In recent months headlines have been screaming about “sweatshop hospitals.” Registered nurses, resident doctors and interns from various medical facilities have been complaining about the conditions they are expected to work under. Some have even taken their stories to US-based news network CNN.
Taiwan’s apparently wonderful national health insurance system, it would seem, is based on the work performed by medical staff in these “sweatshop hospitals.” How these hospitals are run has a direct impact on the quality of treatment and in the end it is the patients who are most affected. However, medical staff have worked under these conditions for many years now and a high level of medical treatment has still been maintained.
Apart from the way these “sweatshop hospitals” have managed to keep going, advanced practice registered nurses (APRNs) have played an integral role in the maintenance of a high standard of medical treatment in Taiwan.
The practice of having APRNs started in the US. The continuous and comprehensive nursing and medical care that they provide, side by side with doctors, is especially important to critically ill patients. Due to a lack of resources, critical-care doctors have to struggle to divide their time between the operating theater, the emergency room and the examination room. Also, as residents are not always very decisive when it comes to treating critically ill patients, it is often APRNs who provide the best support for critical-care physicians. APRNs also care for critically ill patients in intensive care units (ICUs), under the supervision of the critical-care physicians.
When the condition of patients in the ICUs change, APRNs can draw on their wealth of clinical experience to diagnose the nature of this change. When critical-care physicians are unable to be at the scene to see a patient, APRNs can communicate the details of the situation to them. In this way, they can help make up for the lack of critical-care residents.
Taiwan is losing a lot of its registered nurses, especially those in their first year and their fifth to 10th year of service. APRNs start out as senior nurses and get their positions after they go through strict training and pass national examinations. They are therefore paid slightly more than other nurses and, as a result, the position of APRN offers nurses a way in which they can advance their careers, giving them a chance to move on from the normal nursing system.
This chance for career advancement is an attractive option to less senior nurses and this can also help stem the flow of nurses away from the sector. In addition, the clinical experience that APRNs have means they can act as mentors to less senior nurses, as well as being able to assist in the care of critically ill patients. This mitigates, to an extent, the lack of nurses we have to care for the critically ill.
Many hospitals in the US have APRNs and they are starting to become more common in Japan, where the initial emphasis was on having them for the critically ill. After two decades of development here, there are now many APRNs in Taiwan. Apart from helping compensate for the lack of critical-care physicians as well as nurses for the critically ill within Taiwan’s medical system, APRNs have become an important part of the maintenance and improvement of the quality of critical medical care in regional hospitals and medical centers all around the country. Establishing a proper system for APRNs would effectively ease the burdens of Taiwan’s “sweatshop hospitals.”
Lin Pyng-jing is a professor of surgery at Chang Gung Memorial Hospital.
Translated by Drew Cameron.
Concerns that the US might abandon Taiwan are often overstated. While US President Donald Trump’s handling of Ukraine raised unease in Taiwan, it is crucial to recognize that Taiwan is not Ukraine. Under Trump, the US views Ukraine largely as a European problem, whereas the Indo-Pacific region remains its primary geopolitical focus. Taipei holds immense strategic value for Washington and is unlikely to be treated as a bargaining chip in US-China relations. Trump’s vision of “making America great again” would be directly undermined by any move to abandon Taiwan. Despite the rhetoric of “America First,” the Trump administration understands the necessity of
US President Donald Trump’s challenge to domestic American economic-political priorities, and abroad to the global balance of power, are not a threat to the security of Taiwan. Trump’s success can go far to contain the real threat — the Chinese Communist Party’s (CCP) surge to hegemony — while offering expanded defensive opportunities for Taiwan. In a stunning affirmation of the CCP policy of “forceful reunification,” an obscene euphemism for the invasion of Taiwan and the destruction of its democracy, on March 13, 2024, the People’s Liberation Army’s (PLA) used Chinese social media platforms to show the first-time linkage of three new
If you had a vision of the future where China did not dominate the global car industry, you can kiss those dreams goodbye. That is because US President Donald Trump’s promised 25 percent tariff on auto imports takes an ax to the only bits of the emerging electric vehicle (EV) supply chain that are not already dominated by Beijing. The biggest losers when the levies take effect this week would be Japan and South Korea. They account for one-third of the cars imported into the US, and as much as two-thirds of those imported from outside North America. (Mexico and Canada, while
The military is conducting its annual Han Kuang exercises in phases. The minister of national defense recently said that this year’s scenarios would simulate defending the nation against possible actions the Chinese People’s Liberation Army (PLA) might take in an invasion of Taiwan, making the threat of a speculated Chinese invasion in 2027 a heated agenda item again. That year, also referred to as the “Davidson window,” is named after then-US Indo-Pacific Command Admiral Philip Davidson, who in 2021 warned that Chinese President Xi Jinping (習近平) had instructed the PLA to be ready to invade Taiwan by 2027. Xi in 2017
RSS