| 摘要: | 本研究旨在探討臺灣醫療體系中專業權力與性別的交互影響，特別聚焦於專科護理師在醫療體系中所面臨的專業地位與挑戰。研究對象包括主治醫師、專科護理師與護理師。為深入了解不同群體間的權力關係、協作結構與互動本質，本研究進行了15次半結構式質性訪談，涵蓋不同醫院、性別與科別的職業團體，避免單一團體偏見，並通過交叉比對不同群體以進行深入分析。
本研究採用主題分析法，經過編碼後進行主題分類，旨在探討專業權力與性別動力的推進過程。研究結果顯示，專科護理師在取得醫學知識訓練後，參與醫療決策的專業權力有所提升，但最終決策權仍受限於傳統醫療體系的權力結構、法規制度與性別規範。訪談資料顯示，醫療體系中性別隔離現象顯著，男性與女性常被自 動劃分至傳統角色。男性專科護理師可能被誤認為醫師，女性主治醫師則多次被稱 為「小姐」或誤認為「護理師」，女性專科護理師也有類似現象，經常被視為「助理」或「秘書」。這反映出女性在醫療體系中容易受到性別刻板印象影響，難以被視為權威或專業角色，影響其專業權力展現與職業認同。
此外，專科護理師在醫療體系中的專業角色定位仍屬模糊，角色分工界線不清，角色期待與權力展現不一致，經常被視為醫師的助理或秘書，缺乏獨立開立醫囑的權限，最終決策權仍由主治醫師掌握。這些因素阻礙了專科護理師的專業認同感與職業發展，並導致其它職業類別對其角色與定位的混淆與不理解。研究還發現，性別刻板印象與社會文化期待對專業身份形塑與職業發展有深遠影響，這些影響在職業選擇與職業發展過程中持續存在。
This study aims to explore the interactive impact of professional power and gender in the medical system in Taiwan, with a specific focus on the professional status and challenges faced by nurse practitioners in the medical system. The study subjects include attending physicians, nurse practitioners, and nurses. In order to gain a deeper understanding of the power dynamics, collaborative structures, and interaction nature among different groups, this study conducted 15 semi-structured qualitative interviews, covering occupational groups from different hospitals, genders, and specialties to avoid bias from a single group, and conducted in-depth analysis through cross-comparison of different groups.
This study used thematic analysis to code and classify themes, aiming to explore the process of advancing professional power and gender dynamics. The research results showed that nurse practitioners professional power in participating in medical decision-making increased after acquiring medical knowledge training, but the ultimate decision-making authority was still limited by the power structure, regulations, and gender norms of the traditional medical system. Interview data revealed significant gender segregation in the medical system, with men and women often automatically assigned to traditional roles. Male nurse practitioners are often mistaken for doctors, while female attending physicians are frequently referred to as "miss" or mistaken for nurses. Female nurse practitioners also experience similar phenomena, often being seen as "assistants" or "secretaries." This reflects how women in the medical system are easily influenced by gender stereotypes, making it difficult for them to be seen as authoritative or professional roles, affecting their professional power display and occupational identity.
In addition, the professional role positioning of nurse practitioners in the medical system remains unclear, with blurred role boundaries, inconsistent role expectations and power displays. They are often seen as assistants or secretaries to physicians, lacking the authority to independently issue medical orders, with final decision-making power still held by attending physicians. These factors hinder the professional identity and career development of nurse practitioners, leading to confusion and misunderstanding of their roles and positioning by other professional categories. Research has also found that gender stereotypes and societal cultural expectations have a profound impact on the shaping of professional identity and career development, and these influences persist throughout the process of career choice and development. |
