The Ministry of Health and Welfare’s Bill for the Restructuring of Nursing Resources has caused controversy. The Ministry of Health and Welfare insist the bill can increase the nursing workforce, but people in the medical field are against it.


Pro


The number of nurses in Korea is 4.6 per thousand of population. However, this figure is lower than the OECD average of 9.3. The number of nurses is very low compared with Japan’s 10.1. Nurses have many complaints about this situation. Additionally, patients and patients’ families have many complaints about medical services. The Bill for the Restructuring of Nursing Resources will make their situation better.

The first big advantage is increasing the number of nurses. In 2010, 86.2% of hospitals couldn’t meet the number of nurses legislated by Korean medical law. This bill divides the nursing profession into 3 levels. Each nurse has different jobs. Level 1 and 2 practical nurses can’t do difficult work such as helping a doctor in surgery, but nurses can. Nurses can do more difficult work than level 1 and 2 practical nurses. Nurses are more expensive than the other levels because they need to have more training and experience. On the other hand, level 1 and 2 practical nurses are cheaper than nurses. If this bill is passed, hospitals can hire more level 1 and 2 practical nurses than nurses at the same cost. Although hospitals can’t hire only low level nurses, hospitals will hire a minimum of high level nurses and a maximum of low level nurses. Therefore, hospitals can have many nurses compared with the past.

In addition, if this bill is passed, personnel expenses can be reduced. As mentioned above, level 1 and 2 practical nurses are cheaper than nurses. Therefore, hospitals will be able to reduce personnel expenses.

Lastly, this bill can reduce the number of patients per nurse. If this bill is passed, hospitals can hire many level 1 and 2 practical nurses. Lack of nurses has lead to patients’ complaints and contributed to patient deaths. In Eul-ji University College of Nursing, a team investigated surgical patients that had 12 types of surgery in Korean hospitals in 2009. The hospitals were ranked according to the number of nurses. On the basis of this ranking, hospitals that have more nurses can give more attention to patients because they have fewer patients per nurse. These hospitals can save as many as 54 people per 1000 patients. Therefore, increasing nurses is important.

Korea has to think positively about this bill because it has a low number of nurses. A hospital’s purpose is taking care of patients. If this bill is implemented, the people who get the most benefit will be the patients. Therefore, it is right to implement this bill



Con


Recently, the Bill for the Restructuring of Nursing Resources has become a big issue. In Korea, a nurse can do medical treatment but legally a nurse’s aide can’t. However, the bill merges a nurse and a nurse’s aide and classifies those into three levels: level 2 practical nurse, level 1 practical nurse, and nurse. After the bill is passed, the term nurse’s aide will disappear and the new term “practical nurse” will replace it. If level 2 or 1 practical nurses accumulate some experience and pass a test, they can be a nurse. The Ministry of Health and Welfare has promoted passage of the bill because the bill can increase the nursing workforce, of which there is a shortage in Korea. However, the bill has many drawbacks.

First of all, this bill will cause a decline in healthcare quality. Level 2 practical nurses (who graduate from a nursing high school) or level 1 practical nurses (who graduate from a two year college of nursing) do not receive sufficient medical training compared with nurses (who graduate from a four year college of nursing). In other words, level 2 and 1 practical nurses don’t have sufficient ability to engage in medical treatment. Doctors, nurses and professor at colleges of nursing say that just 4 years is not enough for nursing students, much less 2 years. They don’t have enough time to get enough training in medical treatment.

According to an article in The Hankyoreh, general hospitals and university hospitals do not use nurse’s aides. Doctors are concerned about nurse’s aides because they have a bigger possibility of causing medical accidents than nurses. However, from the view of running a hospital, level 2 or 1 practical nurses will be preferred and hired due to their low wages compared with nurses. Consequently, because of a decline in good quality nurses, we can expect that healthcare quality will drop. Also, the damage of this will get back to patients. If medical accidents occur or patients do not trust level 2 and 1 practical nurses, the bill will lose its advantages.

Second, the bill will cause conflict between patients and hospitals. If there are medical accidents because of hospitals which prefer level 2 or 1 practical nurses, patients will want nurses. If things come to this stage, there will be strife between patients who want high quality health-care services and hospitals that prefer to pay low wages.

The bill threatens patients’ health and safety and ignores patients’ right to receive the best quality of nursing care. The Ministry of Health and Welfare should withdraw the bill and should think about a genuine way to improve health care for people.