Medical Community: "Permitted Procedures Not Clearly Defined... Patient Safety at Risk"
Nursing Community: "Administrative Convenience Ignores Realities of Nursing Work"
As the implementation of the "Nursing Act," which legalizes clinical support personnel, approaches, dissatisfaction is being voiced not only within the medical community, including doctors and residents, but also among nurses working on the front lines of healthcare.
The Korean Medical Association (KMA) held a regular briefing at its headquarters in Yongsan-gu, Seoul, on the 22nd and expressed concerns that the Physician Assistant (PA) nurse system is being pushed through hastily, referring to the "Regulations on the Performance of Clinical Support Tasks" released the previous day.
KMA spokesperson Kim Sungkeun stated, "The duties of PA nurses, who are responsible for patient safety and health, have not even been properly defined for each of the 45 individual tasks," and argued, "Listing medical procedures allowed for PA nurses without clear definitions is extremely dangerous."
For example, even within the category of "drain removal," there are various types of drains, and in some cases, removal is only possible through surgery. However, the government announcement simply refers to "drain removal," which, according to the KMA, fails to specify which types of drains PA nurses are permitted to remove.
Doctors working in the field also voiced concerns. Dr. A, head of the emergency room at a general hospital in North Jeolla Province, said, "The organizations responsible for training PA nurses, issuing work instructions to them, and their affiliations are all different, such as associations, attending physicians, and hospitals. From the patient's perspective, it becomes unclear where to file a complaint if a problem arises." Dr. A also warned, "If responsibility for medical procedures is shifted around, there will be loopholes even in the event of medical accidents."
Dr. B, a resigning resident working at a clinic in Seoul, added, "In the case of tracheostomy tube replacement, which has now been permitted for PA nurses, a mistake could puncture the patient's lung, causing tension pneumothorax, and the patient's condition could deteriorate to the point that surgery is required."
The Korean Nurses Association (KNA) also issued a statement criticizing the government, saying, "The Ministry of Health and Welfare's policy of leaving PA nurse training to hospitals and other medical institutions is irresponsible," and urged the government to "immediately stop the desk-bound administration that forces sacrifices on nurses." The KNA condemned the attempt to institutionalize "unofficial training," which relies on verbal instruction from senior nurses in the absence of an established educational system, as a clear case of dereliction of duty and systemic exploitation.
The KNA further pointed out that the 45 clinical support tasks outlined by the Ministry of Health and Welfare reflect an "administrative convenience-oriented approach" that fails to consider the diverse realities of over 40,000 nurses' work. The association emphasized that nurses performing clinical support tasks must receive more than 400 hours of training, have clear qualification standards, and be provided with legal protection and a fair compensation system.
Among frontline nurses, there are also voices expressing fear about the institutionalization of the PA nurse system. Nurse C, with nine years of experience at a general hospital in Seoul, said, "It feels as if nurses are now being exploited legally for less pay, just as residents have been in the past. There seem to be no measures to protect nurses, only more responsibilities being placed on us."
Nurse D, who has worked for seven years at a tertiary general hospital in Seoul, also commented, "For procedures such as bone marrow aspiration, which is among the permitted tasks, even a single mistake could rupture the aorta and result in the patient's death. There still seems to be a lack of discussion about who would be held responsible or legally liable in such cases." She added, "If proper reimbursement is provided for the permitted procedures and PA nurses are given sufficient compensation, it might be acceptable, but that does not seem likely."
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