Tensions between doctors and nurses can often boil beneath the surface. In South Korea, they have burst into the open as months of doctors’ strikes strain the country’s hospitals.
As there are thousands of interns and resident doctors went on strike In February, hospital officials ordered some nurses to take over duties traditionally performed by their white-coated colleagues, including inserting catheters, doing blood work and dispensing prescriptions.
Many nurses have done so reluctantly, saying they were not paid enough, lacked the professional respect accorded doctors and were inadequately protected by the law if something went wrong. They pushed for the passage of the Nursing Act which would expand the scope of their roles and provide them with greater legal protection.
Doctors opposed the bill, saying it would deepen conflicts between the professions, hinder the training of young doctors and ultimately allow nurses to set up their own practices without proper guidelines.
Nurses claimed victory last week, when the National Assembly passed the Nursing Act, which also established clear boundaries on what duties nurses can and cannot perform, a line that has been blurred until now.
“I hope working as a nurse will go better,” said Ah Rim, a 29-year-old nurse in the emergency wing at a general hospital in the southern city of Gwangju. She said it took four years of nursing school and multiple exams to develop the skills she needed for the job, but nurses “haven’t gotten the recognition they deserve.”
The fight highlights the disarray that South Korea’s medical system finds itself in due to the ongoing doctors’ strike, with hospitals understaffed and surgeries postponed or canceled.
The doctors staged a walkout to protest health care policy changes proposed by the government. Most controversial was the plan to expand admissions to medical school, which doctors argued Decline in quality of health care and does not address ongoing issues in the industry.
Since then, the public is depressed with both the doctors and the government for failing to reach an agreement. This week, the government announced it would deploy hundreds of military doctors to emergency rooms — a response to public concerns that hospitals would be understaffed and overwhelmed with patients during the upcoming three-day holiday for the Chusok harvest festival. A recent increase in hospitalizations of people with Covid-19 has added to those fears.
While the country’s medical system has avoided a complete collapse, the risk remains the longer the strike goes on, said Jung Jaehun, a professor of public health at Korea University in Seoul.
“From the outside it looks like the system is intact because we have a strong medical infrastructure, but it’s actually struggling to get by,” Professor Jung said. Experts predict that the strike could go well into next year.
The implementation of the act, which will take effect in June 2025, follows a 19-year campaign by nurses, the Korean Nursing Association said.
Doctors remain critical. Strike threats by nurses affiliated with the Korean Health and Medical Workers Union were “designed to speed up the passage of the Nursing Act,” said Lim Hyun-taek, head of the Korean Medical Association, the country’s largest doctors’ group. Mr Lim last week ended a five-day hunger strike to protest government medical reforms, including medical school students and plans to extend the Nursing Act.
The association says the act will not only harm the training ecosystem of young doctors but also allow nurses to set up their own practices without proper guidance, making it possible for physician assistants to pass themselves off as doctors.
The public has generally supported the legislation, with 70 percent in favor in a 2022 poll. Consumer Action for the Future, a nonprofit consumer group, said the legislation would “enhance the morale and quality of nurses,” which in turn would benefit patients.
According to government statistics, there are about 250,000 working nurses in South Korea. the whole Doctors strikeAccording to the Korean Nursing Association, six out of 10 nurses working at the affected hospitals have been forced to take on some of the duties of junior doctors.
For decades, nurses were required to follow doctors’ orders, even if they were more experienced, sometimes causing friction. Nurses say they are underappreciated and underpaid given the intensity of their work.
“We are treated as little or less than doctors,” said union president Choi Hee-sun. “Nurses will have more respect now that the law dictates what we can do.”
Nurses in South Korea often work in shifts. While on paper they work 40 hours a week, overtime is common, they say.
The Korean Health and Medical Workers Union, a group of 85,000 nurses and health care workers, has campaigned for reduced work hours and higher pay, as well as the passage of a nursing bill.
A proposed strike by union members was averted because employers agreed to raise their wages by between two and four percent – hospitals negotiated individually – and some institutions said they would also experiment with shorter working hours, according to union leaders.
Nurses are celebrating the victory, and deflecting criticism from doctors.
“There’s already a shortage of doctors, but then they don’t want nurses to legally fill some of their roles?” Union President Ms. Choi said. “I don’t understand.”
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