||The controversial policy of 1 fixed day off and 1 flexible rest day (abbreviated as “yili yixiu”) was officially implemented in Taiwan on January 1, 2017, its main regulation being 1 official holiday and 1 rest day each week. Employees cannot be requested to work overtime on the fixed day off in the absence of exceptional circumstances, whereas the rest day is negotiated by employers and employees, and employees’ consent to work overtime can be obtained if employers have operational requirements. This system increases the specified threshold for working overtime to reduce the likelihood of working overtime, reduce working hours, and prevent labor fatigue. The system also offers employers greater flexibility. |
In this study, qualitative in-depth interviews were conducted in six hospitals in southern Taiwan with head nurses of emergency departments in medical centers, regional hospitals, and district hospitals to investigate the impact of “yili yixiu” on emergency departments. The interview outline was divided into seven sections, each exploring the level of impact on various aspects. After the interviews had been conducted, the overall impact of the system was summarized based on the interview results.
The analysis results of this study revealed that the implementation of the new policy had little effect on health care institutes that already allowed 2 days off per week. Thus, the governments’ regulations should not be considered a problem. The actual problem lies in personnel mobilization and scheduling procedures. Although no considerable problems arise under full manpower, such problems could arise in hospitals with manpower shortages. The sophistication of the e-system and the total number of staff members to be managed affect the speed of system development. Furthermore, difficulties related to employees’ working hours and leave arrangements are more complex in high-level hospitals.
The greatest follow-up effect of “yili yixiu” is that in some hospitals, accumulated leave from previous years is disregarded. However, for managers, the newly implemented rest days and special leave days must be allowed and should be used or converted into salary within a specific time frame according to each person’s working days. The current Labor Standards Act requires the consent of employers and employees to arrange special leave, which can be bewildering for employers, particularly in hospitals with large numbers of managers. Some of the head nurses interviewed in this study stated being bewildered by the annual settlement regulation under the current system. Under such circumstances, employers are always faced with the problem of compensating employees for outstanding leave, and employees cannot apply for the leave that they should be allowed under the system. In addition, insurance in public hospitals is divided into public insurance and labor insurance. Fair conditions for all personnel is difficult to achieve because of the different perspectives involved.