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'To leave or not to leave'Korea’s medical culture ⑥ Korean nurses find work tough, rewards weak
  • By Marian Chu
  • Published 2017.04.05 17:22
  • Updated 2017.04.06 17:16
  • comments 0

After graduating from a four-year university in Seoul, Choi Min-jung thought her dream came true.

She interviewed at three university hospitals, went through three rounds of it at one, and got into Asan Medical Center, one of the “Big Five” hospitals, reputed to pay the highest nursing salaries in the nation.

What she had not expected was the physical and emotional toll that it would take on her life – caused by too few nurses and too much work in the nation.

A nurse wheels a patient down the corridor of a university hospital in Seoul.

“I deal with people’s lives, and it’s emotionally frightening when I see a patient whose getting worse,” said Choi, 25, who has worked for a little more than a year as a nurse. “This notwithstanding, I work overtime regularly to make sure the next person does not shoulder more work.”

While more than eight out of 10 nursing college graduates find a job upon graduation and 203 nursing institutions churn out an average of 20,000 students per year, Korea suffers from the shortage of nurses. An OECD statistic shows that Korea has only 5.2 nurses, including nurse aides, per 1,000 people, falling below the organization’s average of 9.2 nurses.

“A fundamental reform is necessary,” said an official of the Korean Nurses Association. “Korea’s public medical service system was created in the 1950s by people not familiar with difficulties nurses were experiencing. All laws and regulations limit nurses’ authority and scope of their activities, making a lopsided system against the latter.”

According to the National Health Insurance Review and Assessment Agency, 177,234 out of 356,289 licensed nurses are working at medical institutions nationwide as of June 2016, meaning less than half are serving in the field. Moreover, one in every three practicing nurses has less than five years of experience.

For Korean nurses, life seems to be an endless cycle of three eight-hour, or two 12-hour shifts, with little rest in between them. Working irregular days and hours that often extend into overtime shifts lasting for an hour or more, many have given up the idea of living a “normal” life -- with weekends and leisure time.

Some nurses who come from small provinces struggle with discrimination, including wages, and others leave hospitals tired of its “burn” culture to work in other fields. Many just yearn to meet a lifetime partner as the way out of their grueling work life.

‘If they don’t berate me, I’m grateful’

Here is a nurse who, like most others bothering at all to answer to questions, wanted to be known by just her family name. Bae, 26, has worked in the cancer ward of a large hospital in Seoul for five years. She deals with death on a daily basis, while trying to work through physically strenuous eight- hour shifts that rotate between day, evening and night.

The main reason she endures this emotionally exhausting, physically demanding work: a wide gap in working conditions between Seoul and provinces. Upon graduation from a university in Daegu, Bae dreamed of working in Seoul to get a higher salary. Hospitals in rural areas pay at least 10,000 dollars less a year than those in Seoul and Gyeonggi Province, the so-called metropolitan area.

Even though Bae succeeded in getting work around Seoul, she came face-to-face with blatant discrimination because of her hometown and her college.

“In university hospitals, promotion differs based on whether you’re alumni at the school or not. Students who graduated three most prestigious universities and alumni at their affiliated hospitals usually get promoted,” Bae said. “I’ve also dealt with discrimination against those from outside of Seoul, but I’ve been lucky with my ward.”

Bae, now in her fifth year, hit a glass ceiling as a graduate from a rural province. “I’ve been working for five years, and the fact my salary doesn’t rise any more, along with the shift rotations, are the most difficult,” Bae said.

“I stick it out because this is all I know,” Bae said.

Kim, another nurse, or former nurse, left the nursing industry to find a more comfortable life -- regular work hours, regular work and no violence.

When Kim started work at a gastrointestinal ward in one of the Big Five hospitals, she confronted one of the most dreaded aspects of life as a nurse – called the “burn (-to-ash)” culture. The “burn” culture is embedded in Korea’s nursing community. Newcomers are not welcome. Mistakes are even less so.

The more experienced nurses commonly referred to as “the old” harass newcomers who make mistakes, verbally, and even physically, passing on their work to newcomers and burdening them with more work. New nurses often cite the unnecessary, and often cruel, methods older nurses use to train them.

Kim says she saw an older nurse pour a bottle of IV fluid on a nurse’s head after she hung it up incorrectly. She was then taken to an empty room, and thrown insults like, “Do you have a thing named brain?”

“It’s primarily military culture in a female-only society,” Kim said. “The old nurses will taunt the new nurses by saying things like, ‘What’s wrong with your makeup’ and ‘Why are you looking at me like that?’ Retaliation? Not even possible. You’ll be branded as being insubordinate and tactless. It’s exile.”

Kim, along with 76 percent of other nurses, has sought to switch out of nursing, looking actively for another job that would treat others with respect.

“I’m working at a pharmaceutical company now. I work overtime sometimes, but I don’t feel as much pressure. I work 9 to 6. The working environment is fair. I can rest when I want to relax.”

‘Marriage is the fastest way out’

A third nurse changed her hospitals twice. Lee, 26, a graduate from a university in Seoul, started her career at her alma mater. What she learned from all those transfers, however, was not much different from others: Marriage is the easiest method to get out of the nursing profession.

“People who wanted to quit, have left already by this point,” Lee, in her third year of service, said. “When I was working, everyone around me was going on blind dates to get married and quit.”

The shortage of nurses has been cited as a problem in the medical community for decades. An official at the nurse association states that there needs to be a better way to attract and retain nurses, citing the need for government and political community to improve work environment for nurses.

“Nurses should be deemed a critical part of the workforce, and should be considered just as important as other medical staffs,” the official said.

He emphasized everything should change, ranging from compensation, work atmosphere, and labor intensity -- through both politics and policies.

The government said it would announce a plan to rectify the current problems and ease the shortage of nurses, by the end of this month.

Another official at the nurse association appears skeptical, however. “Are they just going to sugarcoat the problem with political speech?” he asked. “I don’t think there’ll be anything of great substance.”

yjc@docdocdoc.co.kr

<© Korea Biomedical Review, All rights reserved.>

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