Government and hospitals agree on the need to make better use of nurses
As the government has formalized using practice assistant (PA) nurses to fill the gap of trainee doctors, the need to use PAs is also emerging in hospitals, which say they “cannot just pray for the resigned junior doctors to return.”
On Thursday, the Ministry of Health and Welfare said 104 people applied for the second half of the recruitment of trainee doctors that ended the previous day, which sought to recruit 7,645 interns and residents. Only 13 and 91 applied for internship and residency, resulting in an application rate of a mere 1.4 percent.
Earlier in the year, the government announced the conversion of hospitals into specialist-oriented institutions to make up for the medical void due to the mass resignation of trainee doctors, noting that more PAs are needed for this purpose. It also plans to provide various support measures, as nurse practitioners take over some specialist works in a pilot project.
There are also voices for making better use of nurses in hospitals. It is not only because there are shortages of trainee doctors but also because the government promised to curtail their working hours after they return to work, making it inevitable that the role of nurses will become larger than before.
"We included the creating a task force for institutionalizing clinical nurse specialists (PAs) in this year's collective bargaining demands," an official of the Severance Hospital Labor Union told Korea Biomedical Review over the phone on Thursday, requesting anonymity for privacy. "What qualifications or selection criteria are needed to become a clinical nurse specialist, as well as the educational process, should be discussed by the labor union and the management."
Even if doctors return, there will be a big change, the union official said, adding that nurse practitioners will take on more tasks as working hours decrease. However, not all nurses are prepared, so a systematic selection and training system for clinical nurse specialists is needed.
"Trainee doctors are not returning, and we can't just pray about when they will come back,'" he said. "We must start preparing for many things that will change."
Some hospitals are ending unpaid furloughs that began due to the mass resignations of trainee doctors. They can do so because the bed utilization rate has been partially improved as PAs have taken over part of trainee doctors’ duties.
"The unpaid leave period was extended once, but in the end, we decided not to implement unpaid leave after Aug. 11," said a union official at the Korea University Medicine (KU Medicine), also wanting to remain anonymous. "This is because the hospital is normalizing as the bed utilization rate has increased to some extent. Except for some closed wards, the utilization rate is around 80 percent."
"It's a foregone conclusion that specialists will not return. The hospital has to survive anyway," she said. "Under the current situation, the hospital will maintain the working system based on specialists and PAs. Little by little, the field is stabilizing."
Some hospitals are considering expanding the role of experienced nurse practitioners. However, others point out that legal protection issues, such as institutionalization, must be resolved first.
"Although the hospital is conducting a pilot project on the scope of nurses’ practices, we are minimizing the scope of delegation to nurse practitioners," said a nurse practitioner working at a university hospital in Seoul asking to remain unnamed. "We are more cautious because the doctors who delegated the work could be held legally liable if there is an accident."
The PA continued, "I heard that the hospital is discussing a plan to have nurse practitioners answer calls like full-time doctors at each department’s request. Since each department knows the field well, they are discussing this so that they can report it to the center and it will be reviewed and approved afterward."
However, legal issues need to be resolved first, the PA noted. "Since the legal issues have not been resolved, the hospital is now in a fix,” she added.
(Caption)
As trainee doctors expressed their intention not to return to the hospital in the autumn recruitment, calls are mounting for the use of nurse practitioners in the medical field. (Credit: Getty Images)