Tạo động lực làm việc cho bác sĩ trong các bệnh viện công tại việt nam

TAP CHf PHATTRIEN N H A N Ll/C-56_5(64)20T9

TAO OONG Lire LAM VIEC CHO BAC SI
TRONG CAC BENH VIEN CONG TAI VIET NAM
BACSifiAOTHITHilYTRANG'''

TOMTAT
Dong CO lao dongcua ngudi lao dongxudtphdt tu viec mong mudn thda mdn cdc nhu cdu k
ngdng tdng cao cua ngudi lao dong. Khi ngudi lao dong duoc thda mdn nhijcng nhu cdu thiet y
nhdt eua minh, se mong mudn dupc thda mdn them nhieu nhu cdu khdc nhu tu khdng dinh minh,
duac tdn tiong dugc phdttiien....Chinh vi nhung ly do tiin md viec tao ddng luc lam viec cho ngudi
lao dong Id mpt nhiem vu vd cung quan tiong cua to chdc.
Ddng luc Idm viec tao sukhdc biit ve ndng sudt lao ddng cho cd nhdn vd to chdc. Vdn de tao dpng
luc doi vdi ngudi lao ddng dd dupc nghiin cdu bdi nhieu tdc gid tien the gidi vd d Viet Nam. Tuy
nhien,tiongbdi cdnh hien tai, chu de ndy vdn ludn coy nghiationgthuc te. Detdt cd ngudi lao dpng
hdi Idng vdi cdng viec, taptiungndng cao ndng sudt lao ddng ddp dng yeu cdu cua to chdc thi cdng
tdc tao ddng luc tiong to chdc cdn dupc quan tdm vd nghien cdu mdt cdch khoa hpc, tien ca sd dd
tim ra nhdng gidi phdp hpp ly.
Tir khoa: tao ddng luc cho bdc si, benh vien cdng...
l.Datvande
Nhan luc la nlian td quyet dinh ddi vdi sir
phat trien ciia mot td chiic. Trinh do phat trien
cua ngudn nhan luc la thude do ddi vdi su phat
trien ciia td chiic dd. Chi'nh vi vSy, cac td chiic
tren the gidi ciing nhu d Viet Nam deu rat coi
trpng \iec dau tu phat trien ngudn nhan iuc
trong td chiic ciia minh. Tuy nhi6n, viec dau tu
phat trien ngudn nlian luc la ca mpt qua trinh
vdi chien lupc tdng the va dai han. Chien lupc
ay phai dupc xay dung phu hop nhat vdi bdi
canh kinh te - xa hpi the gidi, trong nudc va tinh

hinh tliuc te ciia td chiic.
Dpi ngu bac si la ngudn luc quan trpng nhat
ciia mdt benh vien. Sii dung hieu qua nguon
nhan luc bac si la phat huy tdi da tiem nang
ciia con ngudi va tao ra gia tri gia tang cho benh
vien. Vl vay, nang cao chat lupng va nang suat
•Benh vien Cho Ray

lao ddng ddi vdi dpi ngu nay can dupc quan
tam.
2. Cof sor ly thuyet ve tao dong lire lam viec
trong mpt td chiirc
Dpng luc lam viec cd anh hudng quan trpng
den hieu qua lam viec ciia td chiic. Day dupc
coi la mdt trong nhung ydu td mang tinh quyet
dinh hieu qua lam \\ec va klia nang canh tranh
ciia td chiic. Dpng luc md ta qua trmh ma theo
dd dpng CO dupc kich thich va truyen vao hanh
dpng. Cd the xem dpng luc lam viec la nhan td
ben trong kichtiiichcon ngudi nd luc lam viec
trong dieu kien cho phep tao ra nang sudt, hieu
qua cao. Bieu hien ciia ddng luc la sir sSn s^g
no luc, say me lam viec nham dat dupc muc
tidu ciia td chiic va muc tieu cua ban than nff
ngUPi
lao dpng.'''
'''PGS^TS Bui Anh Tuin, TS. Pham Thiiy Huong (d6ng chii
bien): Giao tnnh Qudn Iri hdnh v, to chicc. Nxb. Dai hoc Kinh

BAC si DAOTHJTHUY TRANG-TAP B O N G LUC LAM VIEC...

