The recent overcrowding of emergency rooms and shortage of hospital beds across Taiwan has attracted significant public attention. As such, the government and medical institutions have begun discussions on improving the salaries, benefits and work environments of nursing staff, with hopes that public-private cooperation could ease the wave of nurse resignations.
The public and private sectors have been implementing emergency measures and financial incentives as part of a strategy to increase the country’s nursing workforce since 2023. However, more is needed to achieve the long term stability and sustainability of the nursing workforce. Active participation of nursing organizations combined with the proper planning, and development of a vision to ensure a sufficient and high-quality nursing workforce would allow Taiwan to safeguard public health and national security.
In 2021, the World Health Assembly approved the WHO’s Global Strategic Directions for Nursing and Midwifery 2021-2025, urging member states to make comprehensive investments across four policy areas in the field of nursing: education, jobs, leadership and service delivery. Therefore, in addition to creating friendly workplace environments and offering reasonable salaries, Taiwan must also actively invest in educational improvement, expanding the scope of nursing and fostering leadership.
These steps would give nursing staff a clear path to professional development and dignity, increasing their willingness to stay in the field, while attracting more students to pursue nursing, thereby building a stable and sustainable nursing workforce.
Although nurses account for the largest portion of the healthcare workforce, they have the lowest educational qualifications. When nurses are regarded as skilled workers rather than healthcare professionals, their professional autonomy is undermined, resulting in a lack of dignity or sense of accomplishment. When coupled with being expected to support non-professional tasks in a high-pressure, low-respect and high-risk work environment, nurses are often left with two choices — pursue a higher level of education, or leave the field altogether.
Public healthcare is complex, and establishing a clear, tiered and interdisciplinary division of labor to encourage experienced nurses to expand their scope of practice is an effective strategy to retain nursing staff. Nursing assistants could be made responsible for basic physiological monitoring and patient life care, while advanced nurses could offer specialized care for complex conditions and needs such as chronic disease management and intensive care.
A tiered structure in nursing would not only enhance the flexibility of the healthcare system as a whole, but could also promote paths for nurses’ career development and help to alleviate their hardships within the medical system, thereby benefiting medical care, public health and welfare. Finally, investing in leadership by promoting skilled nurses to senior roles and involving them in policymaking would not only give nurses a voice in their workplace, but also ensure the long-term sustainability and development of nursing.
In the face of intense demands and limited workforce, nurses are the best partners to physicians — they are an indispensable part of a healthcare team. Improving nurses’ professional development is more crucial than ever. With enough support and recognition, Taiwan could alleviate its shortage, meet the public’s health needs, enhance professional development, and retain excellent nurses to address the current shortage.
Chen Ching-min is vice president of the Taiwan Nurses’ Association and a professor in National Cheng Kung University’s Department of Nursing.
Translated by Kyra Gustavsen
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