令人敬佩的勇敢護士
◎沈政男（醫師）

「當所有醫療人員身陷地獄，病患必定也非常靠近地獄了。」

請記住說出上述名言的林美琪護士，她會在台灣的醫療史，甚至社會運動史留名。

我無法相信，在台灣這種比軍隊還保守閉塞的護理教育、護理文化裡，會出現這樣一位充滿勇氣與智慧，敢於發聲的女護士。

她在日前寫了英文信到 CNN 網站，獲得刊載，裡頭痛批了台灣健保制度的美好假象，她認為台灣的健保天堂，不過是眾多醫療人員，特別是護士被關進地獄換來的代價。

文中詳述了台灣護士的工作環境、時間、照顧床數，與連生病都不能請假的苛刻要求（如附圖）。

姑且不論其觀點是否周延，以及英文上的小錯誤，她的文章可說擲地有聲，清楚又有力，把喜歡吹噓台灣健保的官員重重甩了一巴掌，也說出了眾多台灣醫療人員的心聲。

她能想到這樣的發聲方式，而且達成目的，實在不簡單。

讓人想起前一陣子揭發禽流感疫情的紀錄片導演李惠仁。

如果一個人可以對抗不合理的政策與制度，那麼一群人團結起來呢？

我將她的大作翻成中文，表達敬意。

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The dark moment of nurses in Taiwan.
台灣護士的黑暗時刻
◎林美琪

The working environment of nurses in Taiwan has entered an extremely serious situation due to working environment changes. 

台灣護士的工作環境，因為工作環境的變化，已經步入一個極度危險的境地。

Taiwan National Health Insurance system seems created a wonderful medical market which is very easily to obtain treatment with low bill for everyone. In the end, all of hospitals are impaired by medical staff shortages and Taiwan government even didn't know what the real problem is! 

台灣的健保系統，似乎創造了一個很容易以低廉費用取得治療的美好醫療市場，結果呢，所有醫院因醫療人員短缺而受到損害，但台灣政府竟然不知真正的問題何在？

Because of National Health Insurance System, resulting low salaries of nurses, long working hours without pay, and high nurse patient rate. Few days ago, we saw the news from CNN reported that The National Health Insurance System in Taiwan is a successful policy, which is a big joke. Especially The United States seems planning to set up a similar policy. We strongly recommend that journalist and the government officials in the United State should come to Taiwan a couple of days for field trip, and then they would be able to understand how the insurance system has pushed the majority of medical workers into a huge hell. 

因著健保體系，衍生了護士低工資、高工時但無給付、與高病護比的狀況。幾天前，我們看到 CNN 新聞報導說，台灣的健保是成功的政策，那真是一個大笑話。特別是美國似乎計畫籌設一個類似的政策。我們強烈建議美國記者與政府官員應該來台灣幾天，做做田野調查，然後他們將會了解，健保體系如何將多數醫療人員推入一個廣大的煉獄。

When all of medical personnel in hell, the patient must be very close to the hell definitely. 

當所有醫療人員身陷地獄，病患必定也非常靠近地獄了。

When all of the medical workers in an unhealthy working environment, the patient must to facing a high risk care quality, because in Taiwan, every nurse should take care of at least eight patients in morning shift, even more. Over twelve patients in afternoon shift and almost take care of nearly twenty patients in night shift! That’s pretty incredible. 

當所有醫療工作者在一個不健康的醫療環境工作，病患必定得面對高危險的照顧品質，因為在台灣，每一位早班護士必須照顧至少八位病患，甚至更多；小夜班超過十二位病患，而大夜班幾乎照顧將近二十位病患！實在難以置信。

Nurses in Taiwan are not only superwomen or supermen, but are also patients. Staff shortages happened in past ten years, the trickiest thing is that Nurses do not have right to sick anymore, only because of nurses shortages. Taiwan's hospitals manager will not let their nurse get a sick leave if the nurse still able to walk even in public hospital system. 

台灣的護士不僅是女超人或超人，也是病患。過去十年，人力短缺，而最弔詭的是，護士沒有權利生病，就因為護士短缺。台灣的醫院管理者不讓護士請病假，只要該護士仍然能夠工作，即使在公立醫院體系也如此。

The Nurse’s working hour in Taiwan often over ten hours every shift, even more. However, the hospital did not give overtime fee; they only give nurses unreasonable pay to buy their break off. The medical environment of the culprit was created by the National Health Insurance System. 

台灣護士的工作時間，通常每班超過十小時，甚至更多。然而，醫院沒有發給加班費，只給護士不合理的給付，收買她們的休假。此一醫療環境元兇，就是健保體系製造出來的。

I want to tell all my friends around the world that it’s not a good thing for you to let your government implement this kind ridiculous policy in your country.

我要告訴世界上所有我的朋友，如果讓你們的政府在你們的國家施行這樣可笑的政策，並不是一件好事。