Til trudc den nay da cd rat nhieu hpc thuye't, nhu can ciia con ngudi theo hai loai dpc lap va
quan diem cung nhu each ti^p cSn khac nhau cd anh hudng tdi hanh vi con ngudi theo nhdng
ve tao dpng luc lao dpng, sau day la mpt sd each khac nhau; kM con ngudi cam thay khdng
thoa man vdi cdng viec cua minh thi hp rat lo
nghien cdu da dupc cdng bd;
2.1. ly thuyet ve cap bac nhu cdu cua Idng ve moi trudng hp dang lam viec, cdn khi hp
cam thay hai Idng ve cdng viec thi hp chi quan
Maslow(I943)
Theo Maslow, ve can ban, nhu cau ciia con tam den cMnh cPng vide. Td dd, dng da phan
ngudi duoc chia lam hai nhdm cUnh; nhu cau thanh hai nhdm nhan td; duy tri va dpng vien.
CO ban (basic needs) va nhu cau bac cao (meta Thuyet hai nhan td cua Herzberg chda dung
needs).
an y quan trpng ddi vdi nha quan ly nhu sau;
- Nhdng nhan td lam thoi man ngudi lao
Nhu cJu cd ban lien quan den cac yeu td the
ly ciia con ngudi nhu mong mudn cd du thitc dpng la khac vdi cac nhan td tao ra sit thoa
to, nudc uong dupc nghi ngdi.. Nhtmg nhu cau man. Vi vay, khdng the mong dpi su thoa man
CO ban nay deu la cac nhu cau khdng the thieu, ngudi lao dpng bang each don gian la xoa bd
anh hudng va quyet dinh su tdn tai cua con cac nguyen nhan gay ra sij bat man.
ngubi nen hp se diu tranh de dupc thda man
Viec quan ly nhan vien cd hieu qua ddi
cac nhu cau ay.
hdi phai giai quyet thoa dang dong thdi ca hai
Nhiing nhu cau cao hon (cdn gpi la nhu cau nhdm nhan td duy tri va dpng vien, chd khdng
bac cao) bao gdm nhiiu nhan td tinh than nhu nen chi chu trpng vao mpt nhdm nao.
su doi hdi cdng bSng, an tam, an toan, vui ve, dia Nhflng phat hien cda Herzberg cho xhiy ring
vi xa hoi su tdn trpng vinh danh vdi mpt ca mpt sd dac diem cua mpt cong viec lien quan
nhan...

tdi su hat long cdng viec, trong khi cac yeu td
Cac nhu cau co ban thudng dupc uu tien chd khac nhau cd lidn quan den su khdng hai Idng
y trudc so vdi nhiing nhu cau bac cao. Vdi bat cdng vide.
ky ai, t\iu ddi an, khat uong... hp se khdng cdn
Cdc yiu td cho su hdi Idng: Thanh tini; Su
dong CO quan tam ddn cac nhu cau ve ve dep, cdng nhan; Ban than edng viec; Trach nhiem;
su ton trpng... Tdy nhien, my theo nhan thdc, Tien bp; Su phat trien.
hen thUc, hoan canh, thd bac cac nhu cau cd
Cdc yeu td cho su khdng hdi Idng: CMnh sach
ban cb the thay ddi Vi du nhu; ngudi ta cd the cdng ty; Su giam sat; Mdi quan he vdi ngudi
han che an, udng ngu ngM de phuc vu cho cac gam sat va ddng nghiep; Dieu kien lam viec;
sunghiep cao ca hon.
Luong Trang thai; Su bao ve.
2.2. Thuyethaiyeu tdcuaHerzberg(1959)
2.3. Ly thuyet thlit ldp muc tiiu ciia Edwin
Nam 1959, F. Herzberg va cac ddng nghiep A Locke
cua minh, sau khi thuc Men cac cudc phdng
Trong mpt bai bao vidt nam 1960 cd tieu de
vSn vdi hon 200 ngudi ky su va ke toan cua "Tien tdi mpt hpe diuye't ve ddng vien va khuyen
nginh cdng nghiep khdc nhau vi da rut ra khich," tien si Edwin A Locke cho rJng lam viec
nhiSu ket luan rat bd ich. Ong dat cac cau hdi cd muc tidu se mang tdi dpng luc giup nhan
ve cac loai nhan td da anh hudng ddn ngudi lao vien dat dupc muc tieu dd va cai thien hieu suSt
dong nhu; khi nao dii cd tac dung dpng vidn hp lam viec.
lam viec va khi nao thi cd tac dung ngupc lai.
Nghien cdu cua Locke cho thay muc tieu
BSng kinh nghiem chuyen mdn, ong chia cac
cang cu thd va khd khan thi ket qua thuc Men se
tdt hon nhieu so vdi cSc muc tidu md ho hoac
16 Quoc dan,MN9i.2009.

BAC si D A O TH I TH UY TRANG - TAO BONG L1/CLAMVI|C.

