Reports of staffing shortages in emergency rooms (ER) across Taiwan’s major hospitals have made headlines over the past few weeks.
The ER overcrowding’s root cause lies in the medical staff shortage, Taiwan Nursing and Medical Industries Union consultant Chen Yu-feng (陳玉鳳) said.
The situation is escalating into a crisis, and the government has yet to propose effective countermeasures. The Ministry of Health and Welfare has introduced a policy aimed at improving bed allocation and enhancing hospital referrals, but the initiative has not gained healthcare professionals’ support.
However, is this crisis truly due to a lack of personnel, or is it a failure of medical management?
At first glance, it might seem that the problem can be attributed solely to insufficient workforce.
However, a deeper examination reveals that factors such as the training of nurses and their ability to apply their expertise in the workplace have a profound impact on the staffing crisis.
One must first assess whether hospitals are properly allocating their nursing staff. Many nurses are forced to take on non-clinical tasks, such as medication delivery, administrative duties, or even explaining medical procedures to patients, which should be done by doctors. As a result, these tasks significantly reduce the time available for patient care. Studies categorize nursing work into direct care, indirect care and related activities, yet in practice, much of nurses’ time is taken up by tasks unrelated to their core competencies.
Additionally, inefficiencies in hospital workflow design exacerbate the issue. The division of nursing duties among intensive care units (ICU), ERs and general wards often fails to align with patient needs. Poor management or staffing shortages frequently result in nurses being overburdened.
The issue extends beyond mere staffing levels. The more critical concern is whether nurses receive adequate training and can effectively apply their skills in real-world clinical settings. Taiwan’s nursing education and training system often places excessive emphasis on theoretical knowledge. As a result, many nurses struggle to adapt to the high-pressure and fast-paced hospital environment. Rather than functioning as independent professionals, they become little more than assistants to physicians. This not only undermines the value of the nursing profession, but also weakens the healthcare system.
Furthermore, hospital culture and management models are eroding nurses’ professional capabilities. Many institutions prioritize administrative convenience, treating nurses as subordinates. This not only leads to skill degradation but also disrupts the balance of medical teamwork.
Simply raising healthcare budgets or increasing nurses’ salaries would not solve the problem. Higher wages alone would not improve professional autonomy or ensure that nurses can effectively apply their expertise. Nursing remains one of the lowest-paid professions in healthcare. The ministry, hospital administrators and nursing associations must rethink the role of nurses, ensuring that their responsibilities align with their competencies. At the same time, nursing education and in-service training should emphasize clinical decisionmaking and crisis management to enable nurses to fully realize their professional value.
Ultimately, the crisis in ERs — and the healthcare system as a whole — is not just a staffing issue, but a structural failure in hospital management. Only by redefining the role of nurses as essential professionals in healthcare teams can Taiwan address its medical challenges.
Chu Jou-juo is a professor in the Department of Labor Relations at National Chung-cheng University.
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