There are 318,282 people in Taiwan registered as nursing professionals, but only 186,458 are practicing nurses — which means a ratio of 58.6 percent — according to the data of the Taiwan Union of Nurses Association (TUNA). The low ratio shows that there are enough nursing professionals in Taiwan, but there is a need for more of the registered nurses to become practicing ones.
In the past six months, as many as 1,726 nurses have quit their jobs. Aside from low salaries and long work hours, there were also protests against health agencies that were withholding COVID-19 subsidies of late. Further, violence against healthcare professionals has put people off the job.
The nursing shortage should be taken seriously. A lack of nursing professionals could lead to dysfunctional hospitals, and people who need medical care would become victims. In response, TUNA has called on the government to improve the nurse-to-patient ratio, provide scholarship and tuition subsidies for nursing students and allow male nurses to carry out substitute military service at hospitals.
In fact, according to current guidelines for substitute military service, male conscripts who hold nursing licenses have the right of priority to carry out substitute service at the National Fire Agency or the Ministry of Health and Welfare’s Social and Family Affairs Administration. Unfortunately, as cross-strait tensions are at their highest in decades, the government has announced that starting from Jan. 1 next year, conscripts born in or after 2005 would undergo more intense combat training in boot camp, while military service is to be extended to one year. As the government has revoked all qualifications and screening orders for substitute service applications except for religious or family factors, the number of substitute service draftees would definitely see a massive slump.
As a result, TUNA’s proposal for male nurses to carry out substitute service in hospitals seems out of the question while drafting a specific act to allow male nurses to do so would violate the principle of equality.
President Tsai Ing-wen (蔡英文) said she would be glad to see women participating in national defense affairs, media reports said.
“If, during a state of defense, the need for civilian services in the civilian health system or in stationary military hospitals cannot be met on a voluntary basis, women between the age of 18 and 55 may be called upon to render such services by or pursuant to a law. Under no circumstances may they be required to render service involving the use of arms,” says Paragraph 4 of Article 12a (compulsory military and alternative civilian service) in the Basic Law for the Federal Republic of Germany.
Due to the plummeting fertility rate, there would soon be fewer substitute service draftees to carry out disaster relief, healthcare duties and rescue missions in Taiwan. To address this, perhaps Taiwan can take a page from the German constitution and amend legislation to allow women of conscription age to carry out substitute service through practicing civil medical services and health duties.
The government should also reinforce the legal system and related guidelines for governing the occupational safety of healthcare practitioners. Amendments to the Health Care Act (醫療法) and conscription guidelines require cooperation across sectors.
It is high time that government divisions come together to address nursing shortage so that all Taiwanese, regardless of gender, can play a role in defending their homeland.
Chao Hsuey-wen is an assistant professor and holds a doctorate in law from Fu Jen Catholic University.
Translated by Rita Wang