring Dysfunctional? Exploring the Negative Experiences of Mentoring Relationship, National Science Council Research Report. Project Number NSC 100-2410-H-366-003-. Tainan: National Science Council, Executive Yuan, R.O.C. (Taiwan), 2012. [In Chinese])
楊斐卿、歐惠容、唐紀絜,2011,「某醫學中心推行護理臨床教師制度之評價」,榮總護理,28卷1期:8~16。(Yang, F. C., Ou Y. J., and Tang C. C., 2011, “Effectiveness of a Clinical Preceptor Program in a Medical Center,” VGH Nursing, Vol. 28, No. 1, 8-16.)
葉麗月,2009,護理臨床教師指導新進人員之意願與相關因素,中國醫藥大學醫務管理系碩士論文。(Yeh, L. Y., 2009, Willingness and Associated Factors for Preceptors to Guide New Staff Nurses, Master Thesis, China Medical University.)
劉文琪,2010,「護理主管對護理臨床指導教師角色期待之初探性研究」,志為護理-慈濟護理雜誌,9卷3期:82~91。(Liu, W. C., 2010, “A Pilot Study on Nursing Supervisors' Expectations toward Nursing Clinical Preceptor's Roles,” Tzu Chi Nursing Journal, Vol. 9, No. 3, 82-91.)
劉向援、黃美智、李引玉、王文玲、駱麗華,1994,「護理臨床教師制度於大學護理教育之推廣」,護理雜誌,41卷1期:79~87。(Liu, S. Y., Lee, Y. Y., Lo, L. H., Huang, M. C., and Wang, W. L., 1994, “Development of Preceptorship Program in Baccalaureate Nursing Education,” The Journal of Nursing, Vol. 41, No. 1, 79-87.)
劉宜芳,2007,「資深的印記 臨床護理輔導員」,志為護理-慈濟護理雜誌,6卷5期:56~56。(Liu, Y. F., 2007, “The Medal of Honor of Being a Preceptor,” Tzu Chi Nursing Journal, Vol. 6, No. 5, 56-56.)
蔡曉婷、宋雅雯、鄒理萍、黃夢婷、黃敏瑢、邱啟潤,2011,「護理職場霸凌的因應方式」,護理雜誌,58卷4期:87~92。(Tsai, S. T., Sung, Y. W., Tzou, L. P., Huang, M. T., Hwang, M. R., and Chiou, C. J., 2014, “Coping Strategies: Bullying in the Nursing Workplace,” The Journal of Nursing, Vol. 58, No. 4, 87-92.)
謝淑惠、許玲女、蔡文正,2007,「96年度台灣護產人員繼續教育及留任措施試辦」,台北:行政院衛生署。(Hsieh, S. H., Hsu, L. N., and Tsai, W. C., 2007, 2007 Taiwan’s Production of Protective Measures Remain in Continuing Education and Pilot Subsidy Program, Taipei city, Department of Health, Executive Yuan.)
Benner, P., 2012, “Educating Nurses: A Call for Radical Rransformation-how Far have We Come?” Journal of Nursing Education, Vol. 51, No. 4, 183-184.
Burk, H. G. and Eby, L. T., 2010, “What Keeps People in Mentoring Relationships when Bad Things Happen? A Field Study from the Protege's Perspective,” Journal of Vocational Behavior, Vol. 77, No. 3, 437-446.
Eby, L. T., McManus, S. E., Simon, S. A., and Russell, J. E. A., 2000, “The Protege's Perspective Regarding Negative Mentoring Experiences: the Development of A Taxonomy,” Journal of Vocational Behavior, Vol. 57, No. 1, 1-21.
Eby, L., Buits, M., Lockwood, A., and Simon, S. A., 2004, “Protégés' Negative Mentoring
Experiences: Construct Development and Nomological Validation,” Personnel Psychology, Vol. 57, No. 2, 411-447.
