The Nursing Law enactment is leading to a nationwide movement within the nursing community regarding the establishment of nursing laws. On April 27th, the Nursing Act enactment bill was passed at the plenary session of the National Assembly, but on May 16th, President Yoon Suk-Yeol exercised his veto over the Nursing Act, spreading into a “law-abiding struggle.”

The College of Nursing at Pusan National University (PNU) also announced a “statement to urge the enactment of the Nursing Law” on May 11th and raised its voice to urge the enactment. Accordingly, “Channel PNU” heard about the necessity of enacting the Nursing Act and future plans through a written interview with Lee Hae-Jeong, the dean of the College of Nursing, on May 18th.

Q. Can you briefly summarize the necessity of enacting the Nursing Act?

A. It can be divided into three major categories:. The limitations of the current medical laws and nursing-related laws, the problem of securing nursing manpower according to the changes in the healthcare environment in Korea, and the preparation of a system to reduce the burden of individual nursing care.

Q. What are the limitations of the current medical laws?

A. Under the current medical law, the duties of nurses are specified as “assistance in medical treatment conducted under the guidance of doctors, dentists, and oriental medical doctors.” Here, a problem arises because the duties of nurses, who are marked as “assistants to treatment,” are not clearly divided. Although there is Article 27 of the Medical Act (prohibition of unlicensed medical practice and so on), work must be performed according to the doctor's instructions in the field, and nurses must take over the work caused by the lack of doctors. As a result, the burden of nurses in Korea is approaching four times the average of the OECD, and the number of patients who one person is on charge of is overloaded.

In addition, the scope of instruction differs depending on the characteristics of hospitals, specialty areas,, and individual doctors, and interpretations of responsibility for results vary. Furthermore, simple task-oriented work orders limit problem solving and decisionmaking competence considering the patient's characteristics and circumstances and the provision of patient-centered nursing based on autonomous and creative thinking.

Q. There is a lot of controversy over the interpretation of the “local community” nursing activities specified in Article 1 of the Nursing Act enactment. Is there a reason you specified the area of ​​expertise expansion to the local community?

A. In Korea, the healthcare paradigm is changing from “centered on disease treatment” to “centered on disease prevention and chronic disease management” because of the increase in the elderly population and chronic diseases due to aging. As a result, the demand for nursing personnel is increasing in senior welfare facilities, schools, daycare centers, children/disabled/elderly welfare facilities, and industries located in various places. In other words, nurses should be able to play their role as medical personnel in facilities and communities other than medical institutions. 

In particular, senior welfare facilities (nursing hospitals and nursing homes), excluding medical institutions, have only manpower standards, and the scope of work is unclear. Many nurses are confused by this. To provide high-quality and safe services to the community, it is necessary to enact a comprehensive law on nursing care and set consistent principles and standards by expanding the scope to the community.

Q. Can you tell us about the practical effects of enacting the Nursing Act?

A. If the Nursing Act is enacted and a clear division of duties is achieved, the quality of nursing work can be improved. This is because the nurse's autonomous decision-making and problem-solving range can be expanded. You can expand your role from task-oriented work to more specialized work. Expansion of expertise will enable collaboration and partnerships between related medical industries. I believe these changes will contribute to the establishment of systematic nursing policies and improve public health by providing better quality nursing services.

Q. How does nursing law affect nursing students?

A. Current nursing students and new nurses need skills and knowledge to grow from beginners to skilled nurses. However, there is currently a lack of specific systems or policies for capacity improvement. If a legal basis is established in this regard, it will be easier to plan, operate, and evaluate the curriculum for new nurses and nursing students, and to secure nursing workforce and resources in charge of education.

Q. Do you have any future plans?

A. The Korean Nursing Association started a law-abiding struggle to reject illegal orders from doctors, such as proxy prescriptions, proxy records, blood sampling, ultrasound, and electrocardiogram tests, following the president's rejection of the Nursing Act. The goal is for the Nursing Act to be re-promoted in the National Assembly. In addition, efforts are being made to correct fake news and false facts that have spread due to opposition forces. 

Our Nursing University is also planning to inform the correct contents related to enacting the Nursing Act through various paths according to the direction of the Korean Nursing Association. We are trying to change the perception of policymakers and the public, and to support the necessity of enacting the Nursing Act.

Q. Is there a position in nursing that you would like to convey to the public?

A. Even in the United States, the American Nursing Association has made efforts for about 100 years since the early 1900s to achieve the current level of nursing environment. It's a bit late, but the nursing community in Korea is doing its best to gather strength. Every action we choose is a way to bring the truth to the public. I sincerely hope that these efforts will enable the re-promotion of the Nursing Act and eventually lead to its enactment.

Reporter Sim Se-Hee

Translated by Kim Hyeon-Hee