Public Hearing on Institutionalizing Medical Support Work to Be Held on the 21st
Ten New Duties Added, Including Arterial Line Insertion and Anesthesia Monitoring
Thirteen Tasks, Such as Tissue Sampling and Endotracheal Intubation/Extubation, Excluded
Regulations to Be Finalized and Announced After Gathering Public Feedback
Under the Nursing Act, which will take effect on June 21, 'Physician Assistant (PA) nurses' will be able to perform certain delegated physician tasks, such as bone marrow aspiration?where a needle is inserted into a patient's bone marrow to collect marrow tissue?operation and management of cardiopulmonary bypass and cardiopulmonary support equipment, as well as procedures like vaginal examinations during childbirth, skin suturing, and drafting preliminary medical certificates.
Health and Welfare Deputy Minister Minsoo Park is talking with members of the Medical Solidarity Headquarters of the Public Transport Union of the Korean Confederation of Trade Unions, who are picketing while waiting for Deputy Minister Park, during the public hearing on the institutionalization plan for medical support work following the enactment of the Nursing Act held at Peak & Park Convention in Yongsan-gu, Seoul on the 21st. Photo by Yonhap News
On May 21, the Ministry of Health and Welfare released the "Regulations on the Performance of Medical Support Work," which includes a notice of the medical support service activity list containing these details.
Medical support personnel, who have been referred to as PA nurses, have so far been utilized as substitute personnel for residents in medical institutions facing physician shortages. However, due to the absence of specific regulations under the Medical Service Act, they have operated in an unstable status and have effectively performed illegal duties. However, following medical service gaps caused by conflicts between the government and medical associations last year, the Nursing Act was enacted to improve nurses' working conditions and enhance their expertise, and is scheduled to take effect on June 21.
PA nurses are defined as either advanced practice nurses qualified under the Nursing Act or dedicated nurses who have at least three years of clinical experience and have completed required training. However, those with at least one year of experience in medical support work may perform these duties even if they have less than three years of clinical experience. Under the Nursing Act, these personnel will be able to legally perform medical acts traditionally done by residents and other physicians, based on the guidance and delegation of a physician.
The detailed duties of PA nurses, released on this day, have been integrated and adjusted to a total of 45 items?13 items were excluded and 10 new items were added from the 54 acts previously permitted under the "pilot project on nursing duties." These include: monitoring and transport for critically ill patients, insertion/replacement/removal of nasogastric and drainage tubes, dressing of surgical sites, drafting preliminary consent forms and medical certificates for surgeries, invasive surgical support and assistance, arterial blood sampling, skin suturing, bone marrow and ascites aspiration, vaginal examinations during childbirth, assistance with chest tube insertion and thoracentesis, and preparation and operation of cardiopulmonary bypass and cardiopulmonary support equipment.
On the other hand, the following tasks, which were determined to be the exclusive duties of physicians during the pilot project period, have been excluded: insertion of peripherally inserted central catheters (PICC), insertion and management of central venous catheters, collection of cerebrospinal fluid, endotracheal intubation and extubation for general anesthesia, intubation and extubation for critical care patients, blood component collection, tissue sampling, and evaluation of treatment side effects.
Going forward, medical institutions performing medical support work must establish an "operations committee" consisting of at least five members, including one in-hospital chairperson. The committee must include at least one physician and one nurse. The operations committee will review and approve job descriptions for each nurse and oversee and supervise to ensure that medical support personnel perform duties within the scope of their completed training.
Education for medical support personnel will consist of theoretical and practical training, as well as on-site practice at their affiliated medical institution. Training institutions include the Korean Nurses Association, the Korean Medical Association, the Korean Hospital Association and their branches or subcommittees, hospital-level medical institutions with 300 or more beds, advanced practice nurse training institutions, public health medical support centers, and other organizations or institutions recognized by the Minister of Health and Welfare as capable of conducting dedicated nurse training programs.
The government currently estimates that there are approximately 17,000 medical support personnel working at medical institutions nationwide. The Ministry of Health and Welfare plans to hold a public hearing on the afternoon of May 21 at Peak & Park Convention in Yongsan-gu, Seoul to gather opinions on the government’s notice, and then finalize and promulgate the regulations on the performance of medical support work through procedures such as legislative notice. Until the effective date of the new regulations, the existing pilot project on nursing duties will continue to be implemented.
Minsoo Park, the Second Vice Minister of Health and Welfare, emphasized, "This public hearing will be the first step in clarifying the roles of nursing personnel and initiating a social discussion to create a safe medical environment," adding, "We will do our best to gather sufficient opinions from various stakeholders to establish a reasonable system that can be accepted in the medical field and trusted by the public."
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