JNA News Release2010 Vol.2

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/index.html

The 1st Japan, China and Korea Nursing Conference
On August 20th and 21st, 2009, the first joint nursing
conference of Chinese Nursing Association (CNA),
Korean Nurses Association (KNA) and Japanese Nursing
Association (JNA) was held in Beijing, China.

Thetheme was “Nursing Shortages and Solutions in Japan,
China, and Korea.” and approximately 1,900 participants(1,600 from China, 100 from Hong Kong/ Macau, 50 fromTaiwan, 56 from Korea, and 126 from Japan) participatedwith 34 oral presentations and 123 poster presentations.
Since Chinese Nursing Association was celebrating its
100th Anniversary in 2009, a commemorative ceremony

Front row from left; KNA President Shin, CNA President Li,
JNA President Hisatsune

was held the day before the opening of the conference and special lectures were given by the representatives ofICN, WHO and the Presidents of the Nursing Associations of the three countries.
The next joint conference will be held in November 2010 in Japan.

Kaeru Project for Nurses (Positive Practice Environments in Japan)
In October 2008, claims for workmen’s compensation

recognized by the court as official casualty.

for the death of two nurses were approved by thewords, their working hours were reaching a dangerous

court, acknowledging “karoshi” (death from overwork)

level that could put them at risk of dying from karoshi.

in one nurse (24 years old) and official casualty in theWorking hours that reach a dangerous level does notother (25 years old).

only mean working in rotating shifts (two-shifts,In response, JNA conducted anIn other“ad hoc survey on the actual situation of overtime

irregular

work, night duty and shift work.”

Based on the resultthree-shifts), but also working more than 60 hoursof this survey, JNA announced that approximately

overtime. Such a workload level was pointed out by

20,000 nurses in Japan were likely to be working

the court as harsh working conditions leading tounder similar conditions as those of the casekaroshi.

two-shifts,

three-shifts,

orirregular

To “prevent karoshi from ever happening again” and to“ensure the provision of safe and high quality nursingcare,” JNA proposes a Kaeru Project for Nurses.
The symbol of the project is a frog. “Kaeru” alsoThis project aims to improve the shift work system andmeans “frog” in Japanese, but it has several otherto reduce overtime work through the organizational

meanings too.
Example; To return, to exchange, to hatch, to change.

commitment of each health care institution.

currently proceeding with the following initiatives withthe cooperation of clinical professionals.

1|JNA isJNA News Release2009 Vol.2

 Actions of health care institutions
Phase 1. As an urgent action, efforts are made to put an end to high-risk work style (50 to 60 hours overtime
work in addition to a rotating shift).
Phase 2. The top management will demonstrate leadership and the director, manager and each staff member
will collaborate to implement the activities committed by the whole hospital/ health care institution.
(1)

To assess the actual situation in the workplace and the needs of the employees.

(2)

To provide opportunities for discussions between the employer and the employees.

(3)

To set goals and to formulate, implement and evaluate improvement plans.

 Actions of JNA(1)Press the government to improve the systems and policies.

(2)

Provide support for the implementation of activities, including fruitful training programs for nursing
managers.

(3)

Collect and share information on good practice.

(4)

Establish a partnership between the Ministry of Health, Labour and Welfare, hospital associations, andlabor unions.

The term “Kaeru” in the name of the project not only signifies “returning home” without having to workovertime, but also includes the following meanings.
(1)

To “change” to the principle of providing a safe healthcare environment,(2)

To “change” to the principle of providing high-quality nursing care,(3)

To “change” to the principle of providing a workplace that protects the health and safety of the staff.

It also reflects the word “Kaeru” in the Work-Life Balance Campaign of the Cabinet Office, “Kaeru Japan.”Flexible working styles (Positive Practice Environments in Japan)
According to the survey of JNA (Hospital nursing

consideration for female nursing professionals withsurvey, 2007), 70% of the respondents thought thatthe life events specific to women such as marriage,

the “introduction of a flexible working style” waschildbirth, and child rearing.

effective in securing nursing professionals, proving it

good work-life balance is lost, it becomes difficult for ato be the most effective measure among various othernurse to work full-time and meet the requirements of ainitiatives.

regular staff member, forcing her to leave her job.

