Although nurse practitioners (PAs) will be legalized starting next month, debates continue in the medical field. PA nurses assist physicians during surgeries and also draft diagnoses. There is still much disagreement regarding the training subjects and scope of work.
The Ministry of Health and Welfare held a public hearing on the institutionalization of clinical support tasks under the nursing law on the afternoon of the 21st. A bill that legalizes PA nurses passed the National Assembly in August last year and will come into effect next month. The Ministry held the hearing to listen to the voices from the medical field before legalizing PA nurses.
Vice Minister Park Min-soo said, "PA nurses have played an important role in intensive care units, emergency rooms, and operating rooms, but due to the lack of legal grounds, there has been considerable anxiety in the execution of their duties," and he added, "We will officially recognize their roles."
PA nurses are specialized nurses who have over three years of clinical experience or are qualified in 13 fields, including emergency, anesthesia, and oncology. According to the Ministry, there are over 17,000 PA nurses in the country. Until now, they have straddled the line between legality and illegality due to the absence of relevant laws.
After a gap in medical care arose last year due to conflicts with medical professionals causing resident physicians to leave hospitals, the government established a legal basis to protect PA nurses who will take over these duties. A Ministry official noted, "The legalization of PA nurses aims to professionally train PA nurses who have been operating in the background so they can provide medical services to patients."
◇"One-person protest" by the Nurses Association, "PA nurse education should be managed by the association"
The key issue surrounding PA nurses is education. The Ministry believes that PA nurses can be trained by the Korea Nurses Association, the Korea Medical Association, the Korea Hospital Association, medical institutions with over 300 beds, specialized nursing education institutions, and other organizations or groups recognized by the Minister.
On the other hand, the Nurses Association argues that only the association should provide education for PA nurses. The association stated, "Clinical support is not just simple auxiliary work; it is a high-level area that requires quickly assessing patient conditions and responding immediately to situations," adding, "The government is shifting responsibility to hospitals without any educational infrastructure."
The Nurses Association said that if hospitals train PA nurses, the educational systems will vary significantly from hospital to hospital, thus the association should provide systematic education. They mentioned, "Most hospitals level education (training) relies on senior nurses conveying information verbally," and asserted, "The association should train PA nurses based on sufficient theoretical education and clinical practice." The association has been conducting a one-person protest in front of the Ministry of Health and Welfare since the 20th.
◇Doctors express concerns over the scope of practice
On that day, the Ministry proposed the scope of work for PA nurses. This includes drafting diagnosis letters, skin suturing, bone marrow extraction, chest tube insertion, and extracorporeal circulation, consisting of 45 medical actions. Extracorporeal circulation refers to the method of circulating blood and supplying oxygen using a heart-lung machine when a patient's heart temporarily stops during heart surgery.
Some doctors expressed doubts about the scope of work for PA nurses, particularly raising issues about extracorporeal circulation. They warned that if PA nurses fail to perform extracorporeal circulation correctly, it could affect patient lives. A Ministry official mentioned that the scope of PA nurses' duties has not been finalized and that they plan to reflect opinions from the field.
The public hearing was attended by Vice Minister Park Min-soo, Shin Young-seok, head of the Korea Health and Social Affairs Research Institute, representatives from the Nurses Association, and nurses working on the ground. During a break in the hearing, Vice Minister Park also met with officials from the Korean Public Service and Transportation Workers’ Union to hear field opinions. The union requested that the Ministry gather their input, as well as that of the Nurses Association.