BANG LUONG BAC SI CAO CAP
Ddn vi: trieu l o n g
Bad

Bac 2

Bac 3

Bac 4

Bac 3

Bac 6
8,0

6,2

6,56

6,92

7,28

7,64

Mile
ItfOngd^n

30/6/2019

8,618

9,1184

9,6188

10,1192

10,6196

11,12

Mile
Inong tit
1/7/2019

9,238

9,7744

10,3108

10,8472

11,3836

11,92

Hesd
litong

d^ d^ng.
Ddng vien chung chung ki^u "Cd len" hay ve ddng luc lam \iec ciia can bp y te va DD tai
"Cd het siic di" se it hieu qua hon khuyfo khich Benh vien da khoa Nicosia ciia Cpng hda Sip
ngudi khic b^ng mpt muc tieu cu thd nhu "Cd vdi 67 bac si va 219 dieu dudng tham gia nghien
g^ng lam diing it nh^t 80% nhe" hoac "Tap ciiu cho thay rang: yeu td thanh tiai da dupc xep
trung Sli dung thdi gian that tdt di" Tuong tu, hang la cao nhat trong bdn ddng luc chinh, tiep
muc tieu khd khan thudng cd dpng luc thiic day theo la thii lao, mdi quan he vdi ddng nghiep va
cao hon so vdi muc tieu dd dang bdi \'i ngudi ta cac yeu td vd thupe tinh cdng viec. Nghien ciiU
phai ho^n th^nh nhieu dieu de dat dupc muc nay cho thay rang ddng luc da bi anh hudng bdi
tieu dd.
ca hai yeu td tai chinh va phi tai chinh. Cac hoat
05 nguyen tAc de thiet lap muc tieu: Rd rang, ddng lien quan den su danh gia cao nhu quan ly
Thach thUc, Cam ket, Phan hoi, Dp phufc tap hieu suat hien tai khdng thuc hien tdi uu, NVYT
ciia cdng viec.
nhan thay giam sat/kiem soat, viec lua chpn dd
Ngoai ra, cdn cd nghien cuu ciia Melkidezek
dao tao la khdng rd rang va khdng ddng deu va
T. Leshabari va cdng su ve ddng luc Idm viec
cua nhdn vien y te (NVYT) d benh vien quoc gia do ludng liieu suat la khdng huu ich. Cac loai
Muhimbih cua Tanzania (2008). Nghien ciiu ddng luc phi tai chinh dupc xac dinh nen dupc
nay vdi su tham gia ciia ciia 448 nhan vien benh xem xet khi phat trien cac chien lupc qudn ly
vien. K^t qua nghien cuu cho thay gan mpt niia nguon nhdn luc.
Nghien cuu ciia Hala Ayyash va cdng sU
bac si va didu dudng da klidng hai long vdi cdng
viec cua hp. Nguyen nhan la do cac yeu td v^ (2011) ve Dpng luc lam viec cua dieu dudng tai
miic luong thap, khdng dupc trang bj day dii cac benh vien Gaza dddi Gaza. Cac mau ciia nghidn
tiiiet bi vk dung cu can tliiet de dam bao cham ci:ru nay bao gdm 170 dieu duong. Ket qua cho

sdc benh nhan, khdng cd su danh gia va phan thay mtic dp ddng luc giUa cac ddi tupng nghien
hdi thudng xuyen, cac kenh giao tiep kem giUa cuu la 66,2%. NhQng ngudi tham gia nghien ciru
ngudi lao ddng va quan ly, thieu su tham gia cho rang su quan tam va thu hudng la dpng luc
vao qua trinh ra quyet dinh, va thieu quan tam cao nhat (75,8%), tiep den la quan ly va giam sat
ddi vdi phuc Ipi NV-YT cua benh \ien. Nghien (72,1%), giao tiep (70,0%). cdng nhan va khen
ciiu cua Persefoni Lambrou va cdng su (2009)
thudng (53.9%), mdi trudng va di^u kien l^m


'BAG s i B A O T H j T H C J Y T R A N G - T A P BONG LL/C LAM VIEC...
B A N G L U O N G B A C s i CHfNH
Dan Vi:tri0u dong
B$cl

BlLC2

Bac 3

Bac 4

Bac 5

Bac 6

Bac 7

Bac 8

Hesdlirnng

4,4

4,74

5,08

5,42

5,76

6,1

6,44

6,78

Mure

6,116

6,5886

70612

75338

8.0064

8,479

8,9516

9,4242

6,556

7,0626

7.5692

8,0758

8,5824

9,089

9,5956

10,1022

luungden
30/6/2019
MijTC tuung
ti(l/7/2019

BANG LUONG BAC Si
Don vi:tri$u d o n g
B^cl
He so luong 2,34
Mik

Bac 2

B&C3

Bac 4

Bac 5

Bac 6

Bac 7

Bac 9

Bac 8

2,67

3

3,33

3,66

3,99

4,32

4,65

4,98

3,2526

3,7113

4,17

4,6287

5,0874

5,5461

6,0048

6,4635

6,9222

3,4866

3,9783

4,47

4,9617

5,4534

5,9451

6,4368

6,9136

7,4202

luong den
30/6/2019
Miilc liAAig
tit 1/7/2019

viecdmilc thap nhat (53,6%).''>
3. Cac yeu td tac dpng de'n dong luc lam
vigc cua bac si trong khu v u t benh vi^n cong
talVietNam
3.L Luang
Luong la yeu td rat quan trong ddi vdi ca
nhan ngudi lao ddng ndi chung va M c si ndi
rieng. Tien luong la gia ca silc lao dpng cua bac
si duoc thda thuan thdng qua h o p dong lao
dong vdi benh vien. Tien luong la dong liic de
Mc si lam viec va cdng hien, ndn khi bk dau
c6ng viec d mdt benh vidn nao hp deu mong
mudn tien luong xung dang vdi site lao ddng
ban than bd ra. Tidn luong tuong xilng vdi nSng
suiit lao dOng giup bac si dam bao cudc sdng va
tai tao silc lao ddng. Tuy nhien, mure luong hien

nay ddi vdi bac si trong cac benh vien cdng rat

thap so vdi mat bang chung ciia xa hdi, nhat la
vdi nhiing bac si mdi ra trudng.
Luong cua bac si hien nay dupc phan hang
thanh ba cap: Bac si cao cap (hang I), Bac si
chinh (hang II), Bac si (hang III). Tuong ting
mdi hang la cac mtic luong khac nhau.
Viec xep luong cua bac si trong don vi sit
nghiep c d n g l a p h i e n n a y dupc quy dinh kha cu
did tai Thdng tu lien tich 10/2015/TTLT-BYTBNV Tlieo dd, til ngdy 1/7/2019, mile luong co
sd dupc dieu chinh tang len. Tuong tii n h u cac
ddi tupng vien chile khac, luong ciia bac si dupc
tinh theo mdc luong co sd nhdn vdi he sd. Cii
the mu!c tang nhu sau:
-Mdc luong CO sd tir nay den 30/6/2019:1,39
tridu ddng/thang.
- Mile luong CO sd tit 1/7/2019: 1,49 trieu

