In recent years, the global healthcare system has faced increasingly severe challenges, especially after the outbreak of the COVID-19 pandemic. The burden on medical facilities has been immense, and the issue of healthcare worker burnout has once again come to the forefront. Many healthcare institutions have experienced waves of resignations, with nursing staff being the most severely affected. According to statistics from the Ministry of Health and Welfare, the turnover rate for nursing staff reached 11.73% in 2022, the highest in nearly five years. As of the end of November, there were 301,380 licensed nursing personnel, but only 190,195 were actively practicing, indicating a practice rate of only about 63%. This reveals a significant number of nursing professionals unwilling to continue their nursing careers. However, the shortage of personnel not only affects the quality of healthcare and patient safety but also creates a challenging work environment for healthcare professionals.
In August of this year, some nurses raised the issue on the "Public Policy Participation Platform" set up by the National Development Council, titled "What would happen to Taiwan without nurses?" They advocated for effective measures to ensure an adequate nursing workforce and highlighted various instances of overwork in healthcare labor, including:
1. In past studies, nurses had approximately 10.5 minutes for meals and 6 minutes for restroom breaks. Sacrificing time for meals, rest, and bathroom breaks has become a norm in nursing work.
2. Due to tight manpower situations, nurses cannot take the monthly leave they are entitled to, and the chaotic scheduling exacerbates fatigue and shortages, leading to higher turnover rates.
3. According to the 2022 Ministry of Labor salary survey, the regular monthly salary for nursing personnel is NT$42,750, lower than the NT$55,567 in the healthcare and social assistance industry. Compared to the average salary of doctors at NT$135,401, nursing contributions are undervalued, and their salary levels lack appropriate respect.
4. Comparing nursing salaries with the overall salary growth in Taiwan over the past seven years (10.38%), nursing salaries have only increased by 4.5%. In the post-pandemic era of high inflation, this amounts to a de facto salary reduction for nurses.
Nurses also expressed their sentiments:
"As a psychiatric nurse, leading group activities under national health insurance is reimbursed at NT$63, while occupational therapists receive NT$299. How can the value of nursing be erased at the systemic level?"
"Eating quickly every day, no time for bathroom breaks or water, unable to take sick leave when needed—these gradually erode my dream of becoming a nurse."
"Unreasonable nurse-patient ratios, excessive workload beyond direct patient care, working ten hours a day in the hospital is just the baseline. There's only visible clock-in time, and no one cares about our rights. Unable to eat during working hours, my menstrual pad becomes wet and can't be changed. Even on holidays, I have to attend classes and take exams. This working environment makes me feel like I must have done something wrong in my past life, and now I have to be a nurse to repay some debt."
"I am a new nurse, just entered the workplace not long ago. While I was mentally prepared for a tough job before joining, clinical work is much harder than I imagined. The day shift is scheduled to end at 4 PM, but working until 8 or 9 PM is normal. Finishing at 7 PM is considered lucky. Returning home exhausted, I still have to study and review, leaving no time for my own rest. Even adequate sleep has become a luxury."
"Forget about the low salary; we also have to endure the bullying and shouting of patients' families. It's as if it's the nurse's fault that your family member is sick???"
This proposal garnered over 5,000 endorsements within a brief period of four days, surpassing the required threshold. According to regulations, relevant authorities are obligated to provide a response within two months. Additionally, the Taiwan Medical Union held the "Hellish Workplace Carnival, Medical Labor Rights Parade" at the end of October, bringing together nearly a thousand healthcare professionals, including doctors, nurses, medical laboratory technologist, therapists, and radiographers, to protest. They presented four major demands: "Adequate staffing without overwork," "No worries about a safe workplace," "Respect for professional advancement and treatment improvement," and "Government investment to save National Health Insurance." They hope that government agencies and the presidential candidates of various political parties will take these concerns seriously.
The burnout of healthcare professionals is not just an individual issue for doctors and nurses; it is an urgent problem for the entire healthcare system. We should pay more attention to the health and working conditions of healthcare workers. Through policy, management, and collective efforts, we can establish a reasonable nurse-patient ratio system and improve working conditions to prevent talent loss and avoid a vicious cycle of understaffing and overwork. This will alleviate the burnout of healthcare professionals and provide a better working environment for these guardians of health. Moreover, society should better understand and support these healthcare guardians, collectively creating a healthier and more balanced healthcare environment. This is not only a sign of respect for healthcare professionals but also a contribution to the overall health of society.