Ministry of Health and Welfare, "Adjustment Through Accumulated Information and Field Opinions"
Nursing Association, "Enforcement Decree Enactment Is the Real Game"
As the Nursing Act, which legalizes Physician Assistant (PA) nurses, has passed the National Assembly plenary session, the specific scope of their duties is expected to be determined based on the "Supplementary Guidelines for the Pilot Project on Nursing Duties" announced last March. The core of this is to allow PA nurses to perform medical assistance by being delegated some of the tasks possible from doctors.
On the 30th, Park Hyerin, Director of the Nursing Policy Division at the Ministry of Health and Welfare, stated, "The scope of PA nurses' duties will be determined based on the acts permitted in the pilot project, referencing accumulated statistics and field opinions."
Article 14 of the Nursing Act, passed by the National Assembly on the 28th, specifies that "the specific standards and contents of medical support duties, designation and evaluation of educational institutions, and compliance with standards and procedural requirements for hospital-level medical institutions shall be determined by the Ministry of Health and Welfare Ordinance."
Earlier, the Ministry of Health and Welfare conducted a temporary PA nurse pilot project starting February 27. Following the mass resignation of residents earlier this year, the role of PA nurses has increased, with approximately 14,500 PA nurses active as of the end of June.
Currently, 90 medical acts are permitted for PA nurses. These include splinting, complex dressing, suturing, surgical assistance, tube intubation and extubation, and cutting threads during surgery. When confusion arose regarding the specific scope of duties during the pilot project, the government presented the "Guidelines on Nursing Delegation Prohibited Tasks and Nursing Medical Support Scope" on March 7.
In the pilot project, the ability to perform each detailed act was differentiated by nursing qualification. All nurses were allowed to perform electrocardiogram and ultrasound examinations, simple dressing (general, procedural wounds, simple pressure ulcers, etc.), administration of prescribed anesthetics, emergency cardiopulmonary resuscitation, and emergency drug administration. Suturing (using staplers), complex dressing (surgical site dressing, etc.), and surgical site suturing were permitted only for specialized nurses and dedicated nurses. Prescription of professional medicines, general anesthesia, drafting of Do Not Resuscitate (DNR) orders, and proxy surgery (operating) were considered exclusive duties of doctors and excluded from all nurses' possible duties.
Acts explicitly prohibited according to Supreme Court precedents were also excluded. Prohibited acts include nurses collecting specimens for cervical cytology tests (a test to diagnose cervical cancer by staining cervical cells and observing them under a microscope), sedation anesthesia using propofol, and death diagnosis.
However, the scope of PA nurses' duties to be defined by enforcement ordinances is likely to change. For example, intubation, ultrasound, prostate massage, drainage tube management and removal, and emergency cardiopulmonary resuscitation may seem simple but are considered high-risk procedures by experts.
The nursing industry also emphasizes the importance of setting an appropriate scope of duties for PA nurses. While welcoming the enactment of the Nursing Act, they demand clear distinctions for tasks that nurses cannot perform.
A representative from the Korean Nurses Association said, "The reason we have been demanding the enactment of the Nursing Act was to clarify the scope of nursing duties and create a legal safety net. The real 'main game' is deciding which tasks nurses can perform. It is important to define PA duties only within the capabilities of nurses."
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