ArticleJournal of nursing management2026
The Legislative Trajectory of Korea's Nursing Act: Insights From the Multiple Streams Framework.
Article in Journal of nursing management, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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- The Legislative Trajectory of Korea's Nursing Act: Insights From the Multiple Streams Framework.Journal of nursing management · 2026Article
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Abstract
backgroundThe enactment of the Korean Nursing Act emerged through a prolonged and conflict-laden policy process shaped by workforce instability, interprofessional conflict, and changing political conditions within the Korean healthcare system. Recent healthcare crises, including the COVID-19 pandemic and the 2024 healthcare service vacuum, further intensified policy attention toward nursing workforce governance and healthcare system sustainability.
aimThis study examines the legislative trajectory and postenactment policy developments of the Korean Nursing Act between 2005 and 2025 through the analytical lens of Kingdon's Multiple Streams Framework (MSF).
methodUsing qualitative document analysis, this study analyzed legislative bills, National Assembly records, government documents, organizational statements, media reports, and academic literature related to the Nursing Act. The analysis focused on interactions among the problem, policy, and politics streams, as well as the role of policy windows and policy entrepreneurs throughout the legislative process.
resultsThe findings indicate that longstanding issues-including poor working conditions, ambiguity in nursing roles, workforce instability, and concerns regarding healthcare sustainability-gradually evolved from profession-specific grievances into broader public policy concerns. Focusing events such as the COVID-19 pandemic and the 2024 healthcare service vacuum substantially strengthened the problem stream and altered the political environment surrounding the legislation. The policy stream evolved through repeated revision, negotiation, and conflict over issues including professional boundaries, the "community" clause, and physician assistant (PA) nurses. Within the politics stream, partisan realignment, organized interest-group conflict, and executive intervention significantly influenced the trajectory of policy change. Although convergence among the problem, policy, and legislative political streams enabled passage of the Nursing Act during the 21st National Assembly, presidential veto power ultimately disrupted policy adoption. Enactment during the 22nd National Assembly became possible only after crisis-driven political realignment weakened institutional resistance and enabled renewed stream coupling.
conclusionThis study demonstrates that stream convergence within healthcare policymaking processes may remain unstable under presidential systems characterized by strong executive authority. The findings extend existing applications of the MSF by illustrating how executive veto power may destabilize policy convergence even after substantial legislative agreement has emerged. IMPLICATIONS FOR NURSING MANAGEMENT: The study provides important implications for healthcare workforce governance, nursing leadership, and policy advocacy in aging societies facing healthcare workforce shortages. The findings suggest that effective nursing policy reform requires sustained interprofessional coordination, strategic policy entrepreneurship, and governance systems capable of responding flexibly to healthcare crises and workforce instability.
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