JNA News Release2016.January Vol.19

JNA News Release
Japanese Nursing Association
5-8-2 Jingu-mae, Shibuya-ku, Tokyo 150-0001, JAPAN

Tel: +81-3-5778-8559

Fax: +81-3-5778-8478

http://www.nurse.or.jp/jna/english/

JNA Hosted the Japan Nursing Summit 2015
On September 1st, Japan Nursing Summit 2015 was held
by JNA in Tokyo and was attended by approximately 1,800
participants, such as nurse managers.
Originally, the Japan Nursing Summit started in 1996 andhad been hosted by respective prefectural governments andPrefectural Nursing Associations. After certain achievements
were made through the Summit, which took place 18 times
in succession until 2013, the Summit has completed its role
Suga Sakamoto, JNA President, delivered apresentation titled “Japan Nursing Summit:
Making a Fresh Start” at Japan Nursing
Summit 2015.

at that time and ended once. This time, the Japan Nursing
Summit 2015 was reborn as an event hosted by JNA first time.

The theme for the Japan Nursing Summit 2015

a keynote dialogue, a series of lectures and awas “Nursing Policy in a Super-aged Society withthree-person panel discussion. In the keynote

Fewer Children: Examination and Proposal on

dialogue, initiatives that JNA had been taking were

Nursing Labor Policy.” For 2025 when the baby-

revisited and examined. It was pointed out that theboom generation born after World War II will reachsecuring of nurses had been facing competition

the age of 75 or over, it is estimated that a total ofwith other industries as the working population had

two million nurses will be required, which is

declined due to the super-aged society with fewer

approximately a half million increase from its total

children. In order to attract many people to choose

number in 2011. In order to secure this number of

to pursue nursing as a career, emphasis wasnurses and their quality as well for 2025, theirplaced on the need to change current ways ofworking environment to serve as a nursing

thinking and acting by accepting diversity in sense

profession must be improved.

of values and flexibility in working styles. In the

In the opening of this Summit, JNA President,

series of lectures, 5 speakers reported from their

Suga Sakamoto, delivered a speech titled “Japan

respective standpoints on initiatives taken towardNursing Summit: Making a Fresh Start,” and statedthe improvement of working environment for

the following. “JNA intends the Japan Nursing

nurses, their outcomes, current issues and future

Summit to serve as a platform where nurses will

directions. The lectures were followed by thecontinuously discuss strategies, consider and takeexchange of ideas with the audience. In the three-action autonomously by themselves in order toperson panel discussion, experts in policies onshare and solve issues in nursing policy.”social security, labor and nursing, developed aThis Summit was comprised of three sections –discussion from their own perspectives on issues
in nursing labor and their solutions. The discussion

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JNA News Release2016 Vol.19

confirmed that nurse managers at clinical settings

attainment of policies to solve issues in clinicaland personnel in charge of promoting policies needsettings through holding discussions and more

to tackle initiatives collaboratively in order toimportantly making efforts continuously fromfacilitate the improvement of working environment

actions to examinations. The future Summit will

for nursing, and that regular examinations of suchdiscuss

initiatives will contribute to strengthen the nursing

perspective of policies and share initiatives for the

profession.

attainment, along with tackling the common issues

The Japan Nursing Summit has taken a new
step toward the attainment of nursing policies into

strategies

forsolutions

from

the

beyond differences among facilities and theirenvironment.

practice. JNA aims the Summit to achieve the

A Training System for Nurses to Perform Specific Medical Interventions wasCommenced
On October 1st, implementation of the Training
System for Nurses to Perform Specific Medical
Interventions, which was established as a result of
the revision to the Act on Public Health Nurses,
Midwives and Nurses in 2014, was commenced.
The purpose of this system is to systematically train
nurses who will take a role to support and actuallyprovide services required in the community, such as
home-based care, towards 2025 when the babyboom generation born after World War II will reachthe age of 75 or over. This will be accomplished byestablishing this system and standardizing its
content in cases when specific medical
interventionsi) are performed according to procedure
manuals. Under this system, nurses who perform
specific medical interventions according to theprocedure manuals are required to take training
courses. These courses are provided at training
institutions designated by the Ministry of Health,Labour and Welfare, and are comprised of lectures,
simulation seminars and practice. There are
currently 38 specific medical interventions.
The Institute for Graduate Nurses, one of JNA
branches, was designated as one of training
institutions and commenced training courses for
specific medical interventions in November in thisfiscal year. Also, these courses intended for Certified
Nurses, which are one of credentialing qualifications
certified by JNA, will be commenced in the fiscal
year 2016.
JNA will promote the practical use of this system,
aiming for nurses to take and play desired roles
further in the respective activity sites and to utilize
the expertise of nurses fully. Also, through thissystem, JNA will actively respond to the needs ofpeople in the super-aged society with fewer children.

