From the 8th, Nurses Can Also Perform CPR and Administer Medication to Emergency Patients (Comprehensive)

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The Ministry of Health and Welfare announced that starting from the 8th, nurses will be allowed to perform medical procedures such as administering medication and cardiopulmonary resuscitation (CPR) for emergency patients to address the medical service gap caused by the departure of resident doctors.

The Ministry released the "Supplementary Guidelines for Nurse Duties Related to the Pilot Project" concerning the pilot project for Physician Assistant (PA) nurses, which has been temporarily implemented since the 27th of last month.

The government permitted PA nurses in a pilot project format to replace the duties left vacant by departing resident doctors, but confusion arose on-site regarding the scope of their duties. Due to concerns about exposure to illegal medical practices, the Ministry presented the "Guidelines on Tasks Nurses Cannot Delegate and the Scope of Nurses' Medical Support Duties" to supplement the pilot project.

On the 7th, medical staff were busy moving around at a university hospital in Seoul, where a large hospital began downsizing operations by reducing the number of beds and personnel. Photo by Jinhyung Kang aymsdream@

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Accordingly, the scope of duties was set by distinguishing nurses' proficiency and qualifications (specialist nurse, dedicated nurse, general nurse), and the obligation for medical institutions to provide education and training was also specified.

Dedicated nurses are those trained in specific fields or tasks, corresponding to the so-called "PA nurses."

The government differentiated the permissible tasks for each nurse qualification. Electrocardiogram (ECG) and ultrasound examinations, simple dressing (general, procedural wounds, simple pressure ulcers, etc.), administration of prescribed anesthetics, emergency CPR, and emergency medication administration are allowed for all nurses. However, suturing (including stapler use), complex dressing (such as surgical site dressing), and surgical site suturing are permitted only for specialist and dedicated nurses. Prescribing prescription drugs, general anesthesia, drafting advance directives (DNR), and proxy surgery (performing surgery on behalf of a doctor) are considered exclusive duties of physicians and are excluded from all nurses' permissible duties.

The Ministry plans to respond to field inquiries and approvals through the establishment and operation of the "Nurse Duty Scope Review Committee."

Additionally, when setting the scope of duties, the head of the medical institution must form a Nurse Duty Scope Adjustment Committee, which must include participation from major clinical departments and dedicated nurses, and must consult with the head of the nursing department. The scope of duties will be set and adjusted by reflecting requests from each clinical department while distinguishing nurses' proficiency and qualifications. Assigning or instructing duties outside those agreed upon by the adjustment committee is prohibited.

Management and operation will be under the final responsibility of the head of the medical institution, who will bear ultimate legal responsibility in case of accidents due to inadequate management or supervision.

Acts explicitly prohibited according to Supreme Court precedents are also excluded. Prohibited acts include nurses collecting specimens for cervical cytology tests (a test for cervical cancer diagnosis involving staining and microscopic examination of cervical cells), sedation anesthesia using propofol, and death diagnosis.

The pilot project will be applied from the "severe" stage of the health care crisis until further notice. The Ministry stated, "We will conduct monitoring of the pilot project and promote institutionalization thereafter."

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