Organizational Climate, Role Conflict, and Job Esteem Among Registered Nurses in Physician-Delegated Roles in South...

In South Korea, physician assistant (PA) nurses-registered nurses performing physician-delegated advanced clinical tasks without a nationally standardized licensure system-are increasingly relied upon to address healthcare delivery gaps. This study examined the associations of organizational climate and role conflict with job esteem among PA nurses.

A cross-sectional descriptive design was used. Data were collected from 145 PA nurses at four university hospitals (each ≥ 500 beds) in Daegu, South Korea, between March and April 2025, using validated instruments for organizational climate, role conflict, and job esteem. Multiple linear regression analysis was performed to identify factors associated with job esteem.

Organizational climate was positively correlated with job esteem, while role conflict showed a negative correlation. In the multiple linear regression model, organizational climate and pre-role training experience emerged as significant factors associated with job esteem, jointly explaining 23% of the variance, whereas role conflict did not show an independent association when organizational climate was included in the model.

These findings suggest that supportive organizational climates and structured preparation may be important for sustaining job esteem among nurses working in expanded physician-delegated roles. In the broader context of physician shortages, which can compromise care quality and intensify nurses' workload, strengthening organizational supports for PA nurses is also relevant to maintaining the quality and continuity of healthcare services. These findings may also be informative for other healthcare systems in which nursing role expansion is occurring faster than the development of supporting institutional structures.