What is the scope of the nursing assistant’s medical practice? – Comedy.com


The current medical law stipulates the scope of work of nurses, nursing assistants, and medical technicians. According to this, nurses can observe patients, collect data, provide nursing care, assist in medical treatment, and perform health activities. Nursing assistants, in principle, have to assist nurses in the scope of their duties, but can provide nursing and medical assistance only to clinic-level medical institutions.

However, the law does not clearly stipulate the scope of ‘nursing and medical assistance’ of nursing assistants. However, according to the Supreme Court precedent and the authoritative interpretation of the Ministry of Health and Welfare, the nursing assistant’s nursing and medical assistance work is a medical activity that does not belong to the business area of ​​other licensed persons and can be performed under specific instructions or guidance from a doctor, etc. Diagnosis protection such as blood glucose measurement, blood sampling, subcutaneous/muscular/vascular injections, anesthesia assistance/operational assistance in the operating room, disinfection/anesthesia/urinary duct security/enema/casting, etc. in the hospital ward It is exemplified as an act of subsidizing pharmaceutical affairs, etc. to assist dispensing/medication in medical institutions.

Recently, there has been an interesting ruling on the scope of the nursing assistant’s medical care and the duty of guidance of doctors.

Doctor A, who runs a plastic surgery clinic, performed a forehead lift on patient B. Afterwards, patient B, who came to the hospital to remove the stitches, instructed Nursing Assistant C to remove the stitches alone because he did not have time to treat another patient. C used a scalpel and tweezers to remove the stitches sewn above and below both eyes of the patient. Prosecutors indicted that a nursing assistant practiced unlicensed medical practice, and a doctor instigated a nursing assistant to perform medical practice outside of a license.

According to the court, the act of removing stitches after surgery is a medical practice, and even a nurse or a nurse’s assistant can do it under a doctor’s order. I saw you do In other words, it cannot be regarded as a medical assistance act for a nursing assistant to perform medical treatment alone without the doctor examining the patient at all. The court ruled that the removal of stitches by a nursing assistant, not a doctor, after confirming the patient’s condition, was not considered an acceptable legitimate act in view of social norms, when considering whether or how the stitch removal was urgent. pleaded guilty to He also pleaded guilty to a nursing assistant who claimed that there was no illegality because the stitches were removed under the supervision of a doctor.

In principle, medical practice should be performed by a doctor. Only in hospital-level medical institutions, nursing assistants may perform the doctor’s medical assistant work under the doctor’s instructions or supervision. Here, medical assistant duties include minimally invasive medical practices (microbes or equipment entering the body). Regarding the meaning of ‘doctor’s guidance’, the Ministry of Health and Welfare gave the authoritative interpretation that ‘the degree of work will vary depending on the type of work, but in general, it means that the doctor must be in the same office or at least coexist in a medical institution where supervision is possible’. have.

Combining the authoritative interpretation and precedents of the Ministry of Health and Welfare, doctors can instruct nursing assistants to perform minimally invasive medical practices in clinic-level medical institutions. However, even in this case, it is necessary for the doctor to take the lead and give priority to medical judgments such as examination, and to make it possible to provide guidance on the medical behavior of the nursing assistant in the same clinic where such medical practice is performed.

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