This study explored nurses’ experiences of physician assistant (PA) roles during the 2024 residents’ strike in South Korea, before enactment of the Nursing Act, and aimed to provide foundational evidence for developing PA nursing systems and related policies. Methods: In-depth, one-on-one interviews were conducted with 13 PAs working at an advanced general hospital in A Province between July and August 2024. Data were analyzed using Colaizzi’s phenomenological method. Results: Five categories were identified: “The reality of being shadow workers,” “Existence at the crossroads of conflict,” “Scattered pieces of identity in confusion,” “A journey of moving forward alone and together,” and “Laying the foundation for pioneering new nursing domains.” Conclusion: These findings illuminate the challenges and opportunities experienced by PAs during the 2024 residents’ strike before enactment of the Nursing Act. They also provide foundational evidence for policy development aimed at establishing and expanding PA nursing as a distinct domain in South Korea.