'"' fJguyen Thj Kim Hu|: 'Tao dong lire lao dpng cho dieu
duoDg vien t^i B?nh vi$n Nhi Trung uong", Luan V5n Th^c sT
Quan trj nhan l^rc, m N$i. 2016.

ddng/thang.
Khi mdi ra trudng, luong ciia mdt bdc si chi


BAC si D A O TH! TH OY TRANG - TAO O O N G J J / C L A f ^ ^

6 miic khoang han 2 trieu d6ng. Cung co the cb

them khoan tro cap khac nhimg 66 chi la ddi v6i
bac si c6ng tac d cac benh viSn Ibn, con nhung
bac SI lam tuyen dudi thi r^t it khi c6 them cdc
khoan tro cap nao khac. Miic luong n&y khien
nhieu bac si ludn cam thay bi h^t hiii vi cong viec
vat va ma khong dupc den ddp xiing dang.'^'
Tr6n thuc te, doi vdi dpi ngu bac si, l^m the
ndo can b^ng dupc cac nhu cau, vira lao dpng
de dam bao eupc sdng, vCta d^u tu phat trien
ban thdn va nghien ciru khoa hpc la mpt vl6c
h^t siic kho khan. Vi vay, cac hien tupng nhu
lam them benh vien khac, md phong mach,
lam them nghe tay trai la dieu tat yeu xay ra.
Dieu nay it nhieu lam giam hieu qua cong viec
chuyen mOn, phuong hai den hinh anh ciia
ngudi bdc si va giam siit long tin ciia benh nhan
vd ngudi nhd ddi vdi nhung ngudi chien si do
trSng.
3.2. Thudngvdphuclai
Hien nay, ddi vdi khu vuc benh vien cong,
phan thudng ddnh cho nhuiig thdnh tich ciia
cac bdc si mang tinh khich 1^ tinh than nhifiu
hon Id cd gid tn vat chat. Thudng theo quy dinh
ciia phap luat hien hdnh tdp trung vdo thudng
1§, tet vd xep loai vien chiic hSng ndm, chua cd
quy dinh v^ thudng ddi vdi nhirng thanh tich
mang tinh dot phd cho su phdt trien ciia benh
vien. Hon nCra, gid tri phan thudng danh cho
nhung ca nhan bdc si xudt sac, nhung giai phdp
mang tinh mdi ciia benh vi^n khdng cao nen

chua thuc su tao dpng luc thuc ddy cung nhir su
cdng bang doi vdi cd nhan bac si trong td chiic.
Nhieu bdc s! cho rdng chinh sach khen
thudng cac benh vien dang dp dung vdn chua
phdn dnh diing ket qua thuc hien cdng viec ciia
ngudi lao dpng nen Idm cho mot sd bdc si cam
thay mile tien thudng md hp nhan duoc chua
tuong xiing vdi cdng site ma hp bd ra. Cdc tieu
'" Huyen Anh: "Luong ca ban cua bac sT tir 01/7/2019 dugc
tinh nhir the nao''"; tir website: httpsV/caodangyduocnhatrang.
vn/tm-tuc-doi-song/luong-co-ban-cua-bac-si-tu-172019-duoctinh-nhu-the-nao-c25193.html, tmy cap ngay 17/9/2019.

ehuan ddnh gia thuc hien cdng \iec cua ngudi
lao dpng cdn chung chung, khdng dinh lupng
duac.
3.3. Cong tdc ddnh gid vdxeploqi
Viec ddnh gid can bp, cdng chiic, \A^n chiic
hien nay dang dupc thuc hien tlieo Nghi dinh
sd 56/2015/ND-CP ngay 09/6/2015 vd Nghi
dinh sd 88/2017/CP-CP ngdy 27/7/2017 ciia
Chinh phii. Tuy nhien. cdc tigu chi danh gid va
xdp loai vdn chua lupng hda dupc ket qua cdng
viec. Danh gia cdn mang tinh chii quan, da sd
ngudi lao ddng deu dupc ddnh gia "hoan thdnh
nhiem vu" trii nhungngudi vi pham ky luat hoac
khong dam bao ngdy cong, gid cdng mdi bi ha
xep hang thanh tich. Cach danh gid tren khdng
phdn loai duoc chinh xdc thdnh tich cua ngudi
lao dpng, do dd khdng dam bao tinh cdng bang
trong phdn phdi thu nhap tang them. Qua trinh