i) Specific medical interventions are defined as medical assistance and as interventions that particularly
require the practical ability of understanding, thinking and judging, as well as professional knowledge andtechniques at the high level in cases when nurses perform according to procedure manuals.
For related articles, please refer to JNA News Release Vol 15.
http://www.nurse.or.jp/jna/english/news/pdf/2014nr_15.pdf

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JNA News Release2016 Vol.19

A Notification System for Nurses was Commenced
From October 1st, in compliance with the revisionattract these nurses to return to nursing practice byof the Act on Assurance of Work Forces of Nurses

providing individually-suited information and support.

and Other Medical Experts, it became mandatory for

Also, with the implementation of the notification

nurses to make an effort to notify Nurse Centers insystem, the Central Nurse Center, which JNA iscases such as when leaving nursing jobs atdesignated by the Minister of Health, Labour andhealthcare facilities.

Welfare to operate, launched a separate website

In the past, once nurses no longer engage inthat integrates information registered through thenursing practice, such as after leaving nursing jobs,

notification. Based on the registered information,it had been difficult to trace and grasp the actual

counselors from the Nurse Centers provide support,

situation of these nurses, such as their employment

which is relevant to the actual situation and needs,

status.

such as training referrals and consultations on a

Additionally,

these

nurseshad

few

opportunities to return to work and to continue toengageinnursingpractice.

Withvariety of issues.

theFrom January 2016, on the JNA official website, acommencement of the notification system, it isdedicated page for nurses who submitted the

expected that Nurse Centers will be utilized by more

notification is scheduled to launch and to distributenurses than before, particularly including those who

information related to personal lifestyle such asalready left their jobs, and that Nurse Centers willchild-rearing, long-term care and health.

【Figure: Renewed Support Structure by Nurse Centers】＝According to the Act on Assurance ofWork Forces of Nurses and Other Medical
Experts, those subject to the mandatory
effort of notification are the ones who hold alicense as public health nurses, midwives,
nurses or assistant nurses, with at least oneof the following conditions;・Left healthcare facilities
・No longer engage in the above practice・Not planning to work immediately after
obtaining the respective license
・Not engaging in the above practice as of
October 1, 2015

For related articles, including information on Nurse Centers, please refer to JNA News Release Vol 15.
http://www.nurse.or.jp/jna/english/news/pdf/2014nr_15.pdf

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Learn More about Related Topics in Nursing
Q What are the circumstances of nurses shown by data in terms of employment status?
【Employment rates of female nurses by age group】
Employment rates of female nurses decrease significantly in the age of late 20s and 30s and represent
an M-shaped curve (Fig - 1). Once nurses leave their jobs, only a few of them return to nursing practice.
（％）

Note:
・Employment rates are calculated from rates of those
not engaging in nursing practice in the end of 2010.

84.9

90.0
80.0
70.0
60.0
50.0
40.0
30.0

77.1

69.3 68.1 69.0 72.8 68.2
57.3
41.5

55.3

（Age）

Figure 1: Employment Rates ofFemale Nurses by Age Group Note) 1)【Turnover rates of nurses at hospitals】
For the last 5 years since 2009, turnover rates of nurses at hospitals remain at approximately 11% for
all permanently employed nurses (Fig - 2). For newly graduated nurses, the rates declined from 8.6%
in 2009 to 7.5% in 2011 and have remained around 7% level. In large cities, such as Tokyo and Osaka,turnover rates of permanent nurses tend to be high (Fig - 3). Also, in small-scale hospitals, turnoverrates of permanent nurses and newly graduated nurses tend to be higher (Fig - 4).
（％）

12.0 11.2

11.0

11.0

11.0

10.9

10.0
8.6

8.1

6.0
2009

7.9

7.5

8.0

7.5

2010
2011
2012
2013
Permanently employed nurses Note）
Newly graduated nurses

Figure 2: Transition in Turnover Rates Note)of Nurses at Hospitals 2)

Note:・Turnover rates for permanently employed nurses=Total number of those resigned each year / Average numberof those employed each year X 100
・Turnover rates for newly graduated nurses=Total number of those resigned each year / Number of thosebecame employed each year X 100
・Permanently employed nurses=Nurses employed permanently on full-time or short-timeworking schedules

