[간호사로 산다는 것] “The number of patients has decreased, so don’t come out today and go on vacation.”

Advanced General Hospital University Hospital Outpatient Reservation <br>” src=”http://www.hkn24.com/news/photo/202106/319557_183975_1746.jpg”><figcaption>Photos are not related to any particular article. [출처=헬스코리아뉴스 D/B]</figcaption></figure></div>

<p>[헬스코리아뉴스 / 박원진]  Hospitals are inevitably working 24 hours a day due to the nature of the work that is responsible for the health and life of patients.  Irregular work schedules, in which three shifts, such as D (day shift), E (evening shift), and N (night shift), are alternated, include gastrointestinal disorders such as disruption of circadian rhythm, lack of sleep, insomnia, indigestion, and cancer. It is a workplace where normal life is difficult due to various diseases and severing interpersonal relationships.</p>

<p>To remedy these problems, the hospital’s labor union has a provision for protecting shift workers in the collective agreement.  Representative protection clauses for shift workers include limiting the number of night shifts per month, limiting the number of consecutive working days, guaranteeing a break between work and working hours, guaranteeing a minimum rest period after night shift, prohibiting the formation of a lame work schedule, prohibiting changes to the confirmed work schedule (number), and night Guaranteed sleep leave due to work.</p>

<p>However, it was found that these shift worker protection measures were limited to relief.  This is the result of a survey conducted by the health and medical union on the status of night shift work at 102 medical institutions where union members are organized.</p>

<p>According to the results of the investigation, the work schedule (number) was confirmed, but there were many cases where it was suddenly changed.  It is mainly caused by sick leave, investigation, petition leave, unscheduled sudden resignation or accident, outbreak of an infected person such as Corona 19 or self-isolation, pregnancy, childbirth, department transfer, personnel appointment, change in doctor’s schedule, sudden occurrence of transplant patients, etc. .</p>

<p>On the other hand, there was a case of forcibly granting leave (emergency OFF) by suddenly changing the work schedule on the same day because the number of patients or various examinations decreased, or because an inpatient canceled hospitalization.</p>

<p>The workers at A Private University Hospital in Chungcheong Province responded, “If the number of patients in the ward or intensive care unit is small, emergency OFF is given to rest, and later, it is treated as personal annual leave.”  This means that they are forced to use annual leave that is not on schedule.</p>

<p>In addition, there were cases in which the work schedule was suddenly changed to promote the exhaustion of annual leave, and there were cases in which the work schedule was changed to distribute annual leave of high, medium, and low annual leave. </p>

<p><strong>Emergency OFF notification due to decrease in patients … “I want to live a planned life”</strong></p>

<p>In the case of emergency OFF, there were many absurd cases.  On the way to work without any notice, he suddenly received a call saying, “Don’t come out today because the number of patients has decreased” or “Don’t go to work because there are no patients today” and headed back home.  In some cases, the number of employees was adjusted by contacting on the same day or the day before because the number of patients was large compared to the number of patients. In other cases, emergency OFF was granted because the severity of the patient was low.</p>

<p>In some cases, such as Chungcheongnam-do B district medical center, emergency OFF was granted while reducing the number of employees due to poor management. As in Gangwon-do C district medical center, when the number of hospitalized patients decreases during the holidays or when the doctor goes on leave for more than two days, an emergency OFF is granted. In some cases, annual leave was exhausted.</p>

<p>In the case of D National University Hospital in the Yeongnam area, it was found that emergency OFF was given when the bed capacity utilization rate was less than 50%.  In some places, emergency OFF is prohibited through labor-management negotiations, and in some places it is agreed that “we do not change the staffing schedule for the next day due to a short-term decrease in ward patients”. There is a case of forced consumption of annual leave during the period.</p>

<p>Because of the unexpected emergency OFF, hospital workers such as nurses complain that “I can’t live my planned life.”</p>

<p>The hospital workers who responded to the fact-finding survey said, “They say they make changes with their consent, but they are actually forcing consent”, “Individual intentions are not reflected and they are notified in effect”, “Emergency OFF cannot be regarded as a complete OFF”, They complain that “it has become a means of consuming semi-compulsory annual leave”.</p>