ddnh gid chiu su chi phdi nhieu bdi cdc ydu td
nhu lanh dao, mdi quan he ddng nghiep, cam
tinh... Su khdng cdng bang gdy ndn cdm xuc tieu
cue, dnh hudng manh me ddn tdm ly ciia ngudi
lao dpng, dan den su bat mdn, tir dd cd cac bieu
hien nhu khdng lam viec het siic, khdng hop tdc
hoac cao han Id cac hdnh dong khang cu mang
tinh chdng ddi,
3.4. Nhu cdu khdng dinh bdn thdn vd nhu
cdu duac ton trong
Sau khi da ldnh nghe, trd thdnh bac si gidi,
nhi^u ngudi mudn dupc thdng tien, cd chiic
vu cao hon, dupc xem trpng hon ve nang luc
chuyen mdn, cd dupc vi tri xirng dang han.
Song, m duy "sdng Idu Idn Ido lang" tai cac benh
vidn cdng vdn cdn tdn tai, tao nen tam ly chan
nan trong dpi ngu bdc si tre, khien hp nay sinh
nhu cau thay ddi nidi trudng 1dm viec chuyen
sang cac benh vien tu, noi cac bac si cd thuc tai
thudng duoc trpng dung xuiig dang.
3.5. Mdi trudng lam viec
Thuc te nhu cau cham sdc benh nhdn ngay
cdng tdng. Tuy nhien su ddu tu co sd vat chat
cho benh Men Id rat ban che. Co sd vat chat


BACSIPAOTHJTHUYTRANG-TAQPONGLI/CLAMVIEC.
khdng ddp iing kip, nhan luc khdng dii ve sd
luang va chat lupng dan den tinh trang qud
tai trong bdnh vien. Hien nay, d cdc benh vien

cdng, cdc bdc si chiu nhieu dp luc cdng vide
vdi sd lupng bdnh nhan ngdy cang Idn nhung
lai thidu cdc di^u kien lam viec vd mdi trudng
lam viec khdng thoai mdi (dn do, nguy co tiep
xuc mam benh cao, thdi gian Idm viec ddi, cang
thang)... 1dm cho viec thuc hidn y diic tai benh
vien cd nhung han che nhat dinh md bac si
khong he mong mudn.
3.6. Phdn cong vd bd tri cong viic hop ly
Vi benh nhdn ddng nhung nhan luc bac si
chuyen mdn thieu nen viec bd tri chong eheo,
phdn cdng cdng viec khdng diing chuyen mdn
cung la mdt trong nhung ydu td tac dpng tieu
cue den dong luc Idm vide cua bdc si trong benh
vien cong hien nay.
3.7. Cdng thdng nghe nghiep
Moi tmdng Idm viec khdng thuan Ipi, su qud
tai trong cdng viec, thdi gian lam viec kdo ddi,
trach nhiem cdng viec cao, cang thang khi tidp
xiic vdi benh nhan vd ngudi nha benh nhdn,
ddn den hien tuong bac si rai vdo tinh trang
cang thdng nghe nghiep vdi nhung miic dp
khac nhau.
Ngoai ra, cdng vide ddi hdi phai true ca ddm
va cac ngay nghi, ngdy Id, do vay cdc bdc si, ddc
biet la bac si nOt khdng cd nhieu thdi gian cho
gia dinh; cdng viec hdng ngay phai tiep xiic vdi
benh nhan, thudng xuyen tiep xuc vdi yen to
nguy CO gdy benh, dnh hudng den siic khoe...
la nhiing nguyen nhan khien bdc si bat man vdi

ngh^ nghiep.
3.8. Thdi gian ddnh cho viec hoc tap vd
nghien cdu khoa hoc
Vi luong thdi gian danh cho cdng vide hdng
ngay qua Idn ndn thdi gian de cdc bdc si danh
cho viec hpc tap vd nghien ciiu khoa hpc la rat
it, tham chi bdng khdng. Dieu nay ddn tdi vide
mudn cd thdi gian hpc tap phat trien ban than
hoac nghien ciiu khoa hpc bdc si phdi rdi bd

cdng viec hien tai ciia minh.
4. Mpt so de xuat de tao dpng luc lam viec
cho bac si d cac benh vien cdng Viet Nam
4.1. Ti-d luang tuang xdng sdc lao ddng vd
trin CO sd ket qua cong viec cua bdc si
Luong bdc si hidn nay dupc cho la khdng
theo CO che thi trudng, chua dam bao duac
cudc sdng. Tra luong theo ngach bdc, thdm
nien, bdng cap ban Id ket qua cdng viec cdng
vdi CO che ddnh gid nhidu bat cap khdng tao ra
su cdng bdng giira cac cd nhdn. Dieu ndy d§ tao
ra su bat binh va giam ndng sudt lao ddng ciia
bac si. Vl vay, thuc hien cai cdch chinh sdeh tien
luong ddi vdi khu vuc benh vien cdng Id didu
can thiet. Mdc khdc, co che trd luong nen dupc
thuc hien tren co sd thdnh qua cdng viec de
dam bao tinh cdng bdng.
Cd the tham khdo cdch tra luong theo cdch
sau:
Luong = P1+P2+P3