In Japan, to continue working as a regular staff

The introduction of flexible working styles aims tomember, a nursing professional is often required toallow nursing professionals to combine work with life

workshifts.

and continue their career throughout the different life

Consequently, if a nursing professional is unable tostages without having to resign, which in turn, will

work on a full-time basis, he/she is often employed as

promote the recruitment and retention of humana “part-time worker,” with less favorable working

resources at health care facilities.

conditions,

expected to allow improvement in expertise and toinrotating

andshifts,

thisdevelopment difficult.

includingmakesnightcontinuous

career

It can be deduced that thenursing shortage is the result of employers’ lack of2|

It is obvious that when aMoreover, it isensure greater quality of nursing practice.

In termsof the working styles of nursing professionals, JNA is

JNA News Release2009 Vol.2

calling for the introduction of a non-uniform style thattakes

thework-lifebalanceofworkers

into

A society that has achieved a good work-lifebalance is:consideration.

A society that allows each citizen to work with Examples of flexible working styles of the nursingprofessionals
1. One can choose the working hours.

motivation

andsatisfaction,

fulfillwork

responsibilities, and make diverse lifestyle choices
at each stages of life within the family andcommunity, such as during the child-rearing period

2. One can choose the time zone.
3. One can choose whether to work in rotational

and in later periods of life.
In particular, it is a society that (a) ensures financial

shifts or not.
4. One can easily make changes in the chosen
working style: between regular and part-timebasis, or between administrative leave andindependence through employment, (b) ensures
each person to have time to lead a healthy andfulfilling life, and (c) provides diverse options ofwork styles/ life styles.

reinstatement.
5. There are long-term/ short-term leave systems.
6. Equal treatment is ensured for part-time/（Source：The Cabinet Office
http://www8.cao.go.jp/wlb/towa/definition.html）

temporary workers.
● Tokyo Metropolitan Government’s grant project, “short-time regular staff system”
In FY 2009, Tokyo Metropolitan Government became

introduce the short-time regular staff system.

Thisthe first local government to start a grant project,suggests that the Tokyo Metropolitan Government“short-time regular staff system.”

For this project, theconsiders that the short-time regular staff system will

Tokyo Metropolitan Government subsidizes some ofbe effective in preventing the high turnover of nurses.

the expenses of hospitals with fewer than 300 beds to

In-Hospital Midwife-Led Care System
With the decreasing number of obstetricians and themidwives to provide both physical examinations anddeclining birth rate, the number of facilities providing

health guidance with professional autonomy and byobstetric care has decreased from 3,991 facilities inpromoting in-hospital midwifery clinics (outpatient) as

1996 to 2,933 facilities in 2005.

well as in-hospital midwifery care (inpatient).

Under thesecircumstances, the national government is rapidly

According to a web-based survey targeting the users

proceeding with intensification and networking ofof these in-hospital midwife-led care system, theobstetric care, to provide safe and reliable places foraverage duration of consultation time was double thatchildbirth.

providedSince 2008, the Ministry of Health, Labourbyobstetriciansalone.

(Source:and Welfare has initiated various initiatives tohttp://www.digitalboutique.jp/pub/pdf/PR080201_Sank

establish in-hospital maternity centers and midwiferyaFusoku.pdf)

outpatient services.

and considered it “easy to ask questions” during

Meanwhile, JNA has been making its own efforts tohealth examinations by midwives, and the outpatient

promote midwifery system in hospitals since 2004, byserviceswerehighlyexamining midwife-led care system that allows

appreciated by pregnant women and mothers.

Most3|Pregnant women felt “comfortable”

providedbymidwives

JNA News Release2009 Vol.2

comments were supportive of the services.

