New legislation has come into effect exempting all nurses from Article 84-1 of the Labor Standards Act (勞動基準法), which states that employers in certain categories can negotiate work hours with their employees. This raises three main points of concern.
First: Will hospitals be able to operate according to the law and simultaneously guarantee the rights of their staff?
Second: Will hospitals have to suspend services if they are understaffed, and thereby infringe on the rights of their patients?
Finally: If nurses, during the provision of patient care, keep rigidly to their stated work hours and do not wait for the next shift to arrive, will this not endanger patients’ safety?
The prevailing trend is toward being more stringent when it comes to human rights guarantees.
If any hospital dares to violate the new regulations, or does not enforce them fully, they are sure to be found out sooner or later.
The less serious offenders will be fined, but in the more serious cases, the running of the hospital will certainly be affected. It goes without saying that I am concerned that hospitals will, in fact, find it difficult to run properly and offer these guarantees to their employees at the same time.
Hospital staffing shortages are not new. The problem is so prevalent not because hospitals are unwilling to employ nurses, but because they cannot find suitably qualified people. It is difficult work: Patients’ families can be disrespectful, they are under constant pressure from assessments and the law is not flexible enough to take into account the special circumstances of their jobs, to name but a few factors.
It is not the case, as certain NGOs say, that hospitals think only of profits, and do nothing to look after their employees.
Many hospitals have dealt with the problem of staff shortages by reducing their number of hospital beds. Whether this move has actually affected patients’ rights is difficult to evaluate, but at the very least, hospitals should also do their best to get patients in and out as quickly as possible, so that others can be admitted.
The closure of night clinics is similar to the reduction of the numbers of hospital beds: It is a necessary evil due to staff shortages. It is not too extreme to say that hospitals are in a precarious position here. As the new rules come into effect, we need to think carefully about how to fill the staff shortages. If we cannot fill these positions, it is a real possibility that services such as night clinics will have to be suspended.
With an effective shift handover system in place, even in the case of the treatment of acute and serious cases, it should not be too difficult to ensure the shift is handed over smoothly and seamlessly.
Of course, it is entirely understandable that many nurses, even when protected by the new stipulations in the Labor Standards Act, will be quite willing to wait until the shift is handed over, simply out of a sense of responsibility. And naturally the hospital should offer some sort of incentive or compensation for them to do so. This kind of thing happens in other fields, why could it not apply in hospitals?
After all, people working in the medical profession are sure to have the professional ethics and natural disposition to work like this: They are unlikely to act merely out of their own convenience, sacrificing the rights of the patient.
Some people might misrepresent this and say that this is just hospitals concocting various precepts to mistreat their staff.
Newspaper headlines talk of leaving behind the sweatshop culture and the contract responsibility system of hospitals, as if the two can be equated. This is an unfair misrepresentation of the situation.
Shih Shou-chuan is vice superintendent of Mackay Memorial Hospital.
Translated by Paul Cooper