JNA News Release2013 April, Vol.11

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

Tel: +81-3-5778-8559

Fax: +81-3-5778-5602

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

Message from JNA President Suga Sakamoto
It is almost 2 years since I have taken office as President.

Since I

assumed this post, I have consistently maintained that we have to put“emphasis on the clinical field,” value the thoughts of nurse managers andstaff, and make JNA an organization that can actually relate to the clinicalfield.

Japan experienced a change of regime last year, but thegovernment movement toward the reform of social security and health care
continue to progress.

JNA carries on with making policy proposals as aprofessional association to meet the expectations of the public, and also tocontribute to the satisfaction of its members.

We will work hard withpassion as the nurses take lead in supporting Japan, which facing a
super-aged society.
Two years have passed since the Great East Japan Earthquake on March
11th, 2011, but reconstruction activities in the affected areas are still under way.
reconstruction.

JNA keeps on supporting theIn the disaster session of the International Council of Nurses (ICN) 25th Quadrennial

Congress held this May, JNA has the opportunity to talk about our efforts and its preparations for the future.
JNA would like to share our experience with nurses in the world, and be of some help to them in preparing fordisasters that are occurring all over the world. ■Guidelines on Night Shift and Shift Work for Nurses
After the court accepted claims for working person‟s compensation for two nurses inOctober 2008, one (a 24-year-old nurse) acknowledged as “karoshi” (death fromoverwork), and the other (a 25-year-old nurse) as an official casualty, JNA conducted
an “ad hoc survey on the actual situation of overtime work, night shift and shift work.”
Based on the results, it became clear that more than 60% of nurses working in
hospitals “worked in shifts,” and that 2.5% of the nurses who “worked in shifts” had“more than 60 hours of overtime.”

In other words, approximately 20 thousand nurses in Japan are likely to beworking under similar conditions as those of the case that was recognized by the court as an official casualty, orfor the same working hours reaching a dangerous level at risk for karoshi*.

JNA has been approaching nurses

and making requests to the government to improve the working conditions and environment of nurses.
(Please refer to JNA News Release Vol. 2 & Vol. 5 http://www.nurse.or.jp/jna/english/news/index.html)*Dangerous level at risk for karoshi means working in rotating shifts (two-shifts, irregular two-shifts, three-shifts, or irregular
three-shifts), and also working more than 60 hours overtime, or working under similar conditions as those pointed out by the court
as harsh working conditions leading to karoshi.

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On March 7th, we officially announced the “Guidelines

but may also increase the risk of medical accidents.

on Night Shift and Shift Work for Nurses” which isBased on the basic understanding that “the safety andJNA‟s own guidelines that we have been working on,

health of the nurses protect the safety and health ofas one of JNA‟s activities to improve the workingthe patients,” this guideline was created as a tool toconditions of nurses.

“reduce the burden of the night shift and shift work and

To protect the lives and health of patients and provide

manage the risks,” reflecting the actual situation ofsafe care, nurses themselves must work safely and inclinical settings and evidence of labor science.

good health.

Recent knowledge on labor science

hope these standards are utilized as check items, as

reveals that the burden of night shifts and shift work inwell as an indicator or target for improvement, in line

general not only increases health risks for the nurses,

with the situation of each institution. ■JNA

Standards for organizing shift schedules
in the JNA “Guidelines on Night Shift and Shift Work for Nurses”
ItemStandard

1)

Time between shifts

Provide 11 hours or longer time between shifts.

2)

Total hours spent at work

Total hours spent at work are up to 13 hours.

3)

Number of night shifts

Night shifts should basically be within 8 times a month in a system of3 shifts per day. If using another shift systems, the number should
adjust to the work hours.

4)

Number of consecutivenight shifts

5)

Number of consecutive
working days6)Time allocated for breaks

Up to 2 consecutive night shifts.

Up to 5 days.
Provide 1 hour or more in the middle of a night shift, and a period
according to the length and load of the shift during a day shift.

7)

Naps during night shifts

Provide an uninterrupted nap time in the middle of the night shift.

8)Rest following a night shift

Provide a rest period of 48 hours or more after 2 consecutive night(including days off)

shifts. A rest period of 24 hours or more is desirable after 1 night shift.

Consecutive days off on

Consecutive days off over Saturday and Sunday without preceding

weekends

following night shift should be ensured at least once a month.

9)10) Direction of rotation

The roster to be forward rotating.

11) Start of the morning shift

Avoid starting the morning shift before 7 AM.