Trong dd:
PI: Nd luc ndng cao trinh dp chuyen mdn
ciia cd nhdn (30%): hpc chuyen khoa sdu, tham
gia ddo tao y kiioa hen tue (CME), nghien ciiu
khoa hpc theo dinh hudng chien lupc chuyen
mdn ciia benh vidn.
P2: Nd luc chia se tri thiic va tham gia phdt
trien chuyen mdn cho benh vien (40%): tham
gia hpi chan, tham gia xir tri ca khd, td chirc
workshop chuyen de sdu, huan luyen dao tao
bdc si tre. Bien soan phdt do, quy trinh chuyen
mon, kiem soat, cdi tien boat ddng chuyen mdn.
P3: Tliu nhap true tiep tir benh nhdn (sd
lupng ca kham, ca md) (30%)
Trong ba thdnh phan thi PI, P2 la khdng
gidi han, dupc khuyen kich lam dupc cang
nhieu thu nhap cdng nhieu. Rieng P3 Id phai
dat ngudng, mdi bac si kham tdi da n ca/ngdy,
md m ca/ngdy (n, m tiiy thude vao timg noi) de
trdnh lupng benh nhan tap trung vao mdt vdi
bac SI, va khong cdn co hdi cho cdc bdc si khdc
Idm Idm sang, de tranh viec loi keo tranh gldnh.


BAC SI DAOTHI THOYTRANG - TAO OONG u/cj^Aivrvi|o
ddng thdi vdn khuyen khich bdc si chdm sdc
chu ddo cho benh nhan. Viec xdp hang (rating)
bdc si theo loai A, B, C tuong ung vdi tien khdm
vd tien md ma benh nhan phai trd Id can thiet
phai ddt ra de dieu tiet vd ddng vien.

Nhdm nhung bdc si cd benh nhan tap trung
cao nhat - nhdm A, se cd miic gid khdm va gia
md cao hon 30-50% so vdi nhdm B. Va tuong tU
cho nhdm C. BangratUig va gia phai dupe niem
yet cdng khai cho benh nhan. Mdi quy, benh
vien se thdng ke va dieu chinh bang xep hang
mdt Ian.
P3 cho trudng hpp bdc si khdng tham gia
khdm va md true tiep (bdc si back-office) dupc
ddnh gid dua tren miic dp hodn tlidnh cdng
viec dupc giao vd dupc do lubng bang cdc chi sd
danh gid thanh tich duoc thiet ke ddt trung. Vi
du P3 ciia kiem soat nhidm khuan se dupc gan
vdi ty le nhidm khuan benh vien. P3 ciia ICU se
gan vdi ty le hdi phuc trudc va sau vdo ICU. P3
ciia gay me hdi siic gdn vdi ty le gdy me hdi siic
thdnh cdng.
Trong ba thdnh phan thi P2 cd trpng sd cao
nhat, de budc mot tri thiic phai ddng gdp tri
thiic cho benh vien. Benh vien phdt trien thi bdc
si phdt trien, benh vien ton tai thi bdc si tdn tai,
tranh tinh trang bac si giau nghe, giu bi quyet
khdm chUa benh de phat trien cd nhdn md
khdng chia se tri thiic.'"*'
4.2. Khen thudng vd phuc led
Khen thudng
Tien thudng nen gan lien vdi thdnh tich ciia
bdc si vd la nguon ddng vidn khi hp dat duac
thdnh tich. Mudn vay, benh vien phai xdy dung
cdc tieu chi khen thudng cu the dua tren ket

qua thuc hien cdng ^ c ciia timg bdc si trong
ky danh gid de cd the phdn loai va so sdnh dupc
*•*' ThS. Huynh Bao Tuan (Giang vien Khoa Quan !y cong nghiep - DH Bach Khoa TP.HCM): "Tra luong theo san phSm va
cai gia phai tra qua dat cho nganh Y", tir website: http://www
qpsolutions.vn/newsdetail.asp''newsID=]0542&ca£lid=7&cat2id=18&title=tra-luong-theo-san-pham-va-cai-gia-phai-traqua-dat-cho-nganh-y, truy cap ngay 17/9/2019.

cdc mire thudng cho cdc bdc si d ciing vi tri, tii
dd cdc bdc si cd co sd phan dau trong cdng viec.
Cdng tac khen thudng can phai dam bao sir
khdch quan vd cdng bdng dUa tren ket qua thuc
hien cdng viec ciia timg bdc si. thanh tich chung
ciia nhdm va miic dp phdc tap cua cdng vide de
hp cam thay phan khdi khi hidt nhiing no luc
hodn thdnh cdng viec ciia hp iudn dupc to chiic
ghi nhdn.
Quyet dinh khen thudng can dupc dua ra
mdt cdch kip thdi, dung liic vd phdi dupc tidn
hdnh cdng khai mang tinh khuyen khich cao de
khich letinhthan ciia ngudi dupc khen thudng
Cling nhu neu guong cho ngudi khac noi theo.
Khuyen khich bac si tham gia ddng gdp y
kien xdy dung chuong trinh khen thudng de cd
the xdy dung dupe chuong trinh khen thudng
phu hpp vdi nguyen vpng ciia ngudi lao dpng.
Phuc Ipi
Ap luc cdng vide khidn cdc bac si ludn cam
thay cdng thang. Do dd, ngodi cac phiic loi
thdng thudng hien nay nhu du lich hdng ndm,
giao luu van hda van nghe..., benh vien can xay
dung mdt khdng gian giai tri, thu gidn cho bde