20～99 beds
Tokyo

14.6

100～199 beds

14.0

200～299 beds

13.9

300～399 beds

9.6

Kanagawa

8.1

Osaka

0.0

5.0

10.0

15.0
（％）

Permanenly employed nurses

Newly graduated nurses

Figure 3: Turnover Rates of Nuses byPrefecture 3)（Fiscal year 2013）

11.0

6.8

400～499 beds

6.3
6.1

11.9

8.4

10.2

Iwate

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10.0

7.2

More than 500 beds

6.9
0.0

5.0

Permanently employed nurses

13.2
12.9
11.9

9.8
10.3
10.0

15.0

Newly graduated nurses

Figure 4: Turnover Rates of Nuses by
Hospital Bed 3) （Fiscal year 2013）（％）

JNA News Release2016 Vol.19【Reasons for leaving jobs among nurses】
Among nurses not engaging in nursing practice, reasons for having left jobs are mainly marriage,
childbirth and child-rearing in terms of personal circumstances, and long working hours and the burdenof night shifts in terms of workplace environment (Fig - 5). The former 3 reasons relating to personal
circumstances particularly reflects tough working conditions, such as the heavy burden from work. Also,
the tough working conditions are one of factors that discourage nurses to return to work after marriage
and childbirth.
Reasons due to personal circumstances：
Pregnancy・Childbirth
MarriageChild-rearing
One's own healthRelocation
Job transfer of one's spouse
Cannot balance with housework

30.0
28.4
21.7
16.4
15.8
13.5
12.5

Reasons due to workplace environment：
Long working hours・overtime hours
Heavy burden of night shifts
Heavy responsibility・concern about medical accidents
Cannot take annual leave
Relationships with supervisors
Not satisfied with employment conditions
Relationships with colleagues

21.9
17.8
14.9
14.4
11.3
8.6
7.1
0.0

5.0

10.0

15.0

20.0

25.0

30.0

（％）

Figure 5: Reasons for Leaving Jobs among Nurses 4)【Support and systems for nurses at the time of returning to work】
There are a significant number of nurses who had returned to work without receiving any support (Fig- 6). On the other hand, items ranked highest as support or systems nurses who left jobs wished toreceive or unitize at the time of returning to work were exemption from overtime work, shorter working
hours and exemption from work on holidays.
Exemption from overtime work

49.5

3.8

Shorter working hours

44.9

18.1

Exemption from work on holidays

44.9

8.3

Exemption from night shifts or reduced number of night shifts

33.9

9.7

Day care within or outside healthcare facilities (preschool)

12.6

20.9
17.1

Staggered or flexible working hours

3.0
5.6

The above supportNote) is not necessary
The above supportNote) is not received

0.0

10.0

52.5
20.0

30.0

40.0

50.0

Support wished to receive / system wished to utilize（number of nurses left their jobs：n=1,085）
Support received / system unitilized（number of nurses returned to work：n=3,094）

60.0

（％）

Figure 6: Support and Systems at the Time of Returning to Work 5)

Note:
As the items for support and systems at the time of returning to work, 6 items are listed in the figure 6. However,other items that are not listed in the figure are also included in the actual survey.

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JNA News Release2016 Vol.19

JNA has been moving forward with initiatives to improve working environment for nurses, so that nurses
can choose from diverse ways of working and continue their career as a profession at their respective
life stages. Such initiatives include the promotion of work-life balance and support for the dissemination
and application of “Guidelines on Night Shift and Shift Work for Nurses” formulated by JNA in 2013.
Also, prefectural Nurse Centers provide training and information to support nurses to return to work on
a request basis.

Let us introduce our mascots!
・Pink dinosaur wearing WLB T-shirt is a Kango-saurus (Nursing-saurus in English), who cheers andsupports the promotion of Work-Life Balance.
・Green frogs are the mascot for a Kaeru project to transform healthcare environment and clinicalsettings by several measures through organizational commitment of healthcare facilities, such as byimproving shift wok systems and by reducing overtime work. The frogs (Kaeru in Japanese) arechosen for the mascot because Kaeru has several meanings such as frog and to transform in English.
Reference:
1) Data obtained from Miyazaki, Satoru. Recent Employment Rates of Japanese Nursing Staff: Using theUpdated Estimation Method. Institute for Technology, Enterprise and Competitiveness Working Paper
Series. Doshisha University; 2012. [in Japanese]2) Survey on the Demand and Supply of Hospital Nurses, Japanese Nursing Association. [in Japanese]3) Survey on the Demand and Supply of Hospital Nurses, Japanese Nursing Association; 2014. [in Japanese]4) Survey Report on the Intention of Working among Nurses Retired or Not Engaging in Nursing Practice,Japanese Nursing Association; 2007. [in Japanese]5) Data obtained from Survey on the Actual Situation of Employment Status among Nurses, Ministry of Health,Labour and Welfare; 2011.

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