Recently, a rookie nurse who worked at a prestigious hospital located in Seoul committed suicide. The new nurse is said to have just started her career but had been under stress from the massive workload. She was forced to work during the New Year’s holidays and could not take it any longer so she chose to take her own life. In response, the family claimed that her suicide was caused by brutal workplace culture ‘Tae-um’, which literally translated means burning junior nurses into ash, in Korean hospitals. Despite the nations’ shock about this story, it was not the first time ‘Tae-um’ culture was a hot topic in the workplace. It has been a long practiced bad habit from the culture of hospitals employees’ that happens only in Korea. In 2005, two new nurses committed suicide in succession due to the Tae-um at Cheonam National University Hospital, and it has not changed in the past decade. Therefore, now it the time to start talking about the impact of Tae-um on Korean society.

 The Tae-um phenomena at hospitals can be translated into ‘burning’ someone out in a literal way. It means seniors nurses burn junior nurse’s soul until it turns into ashes. A newly hired nurse is paired with a senior nurse to receive practical training. The training sessions are when verbal abuse and even assaults occur all the time. According to a survey by the Korean Nurses Association, the average rate of annual turnover for new nurses was 34 percent. 40 percent of nurses answered that they have experienced Tae-um. Thirty percent of the offenders were directly related to the crime.

 The Dankook Herald (DKH) covered Tae-um based on the following examples told from actual nurses.

▲ KHMWU conducted a nationwide survery on medical staffs' workplace culture. 11662 members of the Union proved severity of Tae-um.

 1) The pregnancy sequence

 Due to a lack of workforce, nurses have to stand in a queue to take maternity leave, a process that interferes with their planned parenting. A nurse who doesn’t follow the orders feels uncomfortable and sorry for being pregnant at someone else’s turn. According to a survey from Korean Health and Medical Workers’ Union (KHMWU), about 15 percent of the respondents replied that they have experienced this sequencing request. Considering that pregnancy is a female issue, more precisely women of childbearing age, the number of respondents that had negative experiences when it comes to dealing with the topic of pregnancies cannot be ignored.

 2) The resignation sequence

 Just like the pregnancy sequence practice, nurses sometimes face circumstances where they are required to take turns to quit a job. The frequent retirement of new nurses is said to be the reason for resignation sequence. 

 3) Cruel shift schedules

 Larger hospitals, such as university hospitals, usually wok in three shifts, and junior nurses are assigned overnight duty and early morning shifts successively. According to the KHMWU survey, 37.3 percent of nurses said they were forced to work on holidays or stay for overtime projects, while 51.3 percent of nurses experienced sudden changes in schedules. In addition, 59.7 percent of hospitals workers have to go to work earlier than documented schedules and finished late, but do not receive overtime pay.
 
 4) Engaging them in important tasks, such as meetings, events, and so on

 Giving important tasks to the new nurses, who are already having a hard time handling their excessive workload, makes it hard for them to hold on at the hospitals. Most of the time, they say they are not rewarded for having attended training, meetings, or workshops, even if they have worked on a task outside of their scope. 

 5) Using abusive language, assault, and sexual harassment

 If a junior nurse makes a mistake during their first few sessions, senior nurses will often launch verbal abuse and insults towards them. Verbal abuse makes junior nurses feel timid and leads them to make other mistakes. Sexual harassment is another serious problem but it’s beyond the responsibility of senior nurses. The young nurses said that they were forced to sing and dance in sensual clothing while participating in off-duty events.

 Tae-um practice is complex. The roots of the problems are deeply entrenched in the fundamental working conditions. The first cause is the inadequate service environment. According to statistics by the Korean Nurses Association, most medical institutions don’t observe the legal standards for a nursing workforce. In fact, 87 percent out of 1,800 medical institutions do not meet the legal requirements for staffing. However, even in medical institutions that meet the standards, the number of patients that each nurse is responsible for is two or three times more than that of United States, Japan, Canada, and Australia. A typical illustration of danger this puts patients in can be illustrated in the Miryang fire. A blaze broke at Sejong Hospital in Miryang on January 26, 2018. In the fire, 51 people died and 141 were injured. Lacking an appropriate number of nurses was one of the factors that aggravated the death and injury toll. To observe the law, a hospital that size must have 35 on duty, but there were only 6 nurses there at that time.

 The second cause was a weak education system. New nurses should receive training sessions from the preceptor, a term inferring the senior nurse who is in charge of the education, to ensure effective adaptation to their system. However, there was a lack of staff and funding available at the hospitals. So senior nurses had to act as the mentor for new nurses and care for the newcomer’s patients at the same time. As a result, a faulty organizational culture was naturally formed due to the staff being overworked. Choi so-mi, the president of Seoul National University’s College of Nursing, said “Inexperienced nurses are put into real medical sites without preparation. They experience adaptation difficulties, and as a result, newcomers would always leave in their first few months.”

 According to Professor Yang Kyung-jae’s (Institute of Health Science Research, Korea University) “Development Plan for Health Insurance, Nursing Grading System and Nursing Assistant Training Course”, in medically advanced countries like USA, Canada, Japan, France, and Germany job scopes and workforce limits are clearly stated in the law. In the US and Canada, there is a ‘Nursing Practice Act’ in every state while in Japan, there is a clear distinction between nurses’ responsibilities. In the United States, for example, the personnel responsible for nursing are divided into RN (Registered Nurse), LPN (Licensed Practical Nurse), CAN (Certified Nurse Assistant), and their roles are very different from Korea. 

 RN is a nursing profession under the Nursing Practice Act of the United States. Unlike in Korea, these nurses can legally perform some medical activities in addition to nursing practices without being given instruction by a physician. Although it varies from state to state the tasks they can perform include nursing, counseling, education, handling medication prescribed by the doctor, and treatment.

 An LPN works under the supervision of a doctor and RN. Although the regulations for LPN vary slightly from state to state, they are generally prescribed by doctors and RN and they are involved in basic medication, dressing, nutrition monitoring, sample collection, drug management. While CNAs can be licensed for one to two months (more than 120 hours) at a community college, and they usually work in nursing hospitals like changing the bedspread or helping patients move rather than nurse.

 People usually have a misconception about certain types of professions. Some occupations like actors, singers, and teachers are constantly under the scrutiny of society. Their actions and movements are being watched and magnified. They make their judgement based on what responsibilities people put upon them, instead of viewing them as human being. Actors and singer are usually thought by the society as public figures and they eventually set up and unspoken rule of how they should act and judgment is often laid on them before being verified. With that, the basic rights of these people are literally taken away as they are no longer perceived as ordinary people. 

 The same problem now known as nurses’ Tae-um happens among the nurses in Korea. Just because their jobs are a matters of life and death, doesn’t mean that their rights to appropriate and equivalent treatment should be stripped away. They, out of all people, deserve every right to enjoy legal working hours, meal breaks, and even vacations. After all, they are humans. So, why can’t people see it? The nurses have been suffering from Tae-um for so long; it is about time that society saved them, starting with operational changes and new laws to define their rights.

박채리, Edward Ng, 심형석, 윤진현  dankookherald@gmail.com