Tensions between doctors and nurses can often simmer underneath the surface. In South Korea, they have spilled into the open as a monthslong doctors’ strike strains the nation’s hospitals.
Since thousands of intern and resident doctors went on strike in February, hospital bosses have ordered some nurses to take on duties traditionally fulfilled by their white-coated colleagues, including inserting catheters, doing blood work and issuing prescriptions.
Many nurses have done so reluctantly, saying they were not paid enough, lacked the professional respect accorded to doctors and were inadequately protected by law if something went wrong. They pushed for the passage of a nursing act that would widen the scope of their roles and provide them with greater legal safeguards.
Doctors opposed the bill, saying it would deepen the conflict between the professions, inhibit the training of young doctors, and ultimately allow nurses to set up their own practices without proper guidelines.
The nurses claimed victory last week, when the National Assembly passed the nursing act, which also established clear boundaries as to what duties nurses can or cannot do, a line that has until now been blurred.
“I’m hopeful that working as a nurse will be much better moving forward,” said Ah Rim, a 29-year-old nurse in the emergency wing at a general hospital in Gwangju, a city in the country’s south. It took four years of nursing school and multiple exams to develop the skills required for her job, she said, but nurses have “not gotten the recognition they deserve.”
The fight illustrates the disorder that South Korea’s medical system finds itself in because of the ongoing doctors’ strike, with hospitals short-staffed and surgeries postponed or canceled.
Doctors walked out in protest at health care policy changes proposed by the government. The most contentious item was a plan to expand medical school admissions, which doctors argue would decrease the quality of health care and not solve ongoing issues in the industry.
Since then, the public has grown frustrated 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 overflowing with patients during the upcoming three-day holiday for the Chuseok harvest festival. A recent rise in hospital admissions of people with Covid-19 added to those fears.
While the nation’s medical system has averted a total collapse, it risks one the longer the strike goes on, said Professor Jung Jaehun, a public health professor at Korea University in Seoul.
“It may look from the outside that the system is intact because we have a strong medical infrastructure, but it’s actually struggling to get by,” Professor Jung said. Experts predict the strike could well go into next year.
The Korean Nursing Association said the passage of the act, which will take effect in June 2025, follows 19 years of campaigning by nurses.
Doctors remain critical. Threats of a strike by nurses belonging to the Korean Health and Medical Workers’ Union were made “to get the nursing act passed quickly,” said Lim Hyun-taek, the head of the Korean Medical Association, the nation’s largest doctor group. Mr. Lim ended a five-day hunger strike last week to protest government medical reforms, which included a plan to increase medical school students and the nursing act.
The association says that the act will not only damage the training ecosystem of young doctors but allow nurses to set up their own practices without proper guidance, making it possible for physician assistants to portray themselves as doctors.
The public has generally been supportive of the act, with a poll in 2022 showing 70 percent of people in favor. Consumer Action for Future, a nonprofit consumer group, said the law would “enhance the ethics and quality of nurses,” which would in turn benefit patients.
There are around 250,000 working nurses in South Korea, according to government figures. Throughout the doctors’ strike, six out of 10 nurses working at affected hospitals have been pressured to take on some duties of junior doctors, according to the Korean Nursing Association
For decades, nurses had been required to follow doctors’ orders even if they were more experienced, sometimes causing friction. Nurses say they have been underappreciated and underpaid given the intensity of their work.
“We’ve been considered as less than or below the doctors,” said Choi Hee-Sun, the president of the union. “Nurses will get 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, working 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 decreased working hours and higher pay, as well as the passing of the nursing bill.
The proposed strike by members of the union was averted after employers agreed to increase their wages by between two and four percent — hospitals negotiated individually — and some of the institutions said they would experiment with shorter working hours as well, according to union leaders.
Nurses are celebrating the wins, and shrugging off criticism from doctors.
“There is a lack of doctors already, but then they don’t want nurses to legally take on some of their roles?” said Ms. Choi, the union president. “I don’t understand.”
The post Nurses Win a Bigger Role as Doctors Strike in South Korea appeared first on New York Times.
