| 摘要: | 人民有選擇工作、從事工作的自由，包括選擇工作時間、職業類型、工作內容及勞動條件等，為憲法所保障。勞工應有權利與雇主進行約定其工作時間，而面對雇主延長工時之請求，除雇主應有給付加班費之義務外，勞工應有與雇主約定延長工時之自由。勞資關係及經濟力量確實懸殊，可能導致雙方無法在平等立場就勞動條件、工作時間、加班費或薪資等，進行雙方面對等協商，政府為保障勞工權益，故制定勞動基準法，保障勞工權益並賦予雇主義務。
勞動權益及勞動環境為大家所關心的議題，新冠肺炎過後，勞動市場結構出現轉變，人力缺額更是屢創新高。而護理人員更是在疫情後，紛紛出走進而出現離職潮，最大的原因乃是因為護理勞動環境長年不佳，薪資結構更是普遍低下，除此之外，醫療工作改變及人民意識抬頭，民眾對於醫療照護要求日趨增加，加上人力不足的情況下，使得護理人員工作量暴增，休假天數減少，常常需要靠著加班來完成分內工作及自身健康出現警訊，惡性循環下，護理人員選擇離開工作職場。面對護理崩壞，並非藉由勞基法之工時保障可解決其窘困，護理人員工時過長，往往不只有法制面規定，而是醫院雇主適用或歸避或扭曲法規之適用。護理人員不只有醫療專業工作，另有醫療行政等工作量加諸在身上，使得護理人員超時工作，另外，變形的花花班及不合理的護病比，迫使護理人員逃離血汗的白色巨塔，更使得護理職場工作環境惡化，進而影響到病患就診權利及照護品質下降，乃非病人所願。
因此，本文爬梳相關文獻資料，從護理人員工時議題開始討論，進而剖析其護病比、休假制度之相關爭點，並以加拿大護理人員工作法制及現行勞動環境之問題做一比較，期望能找出蛛絲馬跡，借鏡國外做法，以利我國改善護理職場工作之困境，再以文獻整理方式，探討護理人員工作環境之不利因素以及工作條件不佳，並以司法實務判決為佐，讓實務及臨床工作上作為對照並且進一步分析，而護理人員納入勞基法後，並排除勞基法第84條之1之責任制適用，而其相關配套措施所產生的疑慮，再針對護理人員工時及勞動環境，提出相關對策，以期望能改善現行之工作困境，留住護理人力，提供民眾一個安全有品質的就醫環境。
The people have the freedom to choose their work and engage in it, including the choice of work hours, types of professions, job content, and labor conditions, all of which are protected by the constitution. Workers should have the right to negotiate their work hours with their employers, and when faced with requests from employers to extend working hours, besides the obligation of employers to pay overtime, workers should have the freedom to negotiate extended working hours with their employers. Due to the significant disparity in labor relations and economic power between employers and workers, it may lead to the inability of both parties to negotiate on labor conditions, working hours, overtime pay, or wages from an equal standpoint. To protect workers' rights, the government has enacted labor standards laws to safeguard workers' rights and impose obligations on employers.
Labor rights and the working environment are issues of concern to everyone. After the COVID-19 pandemic, there has been a structural shift in the labor market, with labor shortages reaching new highs. Nurses, in particular, have been leaving their jobs in droves after the pandemic due to perennially poor working conditions and generally low salary structures. In addition to this, changes in healthcare work and an increase in public awareness have led to growing demands for healthcare, exacerbating the workload for nurses who already face a shortage of staff. This has resulted in reduced vacation days, often relying on overtime to complete their tasks, which has raised alarms about their own health. In this vicious cycle, nurses are opting to leave their jobs. Addressing the breakdown in nursing, however, cannot be solved solely by the protection of working hours under labor laws. Nurses often work long hours, not only due to legal regulations but also because hospitals apply, evade, or distort the application of regulations. Nurses not only have medical professional duties but also administrative tasks, leading to overtime work. Moreover, irregular shifts and unreasonable nurse-to-patient ratios force nurses to flee from the toil of the white tower of healthcare, further deteriorating the working environment in nursing, thereby affecting patients' rights to treatment and the quality of care, contrary to their wishes.
Therefore, this paper reviews relevant literature, starting from the discussion of nursing hours, and then discusses nurse-to-patient ratios, vacation systems, and compares them with Canadian nursing labor laws and current issues. The aim is to identify clues, learn from foreign practices, and improve the working conditions in nursing in our country. Additionally, through literature review, it explores unfavorable factors in the nursing work environment and poor working conditions, supported by judicial precedents for practical and clinical work as a reference for further analysis. After nurses are included in the Labor Standards Act and the exclusion of the responsibility system under Article 84-1 of the Labor Standards Act, concerns arising from related supporting measures are addressed. Countermeasures are proposed regarding nursing hours and the working environment in the hope of improving the current working conditions, retaining nursing manpower, and providing the public with a safe and quality medical environment. |
