Nursing in Japan

Working conditions in Japan

Employment status of nursing personnel

As of the end of 2009, there are 1, 433, 772 nursing personnel in workforce, consisting of 53, 212 public health nurses, 31, 312 midwives, 954, 818 nurses and 394, 430 assistant nurses.2) The number of nursing personnel increased 1.3 times over the past decade since 1998, and about 5.8 times compared to 1960. The government adopted policies for securing the nursing workforce, for example, introducing scholarship systems for nursing students in 1962 and increased the budget allocation for nursing educational institutions in 1963. These efforts resulted in a steady increase in nursing personnel. In order to address the shortage of nurses triggered by the rapid aging and changes in circumstances surrounding public health, the Act on Assurance of Work Forces of Nurses and Other Medical Experts enacted in 1992, specifies the responsibility of the government and local governments to train nurses and other personnel, to improve the work environment, and to enhance their quality.

However, due to advanced health care, and increasingly severely ill and aging patients, the demand for nursing personnel is exceeding the supply. Japan has been suffering from a chronic shortage of nurses in terms of both quality and quantity.

Approximately 60% of nursing personnel work at hospitals. However, the ratio has decreased year after year, which shows the diversification of nurses' workplaces.

In accordance with the Long-Term Care Insurance Law enacted in 2000, Facilities for treatment and rehabilitation of chronically ill patients are extended from hospitals to long-term care facilities and home medical care and visiting nursing. The number of nursing personnel required in various workplaces, will continue to increase in the future.

Figure 12: Transition in the number of nursing workers1)2)

Figure 13: Workplaces of nursing personnel2)

[source]
1):Japanese Nursing Association Publishing Company ed. (2010) Statistical Data on Nursing Service in JAPAN 2009, Japanese Nursing Association Publishing Company.
2):Documents from the meeting on 7th projection of supply and demand for nursing personnel , Nursing Division, Health Policy Bureau, MHLW


St. Luke's International Hospital

Working environment

Today there are many issues about the nursing work environment in Japan, including long working hours, night shift and shift work and low wages.

According to the survey by JNA in 2009, the turnover rate became lower than previous, while improvement in the work conditions and the workplace systems for balancing work and life were not adequate. The JNA survey in 2008 showed that one out of 23 persons work at a level considered to lead to death due to overwork (in shifts with overtime of more than 60 hours per month) .

Meanwhile, in hospitals equipped with education and training frameworks, turnover rates of newly graduated nursing personnel were lower. In addition, the introduction of a short-time regular staff system, working shorter hours than normal full-time staff though the status is not part-timers but regular staff members, seems to have an effect to prevent the turnover.

The government has conducted the following measures and expected these to be penetrated into nursing work environment; a work-life balance campaign, accelerated adoption of the short-hour regular staff system, revision of the Guidelines for Review of Working Hours concerning measures to improve the utilization of paid holidays, and amendment of the Child Care and Family Care Leave Law requiring workplaces to allow workers rearing a child under three to work short hours or to excuse them from overtime work at their request.

Table 5:
Item Survey in 2009 Previous survey
Turnover rate Full-time nursing personnel 11.9% 12.6%(2008)
Newly-graduated personnel 8.9% 9.2%(2008)
Work conditions Days of taken paid holidays 8.4days 8.0days(2005)
Average utilization of paid holidays 46.0% 41.1%(2005)
Night shifts of nursing personnel with preschoolers 59.5% Unknown

[source] Nursing Professionals Status Survey 2009, Hospital Nursing Professionals Supply and Demand Status Survey 2009, Japanese Nursing Association

Figure 14: Routinely paid salary by profession(April 2010)

Routinely paid salary by profession(April 2010)

[source] Survey on Salary by Occupation 2010, National Personnel Authority

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