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PA nurses to fill medical manpower gap amid gov't-doctor conflict
Nurses are seen walking in a major hospital in Incheon, Thursday. Yonhap
By Jun Ji-hye
Nurses allowed to perform CPR on emergency patients as trainee doctors' walkout continues
The government is planning to make the most use of physician assistant (PA) nurses — unique to Korea’s medical field — to cope with disruptions to medical services caused by a nationwide walkout by thousands of trainee doctors in protest against the government policy to increase the number of medical students next year.
The Ministry of Health and Welfare said Thursday that it decided to increase the role of nurses at emergency care units at general hospitals and training hospitals.
It will release relevant guidelines on Friday, enabling nurses with several years of experience to undertake specific responsibilities that are normally held by doctors, such as performing CPR and injecting medication into patients in a critical condition. The related pilot program was already launched on Feb. 27.
The guidelines, aimed at better clarifying the scope of nurses’ duties, are expected to give a boost to the legalization of the PA nurse system, which is technically illegal per the country’s Medical Service Act, but for all intents and purposes, has been operating as such for about 20 years .
President Yoon Suk Yeol speaks during a government meeting on doctors' collective action at the Government Complex Sejong, Wednesday. Courtesy of presidential office
“We will actively utilize PA nurses,” President Yoon Suk Yeol said on Wednesday while he presided over a government meeting to address the collective action of doctors.
“Through the pilot program, we will allow PA nurses to fill the medical service vacuum left by the striking trainee doctors and legally protect them.”
Doctors are protesting the government’s decision to raise the enrollment quota at 40 medical schools nationwide by an 2,000 places from the current 3,058 starting next year. This proposal is aimed at addressing a shortage of doctors and improving public access to medical services. However, doctors argue that the current education and training systems in medical schools are ill-equipped to accommodate such an expansion.
The government came up with the idea of utilizing PA nurses because patients and their families have had surgeries and other medical procedures postponed or rescheduled due to the ongoing mass walkout by interns and resident doctors.
In other countries, such as the United States and Canada, PAs refer to licensed medical professionals who examine, diagnose and treat patients under the supervision of physicians.
Korea’s medical community uses the same title, but PAs in Korea refer to skilled nurses who assist doctors in carrying out operations and procedures, and take part in the development of treatment plans and even the prescription of medication, most of which are responsibilities meant to be held by trainee doctors.
Korean hospitals have appointed skilled nurses as PAs since the early 2000s as part of efforts to cut costs, as PAs do not require additional courses or professional licenses.
The number of PA nurses is estimated at around 20,000 nationwide, according to the Korean Health and Medical Workers’ Union.
In April last year, a nursing bill, designed to clarify the roles and responsibilities of nurses, passed the National Assembly, railoaded by the the main opposition Democratic Party of Korea.
But Yoon vetoed the bill the following month, siding with doctors and other medical workers at the time, who claimed that the act would only divide the medical profession and cause conflict and confusion.
The Korean Nurses Association expressed a certain amount of expectations this time, supporting Yoon’s latest remarks concerning nurses.
“Nurses have been put into very difficult situations after trainee doctors left their worksites,” the association said in a statement. “We welcome the president’s promises to pay keen attention to the development of nurses’ careers so they can work with pride.”
In its expanded efforts to minimize the medical service vacuum, the health ministry also announced a decision to invest 188.2 billion won ($141 million) of national health insurance reserves per month to increase compensation for hospitals that actively treat patients in emergency and critical conditions.
“The 188.2 billion won will be offered for a month temporarily, and then the same amount will be offered every month if the current medical disruptions continue,” a ministry official said.