si. Dd cd the Id phdng dpc sach, phdng xem
phim, khu vuc spa thu gian, phdng tap the thao
da nang... de sau nhung gid lao ddng chuyen
mdn cang thang, bdc si cd noi de nghi ngai, giai
tda cang thang, met mdi.
4.3. Cong tdc ddnh gid vd xep loai phdi
duac thuc hien cong bdng
Trong mdi trudng benh vien, de xdy dung
dupc he thdng ddnli gia dung dan, hpp ly vd
cdng bang cho nhdn vien y te ndi chung va bac
si ndi rieng thi viec xay dung cac tieu chudn hay
chi tieu thuc hien cdng viec mdt each hpp ly vd
khdch quan la dieu rat can thiet, tdc la chi tieu
phdi phan dnh dupc ket qua va hdnh vi can cd
de tiiuc hien tdt cdng viec. Trong benh vidn,
tidu ehuan thuc hien cdng vide ciia bac si cd
die dua vdo ban md ta vi tri viec lam. Danh gia
va xep loai dua vdo cdng vide tren ban md ta


BAC SI P A O TH! THUY TRANG - TAG D Q N G LLfC L A M VIEC...

cong them su tan tam vdi nghe va giup dd dong phti hpp vdi nhu cau ciia benh vien, tranh tinh
n^^p- Danh gid chinh xdc, djnh lupng dupc se trang de bdc si lam viec qud tai. Nhan vien y td
giiip bac si yen cdng viec va tim thay niem vui ndi chung vd bac si ndi ridng dupc tuyen dung
tai mditiUdnglam viec.
hay bd nhiem can dam bao cdc tieu ehuan yeu
4.4. Nhu cdu khAng dinh bdn thdn vd nhu cau cua vi tri viec 1dm. Benh vien cdn quan tdm
cdu duac ton trong
den viec bd tri dung ngudi diing vide de phdt

Conngudl se dupc thuc day Idm viec hidu qua huy tdi da ndng luc ciia hp. Ben canh dd nen
khi nhin thay con dudng tuong lai vd dich den tinh gian bien che de loai bd nhiing thanh phan
cu the. Vl vdy, cac Idnh dao benh vien khdng chi khdng lam dupc viec ra khdi td chiic, trdnh cac
hudng bac si den muc tieu ciia td chiic md can tdc ddng tidu cue cho ngudi lao ddng cd nang
giup ho xay dung Id trmh nghe nghidp cho ban luc.
than hp. Dieu nay khdng nhiing tao ddng luc
4.7. Han che cdng thang nghe nghiep
cho bdc si md con tao ra mdt mdi trudng 1dm
De ban chd tdi da cang thSng nghd nghiep
viec phdt trien. Ngodi ra, benh vidn cdn thuc ddi vdi bdc si, benh vien nen dua ra nhiing gidi
hien hieu qua chinh sdeh ddo tao, bdi dudng de phdp nhu gidm thdi gian Idm viec, giam khdi
giup bdc si hoan thdnh muc tieu nghe nghiep vd lupng cdng viec bang each vide tdng dpi ngii bdc
muc tieu phat trien bdnh vidn.
si; ldp kd hoach phan cdng cdng tdc cu th^ dua
4.5. Cdi thien moi tn^mg lam viec
tren y kien ciia bac si va lupng benh nhan thuc
Benh vien can cdi thidn mdi trudng vd didu td; md rpng khu dieu tri tu nguydn nhdm cd thd
kien lam viec cho bdc si: phuong tien cdng tdc tien hdnh khdm, chiia benh ngodi gid theo quy
(may mdc) dupc trang thiet bi theo phuang dinh; tang miic phu cap cho bac si thuc hien
cham CO ban va chuyen sau, tang cudng td khdm chda benh ngodi gid.
chiic cdc budi sinh hoat chuyen mdn, sinh hoat
4.8. Tdng thdi gian ddnh cho viic hoc tap vd
van hda va gia tdng tiep xiic lanh dao. Ve quan nghien cdu khoa hoc
he vdi lanh dao, bdc si mong mudn duoc lang
Thudng xuyen md hoac c^ bac si tham gia cdc
nghe, tdn trpng vd phan hdi true tiep nhidu ban khda hudn luyen ddo tao ngan ban vd dai ban
nham dat dupc hieu qua cdng viec tdt hon.
de ndng cao trinh dp, cap nhat kidn thiic mdi
Benh vien cung nen tang cudng phd bien ve hoat dpng kham vd dieu tri do cdc chuyen
kien thiic quan tri hpc cho nhdn vien quan ly vd gia gidi true tidp giang day. Khuydn khich bdc si

