Enforcement of labor guarantees and mandatory training periods for nurses is necessary to reduce high hospital turnover rates, labor activists said yesterday, condemning proposed reforms to enshrine a “nurse-to-patient ratio” in law for ignoring the problem of enforcement.
About 30 demonstrators from the Taiwan Radical Nurses Union and other labor and activist groups gathered outside the Ministry of Health and Welfare in Taipei to call for stricter enforcement of the regulations.
“A nurse-to-patient ratio is not the solution, because you have to be able to hold onto people if you are going to fill positions and for that you need to have a full training period,” Taiwan Radical Nurses Union president Teng Ya-wen (鄧雅文) said, adding that the nurse-to-patient ratio is already included in the government’s review process, which grants additional subsidies to hospitals which maintain an overall nurse-patient ratio of one to nine.
President-elect Tsai Ing-wen (蔡英文) has promised reforms to enforce a “reasonable nurse-to-patient ratio” as part of broader reforms to improve nurses’ working conditions and reduce the turnover rate.
“No matter how strict the government’s new nurse-to-patient ratio is, the reality is that it will not be enforced,” Teng said.
Union executive director Wu Chia-ling (吳嘉綾) said that hospitals skew statistics to maintain nurse-to-patient ratios on paper, while sacrificing care.
“The problem is that hospitals can cut days off, use ‘deformed’ work schedules, make transfers between departments and hire part-time nurses to falsify their figures,” wu said, adding that the measures cut into the quality of the care provided.
Denying nurses days off and allowing little rest between shifts leaves them with less energy to focus on patients, while sudden transfers across departments leave them unprepared, she said.
“Departments can be worlds apart. How can you expect nurses to fly when you do not give them time to grow wings?” she said, criticizing hospitals for expecting experienced nurses to immediately assume full responsibility for different departments without additional training.
While new nurses receive some training, the vast majority receive less than the recommended three months before being required to take on full responsibility, Teng said, adding that the resulting high turnover rates increase the burden on experienced nurses.
“Hospitals are focused on profit, so they try to cut costs by moving people around and not providing full training periods,” she said, adding that Labor Standard Act (勞動基準法) regulations have not been effectively enforced even after hospitals received additional subsidies for maintaining nurse-to-patient ratios.
“Under the rules, hospitals are only fined for one nurse, even if they have violated rules for 10, because the discovery counts as one infraction. The penalties are also far too light, to the point where hospital’s are only fined tens of thousands of New Taiwan dollars, when to hire another full time nurse they would have to pay NT$600,000 a year,” she said, calling for hospital’s found guilty of infractions to be forbidden from selling “self-paid” hospital beds and services.
“It is not that hospitals do not have the money, otherwise they could not continue to fund new expansions,” she said. “The government has actually already given them money [to improve nurse-to-patient ratios], but hospitals have not followed through.”
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