Eby, L. T., Butts, M. M., Durley, J., and Ragins, B., 2010, “Are Bad Experiences Stronger than Good Ones in Mentoring Relationships? Evidence from the Protege and Mentor Perspective,” Journal of Vocational Behavior, Vol. 77, No. 1, 81-92.
Eby, L. T. and McManus, S. E., 2004, “The Protege's Role in Negative Mentoring Experiences,” Journal of Vocational Behavior, Vol. 65, No. 2, 255-275.
Edwards, S. L. and O'Connell, C. F., 2007, “Exploring Bullying: Implications for Nurse Educators,” Nurse Education in Practice, Vol. 7, No. 1, 26-35.
Ensher, E. A. and Murphy, S. E., 2011, “The Mentoring Relationship Challenges Scale: the Impact of Mentoring Stage, Type, and Gender,” Journal of Vocational Behavior, Vol .79, No.1, 253-266.
Glaser, B. and Strauss, A., 1967, The Discovery of Grounded Theory: Strategies for Qualitative Research, 1st, Chicago: Aldine.
Harrington, S., 2011, “Mentoring New Nurse Practitioners to Accelerate Their Development as Primary Care Providers: A Literature Review,” Journal of the American Academy of Nurse Practitioners, Vol. 23, No. 4, 168-174.
Hayes, E. F., 2005, “Approaches to Mentoring: How to Mentor And Be Mentored,” Journal of the American Academy of Nurse Practitioners, Vol. 17, No. 11, 442-445.
Henderson, A., Fox, R., and Malko-Nyhan, K., 2006, “An Evaluation of Preceptors' Perceptions of Educational Preparation and Organizational Support for Their Role,” Journal of Continuing Education in Nursing, Vol. 37, No. 3, 130-136.
Hill, L. A. and Sawatzky, J. V., 2011, “Transitioning into the Nurse Practitioner Eole through Mentorship,” Journal of Professional Nursing, Vol. 27, No. 3,161-167.
Huang, C. Y. and Weng, R. H., 2012, “Exploring the Antecedents and Cconsequences of Mentoring Relationship Effectiveness in the Healthcare Environment,” Journal of Management & Organization, Vol. 18, No. 5, 685-701.
Hutchinson, M., Jackson, D., Wilkes, L., and Vickers, M. H., 2008, “A New Model of Bullying in the Nursing Workplace: Organizational Characteristics as Critical Antecedents,” Advances in Nursing Science, Vol. 31, No. 2, 60-71.
Huybrecht, S., Loeckx, W., Quaeyhaegens, Y., De Tobel, D., and Mistiaen, W., 2011, “Mentoring in Nursing Education: Perceived Characteristics of Mentors and the Consequences of Mentorship,” Nurse Education Today, Vol. 31, No. 3, 274-278.
Kram, K. E., 1985, Mentoring at Work: Developmental Relationships in Organizational Life, 1st, Glenview: Scott Foresman.
Lewis, M. A., 2006, “Nurse Bullying: Organizational Considerations in the Maintenance and Perpetration of Health Care Bullying Cultures,” Journal of Nursing Management, Vol. 14, No. 1, 52-58.
Noe, R. A., 1988, “Women and Mentoring: A Review and Research Agenda,” Academy of Management Review, Vol. 13, No.1, 65-78.
Scandura, T. A., 1992, “Mentorship and Career Mobility: An Empirical Investigation,” Journal of Organizational Behavior, Vol. 13, No. 2, 169-174.
Simons, S., 2008, “Workplace Bullying Experienced by Massachusetts Registered Nurses and the Relationship to Intention to Leave the Organization,” Advances in Nursing Science, Vol. 31, No. 22, 48-59.
Weng, R. H., Huang, C. Y., Tsai, W. C., Chang, L. Y., Lin, S. E., and Lee, M. Y., 2010, “Exploring the Impact of Mentoring Functions on Job Satisfaction and Organizational Commitment of New Staff Nurses,” BMC Health Services Research, Vol. 1, No. 10, 240.