Experiences of nurses working as physician assistants under the expanded scope-of-practice policy following the 2024 resignation of medical residents in South Korea: a phenomenological study

Purpose: This study aimed to explore the lived experiences of clinical support nurses under the expanded scope-of-practice policy implemented after the mass resignation of medical residents in Korea in 2024. In Korea, these nurses are often referred to as physician assistant (PA) nurses, although they differ from licensed physician assistants or nurse practitioners in the United States. The study sought to understand how the policy was perceived, implemented, and interpreted by nurses who played a key role in maintaining clinical services during a healthcare workforce crisis. Methods: A qualitative phenomenological design based on Colaizzi's method was used. Fourteen clinical support nurses from a tertiary hospital in Seoul participated in in-depth, semi-structured interviews conducted between August and December 2025. The interviews were transcribed verbatim and analyzed through iterative reading, extraction of significant statements, formulation of meanings, and thematic integration. Trustworthiness was established using the criteria of credibility, dependability, transferability, and confirmability. Results: Four essential themes were identified: (1) multifaceted perceptions of the 98-item expanded scope-of-practice policy; (2) gaps in the current education system and demands for structured training; (3) ambivalent experiences during policy implementation; and (4) conditional acceptance of the policy's sustainability and calls for improvement. Participants reported increased professional recognition and autonomy while also experiencing ambiguity in role boundaries, concerns about legal accountability, and emotional burden related to insufficient preparation and protection. Conclusion: The expanded scope-of-practice policy both strengthens professional competence and creates role instability among clinical support nurses. Its sustainable implementation requires clear legal protection, standardized education and certification systems, appropriate compensation, and the active involvement of frontline nurses in policy development.