4p dung kien thiic qudn tri cho cdc boat ddng tham gia hoat ddng nghien ciiu khoa hpc, tham
khdm vd di^u tri, tao dieu kien cho bac si chi tdp du cdc hditiidokhoa hpc.
trung vao chuyen mdn, it mat thdi gian va tdm
5. Ket luan va kien nghi
site trong nhiing cdng viec qudn ly hdnh chinh
Bac si la ngudi tiep xuc thudng xuyen vdi
nhi6u khe.
benh nhdn nen dpi ngu ndy dupc xem Id dai sii
Ngoai ra, benh vidn can xay dung cdc chinh van hda ciia benli Wen. Tao ddng luc Idm viec
sach, quy trinh qudn ly... theo hudng lay loi cho bdc si nghia Id tao ra chat lupng dich vu
I'ch cua nhdn vien y te ndi chung vd bac si ndi kham chfla benh ngdy cdng chuyen nghiep cho
rieng Idmtiringtam va cdng khai, minh bach benh vien.
cac chinh sach, quy trinh quan ly cho loan bd
De tao ddng luc lao ddng cho bac si, bdnh
nhan vien.
vien can thuc hidn cdc giai phdp sau:
4.6. Phan cdng vd bo tri cdng viec hap ly
Tra luong tuong xiing sflc lao ddng va tren co
Benh vien can tuyen dung day dii nhdn luc sd kdt qua cdng vide cua bdc si;


BAC SIDAOTHI T H O Y T R A N G - T A G DONG LlA^LAMVIfC^

2. Nghi dinh sd 72/2D18/NB-CP ngiy
15/5/2018 ciia Chinh phu ve quy dinh mdc
luong Cd sd ddi vdi cdn bd, cdng chdc, viin chd
3. Trudng dai hpc Y te cdng cdng: Gido tiinh
qudn ly ngudn nhdn luc, Nxb. Y hpc. Ha Ndi
2015.
4. PGS.TS. Nguyin Tidp: Gido tiinh Tiin

luang tiin cdng Nxh Lao ddng xa hdi. Ha Ndi
2007.
5. PGS. TS. BCii Anil Tuan, TS. Pham Thdy
Huang (ddng chu bidn): Gido tiinh Qudn tri
hdnh vi td chdc, Nha xuat ban Dai hpc Kinh td
Qudc dan. Ha Ndi. 2009.
6. Hpang Thi Hdng Ldc, Nguyen Qudc Nhi:
"Xay dung khung ly thuydt ve ddng luc lam vide
d khu vuc cdng tai Viet Nam" Tap chi khoa hpc
trudng Dai hpc Can Tha, 2014.
7. Bui Dam va Bill Thi Thu Ha: "Danh gia sU
hai long ddi vdi cdng vide cua bac si benh vien
da khoa Quang Ngai - Nam 2011" Tap chiYhoc
thuc hdnh, s6 4 nam20ll.
8. Nguyen Thi Kim Hue: 'Tao ddng lire lao
ddng cho dieu dudng vidn tai Bdnh vidn Nhi
Trung uong" Luan vdn Thac si Quan tri nhan
luc. Ha NdL 2016.
9. Huyen Anh: 'Luong co ban cua bac si ttt
01/7/2019 dupc ttnh nhu thd nao?"; ttt website:
truy cap
ngdy 17/9/2019.
10. ThS. Huynh Bao Tuan (Giang vien Khoa
Quan ly cdng nghiep - DH Bach Khoa TRHCM):
"Tra luong dieo san pham va cai gia phai tra
TAI LifiU THAM KHAO
qua ddt cho nganh Y"; ttt website: http://www.
1. Quyet dinh sd 122/QD-TTg ngay 10 thang qpsoluHons.vn/newsdetail.asp?newsID=1054
01 nam 2013 ve Phe duyet Chien Iuoc qudc gia 2&catlid=7&cat2id=18&title=tra-luong-theobdo ve chdm sdc vd ndng cao sdc khoe nhdn san-pham-va-cai-gia-phai-tra-qua-dat-choddn, tdm nhin den ndm 2030.
nganh-y, ttuy cap ngay 17/9/2019.

Khen thudng va phuc lai tdt;
C6ng tac danh gia va x6'p loai phai duac thuc
hien cOng bang;
Dap ling nhu cau khang dinh ban than va
nhu cAu duac ton trpng cua bac si;
Cai thien moi tru6ng lam viec;
Phan cong va bo tri cong viec hap ly:
Han che cSng thang nghe nghiep;
Tang th6i gian danh cho viec hpc tap va
nghien cijni khoa hpc.
Kien nghi v6i doi vdi nganh Y te ve cong tac
xay dung dpng luc cho bac si
Ng^nh Y te can quan tam hon nua doi vcfi
c6ng tac tao dong luc cho bac si de nang cao
chat luong kham, chUa benh tai c^c benh vien
va cac CO sd y t^ khac.
Can xay dung chinh sach hd trp phti hpp
hon vdi nhUng bac si cd nguy ca mdc cac benh
ttuyen nhiem, kha nang nhi§m dpc.
Tang trp cap dau dm ddi vdi bac si
Can trang bi vh giam sat cac bao hd lao
dpng day dii cho bac si. Dau tuva hien dai hda
cac trang thidt hi trong cdng tac cham sdc sdc
khoe ngudi benh de giup bac si tranh nguy co
nhiSm ddc va lay bdnh tU benh nhan.
Cin cd chidn lupc thu hut va phat trien
ngudn nhan luc bac si vd cdc benh vien cdng
nham giam thieu qua tai nhan Itrc bac si d cac
benh vien.

Canto chdc nhieu han cac chuong tilnh giao
luu hpc hdi, trao ddi chuyen mdn giua cac benh
vien dd bac si cd ca hpi linh hdi cac kien thdc va
kinh nghidm tir cac bac si gidi trong cic linh vuc
kham chQa bdnh.