Report on the “2012 Survey on the Demand and Supply of Hospital Nurses”

2|JNA conducted the “2012 Survey on the Demandtargeting hospital nursing managers all over theand Supply of Hospital Nurses” in October 2012.

country. This year, in addition to the focus on theThis survey was conducted to understand the trend

turnover rate and the salary of nurses, the surveyof demand and supply and the work situation ofincluded the actual conditions of night shifts andnurses working in hospitals on a nationwide scale.

efforts made to reduce the burden of night shifts.

It has been conducted annually since 1995,

The following is a summary of the results.

JNA News Release
Turnover Rate of Nurses

2013 April, Vol.11
hospitals

answeredthat

theyhad“alreadyThis year‟s survey indicated that the turnover rateaddressed” it, was 6 out of the 11 factors. To namein fiscal year 2011 was 10.9% of full-time nurses,a few from the top, “break during night shifts” wasand 7.5% of newly graduated nurses. Both turnoveraddressed by 84.8%, “limit consecutive working

rates have been decreasing over the last 4 years,days” by 78.7%, and “set a limit to the number ofbut still tend to be high in hospitals where thenight shifts per month (only hospitals with aburden of night shifts is heavy.

three-shift system)” by 76.6%. Only a few of theWorking Hours in Night Shifts

hospitals had specific standards set for hours andThe trend of working hours of night shifts has notnumbers that actually met the standards of the JNA

changed much since the last survey in 2010.

guideline, and the highest was “limit the number of

The hours that a nurse work on night shifts perconsecutive night shifts” by 49.0%.

month was 72 hours or less in 68.1%, but, on theEfforts to Manage Working Hours

other hand, a nurse who worked on night shifts forFor efforts toward managing the working hours tolonger than 72 hours per month amount to 31.9%,

improve the long working hours of nurses, more

and those who worked on night shifts for longer

than half of the hospitals answered “alreadythan 80 hours per month increased to 17.3%.

implemented” as below; “increase nurse aids” wasEfforts to Reduce the Burden of Night Shifts

applied by 64.6%, “adjust workloads so that noIn response to the survey of 11 items involved inovertime will be necessary” by 60.6% , andreducing the burden of the night shifts based on the“promote the task-sharing among nurses and otherJNA‟s “Standards for organizing the shift schedules,”professions” by 60.5%.■

the number of items for which more than 70% of theNews Topics in Japan
Reports from the “Internal project team to promote „quality of employment‟ of nurses and otherpersonnel” are made public
On February 6, the Ministry of Health, Labour and Welfare (MHLW) has been pursuing to reinforce
efforts to secure working conditions and an environment for health care personnel such as nurses anddoctors with an “internal project team to promote „quality of employment‟ of nurses and otherpersonnel” since last October. The basic policies and specific plans after the year 2013 were compiled
and made public. Included in the report are efforts made by each health care institution, aimed toconstruct a self-management system to promote “quality of employment” to systematically improve thewhole working environment. For this system, we will create a realistic guideline that each health careinstitution can follow to implement the PDCA cycle. Efforts are also made by the government working inclose coordination with related organizations, including JNA.
http://www.mhlw.go.jp/stf/houdou/2r9852000002uzu7.html (in Japanese)

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JNA News Release2013 April, Vol.11

Nursing in JapanQ.

Is there a limit to overtime work?

According to Article 32 of the Labor Standards Act, working hours are stipulated as 8 hours a day and 40
hours a week, excluding rest periods. To have workers work longer than these limits, a labour-managementagreement (“36 agreement”) must be concluded. However, even if the “36 agreement” is concluded, theMinister of Health, Labour and Welfare has placed a limit on the hours that one may work overtime. Theagreement therefore has to be concluded within the limits of the “36 agreement” (Table 1). There is also a
special requirement concerning overtime work of those who are raising children or providing nursing carefor their family members, and the limit is 24 hours a month and 150 hours a year.
[Limit of Overtime Hours Placed by the Minister of Health, Labour and Welfare]Worker Under the One-Year

PeriodGeneral Workers

1 week

15 hours

14 hours

2 weeks

27 hours

25 hours

4 weeks

43 hours

40 hours

1 month45 hours

42 hours

2 months

81 hours

75 hours

3 months

120 hours

110 hours

1 year360 hours

320 hours

Variable Working Hours System*Variable Working Hours System: The Labor Standards Act regulates working hours as 8 hours a day and 40
hours a week, but this system allows overtime work to exceed the statutory working hours on a certain day orweek, if it is within the limits of the weekly statutory working hours when averaged out in a given time frame. Thissystem is suitable for work places with workloads that fluctuate within a month or a year, or work places withrotating shifts.

JNA supports Girl Child Education Fund, the initiative ofFlorence Nightingale International Foundation.

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