Nursing in Japan
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Nursing was not an established part of Japan's health care system until 1899 with the Midwives Ordinance. The Registered Nurse Ordinance was passed in 1915 which established a legal substantiation to registered nurses all over Japan. During World War II the Public Health Nurse, Midwife and Nurse Law was created and re-affirmed in 1948. It established educational requirements, standards and licensure. There has been a continued effort to improve nursing in Japan. In 1992 the Nursing Human Resource Law was passed. This law created the development of new university programs for nurses designed to raise the education level of the nurses so that they could be better suited for taking care of the public.
Types of nurses
Public health nursing is designed to help the public and is also driven by the public's needs. The goals of public health nurses are to monitor the spread of disease, keep vigilant watch for environmental hazards, educate the community on how to care for and treat themselves, and train for community disasters.
Midwife nurses are independent of any organization. A midwife takes care of a pregnant woman during labor and postpartum. They assist the mother with breastfeeding, caring for the child, and related tasks.
Individuals who are assistant nurses follow orders from a registered nurse. They report back to the licensed nurse about a patient's condition. Assistant nurses are always supervised by a licensed registered nurse.
In 1952 Japan established the first nursing university in the country. An Associate Degree was the only level of certification for years. The Bachelor of Science in Nursing (BSN) was later established. A Doctorate in Nursing is now offered in many universities.
There are three ways that an individual may become a registered nurse in Japan. After obtaining a high school degree the person could go to a nursing university for four years and earn a Bachelor degree, go to a junior nursing college for three years or go to a nursing school for three years. Regardless of where the individual attends school the nursing candidate must take the national exam. Those who attended a nursing university have a bit of an advantage over those who went to a nursing school. They can take the national exam to be a registered nurse, public health nurse or midwife. In the cases of midwives or public health nurses, the student must take a one year course in the desired field after attending a nursing university and passing the national exam to become a registered nurse. The nursing universities offer a wider range of general education classes and have a more rigid teaching style of nursing. Nursing universities train their students to be able to make critical and educated decisions when they are in a medical setting. Physicians often serve as teachers because of the shortage of qualified teaching nurses.
Students that attend a nursing college or a nursing school receive the same degree as one who graduates from a nursing university, but study under a more focused curriculum. The classes offered at nursing colleges and nursing schools are focused on more practical aspects of nursing. These institutions do not offer many general education classes, so students who attend these schools will focus solely on their nursing curricula. Students who attend a nursing college or school do not have the opportunity to become a midwife or a public health nurse at that school, but must enter a specialized training institute after graduation. Once the nurse candidate has passed the qualification exam, the license is held for life and does not have to be re-newed.
There is currently a shortage of nurses in Japan, in part due to the expanding population of elderly. Other reasons for the deficit in nursing applicants are poor working conditions, an increase in assigned workloads, the low social status of nurses, and the cultural idea that married women quit their jobs for family responsibilities. On average, Japanese nurses will make around 280,000 yen a month. Similar to other cultures, the Japanese people view nurses as subordinate to physicians. Nursing work has some negative associations, as according to the American Nurses Association article on Japan, "nursing work has been described using negative terminology such as "hard, dirty, dangerous, low salary, few holidays, minimal chance of marriage and family, and poor image".
Some nurses in Japan are promoting better nursing education as well as promoting the care of the elderly. There are organizations that unite Japanese nurses like the Japanese Nursing Association (JNA). The JNA is not a trade union, but rather a professional organization. Members of the JNA lobby politicians and produce publications about nursing. According to the American Nurses Association's article on Japan the JNA, "works toward the improvement in nursing practice through many activities including the development of a policy research group to influence policy development, a code of ethics for nurses, and standards of nursing practice". The JNA also provides certification for specialists in mental health, oncology and community health. JNA is not the only nursing organization in Japan. There are other subgroups that are typically categorized by the nurses' specialty, like emergency nursing or disaster nursing.
One of the older unions that relates to nursing is the Japanese Federation of Medical Workers Union which was created in 1957. It is a union that includes physicians as well as nurses. This organization was involved with the creation of the Nursing Human Resource Law.
Nurses and physicians
As stated earlier, nurses are considered to subordinate to physicians. While the public often view nurses' jobs as mere assistants for physicians, though nurses with higher levels of education have more independence than a registered nurse.
- "Professional Nurse Salaries - International Comparison". World Salaries. 2008. Retrieved 26 September 2011.