<p>Some respondents complained that “there is a situation where the person who needs to change the work schedule cannot change it,” and “there is a lack of empathy and consent from the employees, which causes conflict.”</p>

<p>The health and medical union said, “Due to emergency OFF, △ change of personal schedule and invasion of privacy △ need to cancel or give up plans, lowering quality of life and lowering morale △ reduced rest time and increased fatigue △ difficulty in daily life △ use of unwanted annual leave △The problem is not one or two, such as when you need annual leave, when you are sick, or when you want to take a break, etc.</p>

<p>According to the results of the survey, emergency OFF is not only due to personal difficulties, but also △ increased workload of co-workers △ resulting physical and mental stress △ irregular sleep and life patterns △ errors at work caused by not understanding the work schedule △ Difficulty in adjusting work capacity, overloading of work, difficulty in division of duties, and violation of work schedule standards, etc. It has also been shown to have an adverse effect on quality.</p>

<p>Respondents in this survey said, “The case where the number of nurses working per shift is reduced due to the shortage of nursing manpower, the work schedule is made and the use of leave is forced semi-compulsively, so that the work is overloaded and compensation is not received should not be repeated anymore.” he appealed  There were also high complaints about not being given the opportunity to apply for work to new nurses or low-skilled nurses because the head nurse arbitrarily forced the use of annual leave or created a work schedule focusing on long-term employees.</p>

<p>Shift nurses suffering from irregular shifts said, “I want to live a planned life.  It is necessary to prevent the department head from wielding the worksheet as a power.  We need to thoroughly monitor our seniors so that they do not arbitrarily change their schedules.” </p>

<p><strong>There are cases of abuse of sleep leave</strong></p>

<p>The sleeping off system implemented as a protection measure for shift workers was also full of loopholes.  In order to guarantee the right to sleep for shift workers, many hospitals have implemented a sleep leave system.  Hospitals are granting one day of sleep leave when the number of night shifts per month reaches a certain number of times (eg, 5, 6, 7, 8, etc.).  In some places, the number of night shifts is accumulated regardless of the month, and when a certain number of night shifts is reached, one day of sleep leave is granted.</p>

<p>However, this sleep leave system also revealed many problems in the implementation process.  According to the results of the medical field survey by the Health and Medical Association, there was a response that “sleep leave is granted only to cases exceeding 7 night shifts per month, not cumulatively, so there are not many cases of actual application.” In order to avoid this, there were cases where each individual writes only 7 night shifts per month on the worksheet” and “The number of night shifts is adjusted to avoid giving sleep leave.”</p>

<p>There have been cases of abuse of the sleep leave system.  In Incheon’s Private University Hospital E, a response came out saying, “Instead of making efforts to reduce night shifts, they are taking sleep leave and are not recruiting manpower to departments with insufficient manpower.”  The respondent analyzed, “This is because the hospital considers it to be more beneficial to give one more sleep leave than to increase the workforce.”</p>

<p>A health care union official told Health Korea News, “The night shift system is the cause of the highest turnover rate among nurses even though they are full-time employees. It is also the key reason why 45.5% of new nurses leave within one year.” He stressed the need for institutional improvement.</p>

<p>“The three-shift system currently implemented in most hospitals is no longer sustainable.  The automobile industry has decided to ban night work altogether, and the day and night shift system has been reorganized into two consecutive daytime shifts, and in the railroad industry, the three- and two-shift system has been reorganized into a four-team, two-shift system.” presented as</p>

<p>Samsung Medical Center has recently introduced seven types of work system, including daytime fixed work, evening fixed work, day-evening work, day-night work, evening-night work, night-only work, and two-shift system, breaking away from the existing three-shift work system.</p>

<p>Meanwhile, the health and medical union, which is announcing a general industrial strike in September, is changing the hospital, where the vicious cycle of ‘shortage of manpower → worst night shift system → high turnover → increase in workload and intensification of labor intensity → exhaustion and turnover → shortage of manpower’ In order to fundamentally reorganize the shift system, under the policy of “making 2021 the first year of fundamentally improving the worst hospital shift system,” the company plans to launch an intense struggle.</p>

		
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