[Nursing Act War] ① Will the Status of Nurses Change After 70 Years?

The foundation of the current Medical Service Act in Korea originates from the 'National Medical Service Act' enacted in 1951. Although it has been amended several times and evolved into the present Medical Service Act, its basic structure has remained intact. The Medical Service Act covers fundamental aspects such as licensing for medical personnel including doctors, dentists, Korean medicine doctors, and nurses, as well as qualifications and regulations governing overall medical practices. The focus is on effectively regulating traditional medical activities centered on doctors' diagnosis and treatment within 'medical institutions.'

The Korean Nurses Association is urging the enactment of the Nursing Act in front of the National Assembly.
[Image source=Yonhap News]

The purpose of enacting the Nursing Act departs from the traditional perspective of the existing medical community. The rapidly approaching aging society and the increase in chronic diseases are shifting the paradigm of health management beyond medical institutions to community and prevention-centered approaches. Reflecting the growing demand for nursing and caregiving services and the increasing professional value of the nursing field, the Nursing Act aims to newly define the independent and professional roles of nursing.

Last month, the National Assembly's Health and Welfare Committee decided to send the Nursing Act bill (committee alternative) directly to the plenary session. The core of the bill is to establish an independent law concerning nursing personnel such as nurses and nursing assistants, and nursing matters, to improve the quality of nursing services. The purpose of the Nursing Act is explicitly stated as "to stipulate necessary matters so that all citizens can receive high-quality nursing benefits in medical institutions and communities." To this end, it specifies licenses and qualifications, scope of work, rights and improvements in treatment, and workforce development plans for nurses, advanced practice nurses, and nursing assistants (nurses, etc.).

One notable difference from the existing Medical Service Act provisions related to nursing personnel is the inclusion of nurses' rights and improvements in treatment. The state and local governments must establish and support policies necessary to encourage long-term service and secure skilled personnel among nurses, etc. Additionally, legal grounds are provided for the state and local governments to financially support medical institutions to secure nurses, etc., and institutions and facilities employing nurses, etc. are also obligated to support improvements in working conditions and treatment.

Measures for workforce development are also specifically included. Hospitals are required to appoint 'education-dedicated nurses' to transfer the knowledge, skills, and competencies necessary for job performance and support adaptation. Education-dedicated nurses will oversee the education of new nurses, plan, operate, and evaluate educational programs, and secure and develop resources needed for education. The bill also includes provisions for the state to fully or partially support the costs required to operate education-dedicated nurses.

However, many contentious parts from the original bill have been largely excluded. The original bill defined nurses' duties as "tasks necessary for patient care" under the supervision of doctors, dentists, and Korean medicine doctors, but the committee alternative maintains the current Medical Service Act's wording of "assisting medical treatment." Also, the government's obligation to establish a comprehensive nursing plan every five years was downgraded to merely requiring the establishment of necessary policies. Since the Nursing Act essentially detaches the nursing and nursing assistant sections from the Medical Service Act, some predict that even if the Nursing Act is enacted, there will be no significant immediate changes in the medical field.

Nonetheless, the Nursing Act bill signifies the establishment of a new medical system by separately regulating nursing personnel from the Medical Service Act, which has governed Korea's medical system for over 70 years. The Korean Nurses Association explained, "If the Nursing Act passes, an environment will be created where excellent and skilled nursing personnel can be continuously employed through proper training, appropriate placement, and improved treatment. This means a path is opened to contribute to the promotion of public health and patient safety."