[Exclusive] Severance Hospital to Pilot '4-Day Workweek' System

Labor-Management Agreement on Pilot Project Introduction
First Case in Domestic Hospital Sector
Confirmed Through Union General Vote

Nurses Work Day-Evening-Night 3 Shifts
Average 10.6 Hours of Work Per Day
"4-Day Workweek Is the Biggest Demand on Site"

Yonsei Severance Hospital Exterior View

[Asia Economy Reporter Lee Chun-hee] The introduction of a '4-day workweek' is being pursued for the first time in the domestic hospital sector. Given the nature of hospitals that must operate 24 hours a day, nurses have endured tight three-shift work schedules and excessive labor burdens, drawing attention to whether their working conditions will improve.

According to related industry sources on the 2nd, Yonsei Medical Center and the Severance Hospital Labor Union reached a tentative agreement on this year's wage negotiations the day before. The tentative agreement also includes starting a pilot project for a 4-day workweek (32 hours per week). This is the first case not only among Korea's so-called 'Big 5' large tertiary hospitals but also among large hospitals in general. The union also emphasized the significance, stating, "We are starting the first pilot project for a 4-day workweek in the Korean hospital sector."

This pilot project will be conducted over one year in three wards, with about five people per ward applying to participate. The biggest issue and a major hurdle during the negotiation process was whether to adjust wages upon introducing the 4-day workweek. For now, the plan is to adjust wages accordingly. Additional personnel will be deployed to compensate for the reduced working hours.

The union stated, "In the special conditions of hospitals, the 4-day workweek is being discussed as the only alternative to reduce working hours," and added, "We will demonstrate many positive effects gained through work-life balance." Regarding wage adjustments, they explained, "Since this is a pilot project involving a small number of people, some adjustments have been made," and "In the long term, the goal is a 4-day workweek without wage cuts." However, this agreement is tentative and must go through a union vote from the 5th to the 8th, with both labor and management signing on the 8th for final approval.

Three-shift work in '24-hour wards'... Actual average daily work hours reach 13.1 hours

Medical staff are caring for a patient in the intensive care unit at Pyeongtaek City Park Ae Hospital, Gyeonggi Province. Photo by Moon Honam munonam@

Throughout the COVID-19 pandemic, issues regarding the excessive labor methods of nurses have been continuously raised. Wards that must operate 24 hours due to inpatients typically operate on a three-shift system. These are divided into ▲Day (7 AM to 3 PM) ▲Evening (3 PM to 11 PM) ▲Night (11 PM to 7 AM the next day).

While the working hours appear to be 8 hours per day, in reality, various overtime tasks such as handovers before and after commuting occur. According to the Korea Labor Institute, the average daily working hours for nurses is 10.6 hours, far exceeding 8 hours. Night shifts average 13.1 hours per shift. Moreover, nurses are classified as a special industry exempt from the 'maximum 52-hour workweek' system, which includes 40 regular hours plus 12 hours of extended work, making their workload even more severe.

As these shift work patterns continue, nurses suffer from disrupted biological rhythms and chronic fatigue, and they have voiced difficulties in maintaining normal family life and childcare. This is also cited as a major cause of job maladjustment and resignation among nurses.

Consequently, calls for reforming the shift work system have been persistent. Samsung Seoul Hospital has effectively abolished the three-shift system by introducing flexible work arrangements. Various work types were introduced, including ▲fixed Day or Evening shifts ▲fixed Day-Evening, Day-Night, Evening-Night shifts ▲fixed Night shifts ▲12-hour two-shift work. As a result, the preference for the traditional three-shift system plummeted to just 1%. The preference for three-shift work is nearly zero.

The Seoul Branch of the Medical Solidarity Headquarters of the Public Transport Union of the Korean Confederation of Trade Unions held a press conference in front of Seoul City Hall last September, titled "Condemning Seoul City for Not Announcing COVID-19 Nursing Staff Standards! Nurses Submit Resignation Letters." / Photo by Moon Honam munonam@

Beyond this, voices advocating for reducing overall working hours by introducing a 4-day workweek have also been continuously raised. Na Soon-ja, Chairperson of the Health and Medical Workers' Union, stated last year, "During preparations for a general strike, the strongest demand from the field was the introduction of a 4-day workweek," and argued, "To guarantee sufficient sleep, rest time, and personal time after night shifts in irregular shift systems institutionally, the total number of working days and hours must be reduced."

In fact, Sweden introduced a '6-hour workday' system in hospitals, resulting in improved health among medical staff. According to an experiment conducted in 2015-2016 in Gothenburg, Sweden, targeting nurses and nursing assistants, reducing daily working hours to 6 while maintaining wages and hiring new staff led to a 143% improvement in nurses' physical strength after work and a 105% improvement in stress satisfaction in the experimental group. In contrast, the control group maintaining the existing work pattern showed deterioration of 65% and 46%, respectively.

Although this is a pilot project, once the precedent is set, demands for a 4-day workweek in the hospital sector are expected to grow. A labor sector official said, "Severance Hospital is a large hospital known as one of the Big 5, and the union has about 5,000 members, making it quite large," adding, "Although no other hospitals have introduced a 4-day workweek yet, now that an actual case has appeared, movements in other hospitals are expected to accelerate."