現今台灣面臨護理人力不足且日益嚴重的問題，越來越少人願意投入護理行業，甚至部分完成護理學業者選擇不從事護理工作。同時，隨著少子化與人口高齡化的加劇，護理人力的缺口成為台灣醫療產業亟需正視的挑戰。究竟是什麼原因導致護理人員流失，並促使從業者選擇轉換跑道？
本研究針對南部某區域醫院不同職務層級的護理人員，探討他們對工作壓力、工作價值與工作期待的看法。本研究以扎根理論為研究方法，並以半結構式訪談蒐集資料，訪談對象涵蓋主管、儲備幹部及新人共10位。旨在了解各層級護理人員的工作現況與感受，訪談結束後針對逐字稿進行內文分析及進行開放性編碼，識別出初步的概念，進行不斷比較分析，發展出核心範疇，最終透過選擇性編碼生成理論。
研究結果顯示，不同職務的護理人員在面臨工作挑戰、追求成就感及展望未來發展時有著不同的見解。此外，組織文化和制度對員工的滿意度及留任意願有著深遠影響。以主管來說管理員工及行政業務的負擔日漸加重使主管壓力增加，並且因業務分配不均、管理部門領導風格導致主管漸漸形成沉默文化；儲備主管因未有完整的主管培訓，在承接主管職務面臨問題時未能有相關的知識及技能而導致員工職務壓力增加，另加上擔負的責任及業務逐漸加重但卻未能回饋在薪酬報償讓員工感到無力及失望，進而失去動力；新人因初入職場，面臨實務作業及師長指導感到緊張，而新人重視工作環境、主管領導及人際關係，若能適應工作環境、信賴並依靠主管或師長指導可以提升留任的意願。
基於此，建議未來研究可擴展至不同等級的醫療機構，並將高層管理者納入探討範圍，以更全面了解組織管理與護理人員職業期待之間的契合度。本研究為改善護理工作環境及提升組織管理效能提供了實務建議。

Taiwan is currently facing a worsening shortage of nursing personnel. Fewer people are willing to enter the nursing profession, and even some who complete nursing studies choose not to work in the field. Additionally, the challenges posed by a declining birthrate and an aging population have exacerbated the nursing workforce gap, making it a critical issue that Taiwan's healthcare industry urgently needs to address. What are the factors driving nursing staff attrition and leading professionals to switch careers.
This study explores the perspectives of nursing staff at different hierarchical levels in a regional hospital in southern Taiwan regarding work-related stress, job value, and career expectations. The research adopts grounded theory as its methodology and uses semi-structured interviews for data collection. A total of 10 participants, including supervisors, reserve managers, and new employees, were interviewed. The aim is to understand the work conditions and experiences of nursing staff across different levels. After the interviews, verbatim transcripts were analyzed through open coding to identify initial concepts, followed by constant comparative analysis to develop core categories, ultimately leading to the generation of a theory through selective coding.
The results reveal that nursing staff at different levels have varying perspectives on facing work challenges, pursuing a sense of accomplishment, and planning future career development. Additionally, organizational culture and policies have a profound impact on employee satisfaction and retention. For supervisors, the increasing burden of managing staff and administrative duties raises their stress levels, and unequal workload distribution and leadership styles contribute to a culture of silence. Reserve managers face heightened job stress due to a lack of comprehensive managerial training, leaving them ill-prepared to handle supervisory responsibilities, which increases pressure on staff. This, combined with growing responsibilities and inadequate compensation, leads to frustration and demotivation. For new employees, entering the workforce brings anxiety due to practical work demands and supervisory guidance. They place high importance on the work environment, leadership, and interpersonal relationships. If they can adapt to the work environment and build trust in their supervisors or mentors, their willingness to stay in the job increases.
Based on these findings, future research should be extended to different levels of healthcare institutions and include senior management to better understand the alignment between organizational management and nursing staff’s career expectations. This study provides practical recommendations for improving the nursing work environment and enhancing organizational management effectiveness.

論文審定書 i
致謝 ii
摘要 iii
Abstract iv
目錄 vi
圖次 viii
表次 ix
第一章 緒論 1
第一節 研究背景與動機 1
第二節 研究目的 1
第三節 研究問題 2
第二章 文獻探討 3
第一節 護理人力 3
第二節 工作環境 5
第三節 工作壓力 7
第四節 工作負荷 7
第三章 研究方法 9
第一節 研究取向 9
第二節 訪談對象 9
第三節 訪談流程與大綱 11
第四節 資料分析 13
第四章 研究結果與分析 14
第一節 護理工作的個人感受 15
第二節 醫療照護間的團隊合作 32
第三節 人力資本與組織策略 35
第五章 結論與建議 70
第一節 結論 70
第二節 管理實務建議 76
第三節 研究限制及未來建議 78
參考文獻 80
附錄 84

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