Medical union says nurses are being ordered to conduct illegal medical procedures
A physician assistant (PA) nurse with 12 years of experience working at a general hospital, who wished to remain anonymous, said he once made an incision in a patient's abdomen to cover for the surgeon who showed up late.
He has also performed some surgical procedures requiring the skills of a licensed doctor, such as an abdominal drainage tube insertion and a bowel resection.
But these procedures cannot be found in any medical records as they are officially illegal medical practices according to the Medical Law, which prohibits medical personnel from performing procedures beyond the scope of their licenses.
The PA's testimony was shared at a press conference organized by the Korean Health and Medical Workers' Union (KHMU), May 12. The event was held to reveal publicly the struggles of nurses who are frequently forced to take on the duties of doctors, thus engaging in illegal medical practices against their will.
The union estimates there are around 10,000 PA nurses nationwide.
Unlike in other countries, such as the U.S. where PAs refer to medical professionals whose duties include diagnosis of illnesses, development of treatment plans and prescription of medication, such a position is not legally recognized here.
In Korea, skilled nurses with several years of experience are appointed by hospitals as PA nurses to assist doctors, but without taking additional training courses or acquiring a professional license.
"Although PA nurses have long become an essential human resource in hospitals due to the chronic shortage of doctors, the absence of specific guidelines on what to do and what not to do pushes them to perform tasks that go beyond their authority and trained skills," Song Geum-hee, a senior official at the KMHU, told The Korea Times.
"Also, their ambiguous position leaves them unprotected in the event of legal disputes involving medical malpractice," she added.
The medical union also pointed out that the years-long practice, under which PA nurses have tacitly been allowed to illegally perform medical procedures, poses a serious threat to the safety of patients.
A recent survey of PA nurses in 102 hospitals conducted by the union showed that many of them were burdened with tasks that go beyond their authority, such as prescribing medication, handling various medical examinations, writing operative records and even calculating the dose of anti-cancer drugs.
The respondents expressed concerns that these situations can lead to fatal incidents of medical malpractice, but at the same time they added that they cannot refuse orders given by doctors in the country's rigid and hierarchical hospital culture.
Song said that the survey results are "the tip of the iceberg," noting that the survey was conducted only among union members.
"The first step the government can take to resolve this long-pending issue is to launch a full-scale investigation into all medical institutions nationwide," she said.
Depending on the results of the nationwide investigation, the medical union asked the government to take appropriate measures, such as clarifying the job responsibility of nurses, by amending the Medical Law if necessary, and step up efforts to resolve the chronic shortage of doctors.
The union workers threatened to walk out in September if the government failed to come up with viable measures by then.
The Ministry of Health and Welfare responded to the threat by saying that it was well aware of their demands and accepted the necessity of further discussions. But the ministry added that it would take some time before the issue is resolved fully, taking into account other stakeholders involved in the matter, such as doctors' associations.
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