Nursing Sector Compliance Struggle... 'Legalization of PA Nurses' Emerges as a Key Issue

Korean Medical Association: "Medical Gap Due to Compliance Struggle? ... Doctors Should Do Doctors' Work"
Refusal to Order Illegal Medical Practices... Formalizing PA Nurse Duties a Key Issue

The Korean Nurses Association (KNA) is continuing its lawful resistance in protest against President Yoon Seok-yeol's exercise of the veto power on the Nursing Act bill. They are refusing to perform medical acts that nurses have conventionally carried out on behalf of doctors and are determined to strictly adhere to the scope of nursing duties.

On the 22nd, Tak Young-ran, the 1st Vice President of the Korean Nurses Association, said in an interview with KBS Radio, "We are engaging in lawful resistance and refusing illegal medical orders from doctors," adding, "To avoid any gaps in patient care, doctors should do what they are supposed to do, and nurses should also perform their nursing duties. That is the fundamental principle."

Amid concerns that continued lawful resistance could cause significant disruption in medical settings, the legalization of so-called PA nurses, who assist doctors, has emerged as a new issue.

Nurses affiliated with the Korean Nurses Association and related personnel held a general rally on the 19th around Sejong-daero, Seoul, condemning President Yoon Seok-yeol's veto of the Nursing Act. Photo by Hyunmin Kim kimhyun81@

The KNA has distributed a list of illegal tasks that nurses must refuse to perform to each medical institution and has operated an illegal medical practice reporting center since the 18th.

The KNA appealed for participation, stating, "Please strongly refuse all illegal work orders occurring in medical settings," and "There is a firm right to refuse illegal acts."

Nurses who perform doctors' tasks are called PA (Physician Assistant) nurses in the medical community. PA nurses have taken on duties such as prescribing, surgery, and blood collection on behalf of doctors, which is clearly illegal under medical law. However, due to manpower shortages and other reasons, this has been tacitly tolerated in practice.

The number of PA nurses nationwide is estimated to exceed 10,000. If the KNA's lawful resistance prolongs, there is a possibility of delays in surgeries and other disruptions in medical settings. In fact, a 2020 survey by the National Health and Medical Industry Labor Union of 288 PA personnel found that 93.4% responded that they were performing doctors' tasks.

The government is also concerned about medical gaps caused by the nursing sector's lawful resistance. However, since the doctors' tasks performed by PA nurses have been illegal practices, the government has no appropriate means to prevent the collective action of nurses refusing these tasks.

Consequently, there are calls for the legalization of PA nurses by clearly defining their scope of work within the law. While the PA profession is legal in countries like the United States, it has not been institutionalized domestically due to opposition from medical associations.

In this regard, the government announced it will prepare support measures for PA nurses by the end of this year. On the 16th, Lim In-taek, Director of Health and Medical Policy at the Ministry of Health and Welfare, held a press conference stating, "Physician Assistant nurses perform various tasks on the ground but lack clear legal status or roles, causing concerns about stability in the field," and added, "By the end of the year, we will develop support measures and guidelines to enable PA nurses to legally and stably engage in nursing duties and announce them."