Inobstetrician would be present if necessary.

addition, when asked, “How do you feel aboutItin-hospital midwifery clinics and in-hospital midwifery

questionnaires targeting the users of health care

care?” less than 1% of those who had experienced

institutions that had adopted an in-hospital midwife-led

childbirth replied, “I feel anxious without the presencecare system revealed a tendency for a highof an obstetrician.”satisfaction rate.

This suggests that women would

has

also

been

reported

thatpostnatal

accept midwife-led care, if they knew that an
In-hospital midwife-led care system
The system that has a “In-hospital Midwifery Clinic (outpatient)” or an “In-hospital Midwifery Care (in-patient)”
within a hospital or clinic and midwives are utilized.

This system allows midwives to provide independent

health examinations of pregnant women and postpartum women, birth assistance and health guidance(health counseling/ education).
By role-separation in partnership with a physician, a midwife will provide midwifery care that meets the needsof each individual, by respecting the wishes of the pregnant and postpartum women and their families, and bypracticing team medical care based on the relevant guidelines.

In particular, midwives will perform physicalexaminations, birth assistance and provide health guidance (health consultation/education) for low-risk
pregnant and postpartum women.
In-Hospital Midwife-Led Care System

Obstetric
Outpatient
Servicecollaboration

In-hospital

In-hospital

Midwifery

Midwifery

ClinicCare Unit

Obstetrics/ andcollaboration

Gynecology
Ward
Obstetrics Unit

Nursing in Japan
FAQ by Japanese Nurses;
What are the health care activities that can be provided by nurse aids (who do not have nursinglicense)?
In Japan, Act on Public Health Nurses, Midwives and Nurses define nursing as to take care of people under
medical treatment and to assist medical treatment. The role of nurse aids are to provide peripheral services
related to nursing work that do not require specialized nursing knowledge.

These are simple procedures

such as moving objects and materials, but the details of the tasks will be decided at each facility.

Since

nurse aids basically work under the supervision of nurses, the nurses have to take responsibility for theiractivities.

4|JNA News Release2009 Vol.2

News Topics in Japan
Revision of the Child Care and Family Care Leave Act
On July 1, the revised Act on the Welfare of Workers Who Take Care of Children or Other Family
Members Including Child Care and Family Care Leave (referred to as the Child Care and Family Care
Leave Act) was promulgated.

Based on the revision, all businesses with 101 or more workers areobliged to allow workers with children under 3 years of age to adopt short working hours (6 hours perday) if they request it, and to exempt them from working overtime (business entities with 100 or fewer
workers are granted a 3-year grace period).
Furthermore, despite the availability of paternity leave (child care leave) system, only 1.56% had
benefited from the system in FY 2007.

In response, in case both parents wish to take child careleave, the revised Act will allow each parent to take leave for a period shorter than 1 year, before thechild reaches the age of 14 months (12 months under the current system).

Until now, it was only

possible to obtain child care leave once, regardless of the duration of leave.

However, the current

revision makes it possible for a father to take another child care leave later if he had taken the firstleave within 8 weeks after the birth. The revision will be effective by June 30, 2010.
Increase in the number of nursing professionals
On July 17, the Ministry of Health, Labour and Welfare published, “The Report on Public HealthAdministration and Services, 2008.”

As of the end of 2008, the numbers of public health nurses,

midwives, and nurses in employment had increased by 8.1%, 7.8% and 8.0% respectively, comparedto the previous report (2006).

However, the number of assistant nurses had decreased by 1.9%. The

number of employed nurses in the age group of 30 to 49 shows a particular increase.
Health care professionals start to receive vaccination against H1N1 influenza
On October 19, vaccination against H1N1 influenza started for health care professionals (including
emergency personnel) who are directly involved in the medical care of H1N1 influenza patients.

It isplanned to vaccinate others consecutively, starting from pregnant women and those with primary
illnesses, children aged one to nine (equivalent to children in third grade of primary school), and theguardians of children under 12 months.

In September, JNA had submitted a request to the Ministry ofHealth, Labour and Welfare, to give priority to visiting nurses and public health nurses who have a riskof acting as a vector in the transmission of H1N1 influenza to home-based patients and community
residents.

5|