Medical Community Proposes 'Annual All-Shift' Nurse-to-Patient Ratio, Nursing Community: This is Policy Regression
Taiwan's Ministry of Health and Welfare is formulating nurse-to-patient ratio standards. Seven major medical associations propose an 'annual all-shift' average, but the National Nurses Association strongly opposes this, warning it constitutes 'policy regression' due to varying workloads and risks across shifts.
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- 📰 Published: April 30, 2026 at 12:53
- 🔍 Collected: April 30, 2026 at 13:01 (8 min after Published)
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Central News Agency
(Central News Agency, Reporter Shen Pei-hua, Taipei, April 30) The Ministry of Health and Welfare is formulating standards for a three-shift nurse-to-patient ratio. Seven major medical organizations suggested using an 'annual all-shift' average as the benchmark. However, the National Nurses Association emphasized that the workload and risks differ across the three shifts, and calculating based on an annual, all-shift average would constitute a regression in the three-shift nurse-to-patient ratio policy.
The Ministry of Health and Welfare will establish an 'Medical Manpower Optimization Research and Promotion Task Force,' primarily to discuss the three-shift nurse-to-patient ratio in relation to the 'Standards for the Establishment of Medical Institutions.' Minister Shih Chung-liang said yesterday that from international experience, not many countries legislate a three-shift nurse-to-patient ratio, but if appropriate regulations are in place, there are indeed positive effects. In principle, discussions and revisions will proceed based on the Standards for the Establishment of Medical Institutions authorized by the Medical Act.
Regarding the adjustment of related regulations, the seven major medical organizations subsequently issued a joint statement, expressing support for the direction of legislating a three-shift nurse-to-patient ratio. However, they also called on the government to prioritize the implementation of the '12 Strategies for Nursing Manpower Policy Preparation,' ensure that hospitals have sufficient resources to improve remuneration, and adhere to the principle of 'encouragement over punishment.' They further suggested that the nurse-to-patient ratio should be based on an 'annual all-shift' average and incorporate differentiated management based on 'disease severity.'
The nursing community, however, holds opposing views on the statement from the seven major medical organizations. The National Nurses Association of the Republic of China responded yesterday via Facebook, stating that they 'cannot accept an annual all-shift average as the nurse-to-patient ratio benchmark' because the care workload, manpower allocation, and patient safety risks inherently differ among day, evening, and night shifts.
The National Nurses Association stated that if the calculation is changed to an annual, all-shift average, it could lead to situations like 'masking the true pressure during night shifts and high-workload periods,' 'reverting the system to a full-day average nurse-to-patient ratio,' and 'making the reform lose its substantive meaning,' which would be tantamount to a regression of the three-shift nurse-to-patient ratio policy.
Furthermore, the seven major medical organizations hope for a reasonable buffer period when 'unforeseeable circumstances cause short-term manpower fluctuations.' The National Nurses Association stated that the term 'unforeseeable circumstances' must have a clear and strict definition, limited to natural disasters, major epidemics, and major sudden events. It should not package situations like insufficient remuneration and scheduling management problems as unforeseeable circumstances; otherwise, patient safety and nursing labor safety will once again be blurred.
The National Nurses Association stated that the nursing community can accept a reasonable buffer period for the policy and supports the government in simultaneously completing health insurance payments, manpower replenishment, night shift incentives, integrated inpatient care, smart technology burden reduction, and information disclosure and audit monitoring mechanisms during the buffer period. However, the buffer period must be a reform period, not a vacuum period, and supporting measures should not become an excuse to delay reform or even allow standards to regress.
The seven major medical organizations include the Taiwan Hospital Association, Taiwan Private Medical Institutions Association, Taiwan Association of Medical Management, Taiwan Medical Center Association, Republic of China Regional Hospital Association, Taiwan Community Hospital Association, and Taiwan Medical Corporate Association. (Edited by Li Shu-hua) 1150430
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(Central News Agency, Reporter Shen Pei-hua, Taipei, April 30) The Ministry of Health and Welfare is formulating standards for a three-shift nurse-to-patient ratio. Seven major medical organizations suggested using an 'annual all-shift' average as the benchmark. However, the National Nurses Association emphasized that the workload and risks differ across the three shifts, and calculating based on an annual, all-shift average would constitute a regression in the three-shift nurse-to-patient ratio policy.
The Ministry of Health and Welfare will establish an 'Medical Manpower Optimization Research and Promotion Task Force,' primarily to discuss the three-shift nurse-to-patient ratio in relation to the 'Standards for the Establishment of Medical Institutions.' Minister Shih Chung-liang said yesterday that from international experience, not many countries legislate a three-shift nurse-to-patient ratio, but if appropriate regulations are in place, there are indeed positive effects. In principle, discussions and revisions will proceed based on the Standards for the Establishment of Medical Institutions authorized by the Medical Act.
Regarding the adjustment of related regulations, the seven major medical organizations subsequently issued a joint statement, expressing support for the direction of legislating a three-shift nurse-to-patient ratio. However, they also called on the government to prioritize the implementation of the '12 Strategies for Nursing Manpower Policy Preparation,' ensure that hospitals have sufficient resources to improve remuneration, and adhere to the principle of 'encouragement over punishment.' They further suggested that the nurse-to-patient ratio should be based on an 'annual all-shift' average and incorporate differentiated management based on 'disease severity.'
The nursing community, however, holds opposing views on the statement from the seven major medical organizations. The National Nurses Association of the Republic of China responded yesterday via Facebook, stating that they 'cannot accept an annual all-shift average as the nurse-to-patient ratio benchmark' because the care workload, manpower allocation, and patient safety risks inherently differ among day, evening, and night shifts.
The National Nurses Association stated that if the calculation is changed to an annual, all-shift average, it could lead to situations like 'masking the true pressure during night shifts and high-workload periods,' 'reverting the system to a full-day average nurse-to-patient ratio,' and 'making the reform lose its substantive meaning,' which would be tantamount to a regression of the three-shift nurse-to-patient ratio policy.
Furthermore, the seven major medical organizations hope for a reasonable buffer period when 'unforeseeable circumstances cause short-term manpower fluctuations.' The National Nurses Association stated that the term 'unforeseeable circumstances' must have a clear and strict definition, limited to natural disasters, major epidemics, and major sudden events. It should not package situations like insufficient remuneration and scheduling management problems as unforeseeable circumstances; otherwise, patient safety and nursing labor safety will once again be blurred.
The National Nurses Association stated that the nursing community can accept a reasonable buffer period for the policy and supports the government in simultaneously completing health insurance payments, manpower replenishment, night shift incentives, integrated inpatient care, smart technology burden reduction, and information disclosure and audit monitoring mechanisms during the buffer period. However, the buffer period must be a reform period, not a vacuum period, and supporting measures should not become an excuse to delay reform or even allow standards to regress.
The seven major medical organizations include the Taiwan Hospital Association, Taiwan Private Medical Institutions Association, Taiwan Association of Medical Management, Taiwan Medical Center Association, Republic of China Regional Hospital Association, Taiwan Community Hospital Association, and Taiwan Medical Corporate Association. (Edited by Li Shu-hua) 1150430
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The text, images, and videos on this website may not be reproduced, publicly broadcast, or publicly transmitted and used without authorization.