JNA News Release2011.July Vol.6

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

Greetings from the New JNA President
I am Suga Sakamoto, and am honored to have been elected at theGeneral Convention in June to serve as the President of JapaneseNursing Association. I look forward to working more closely withnursing professionals in the workplace, making the most of mythree years’ experience as JNA Vice President and thirty-four yearsof clinical experience.

In the dramatically changing healthcare

situation, I believe it is the first priority for JNA to establish a
supportive work environment where nurses are able to devote on
nursing care, and mid-career nurses can feel that their work is very
well worth doing. I will listen carefully to the voices from the clinicalsettings, and make efforts to legislate or institutionalize policies
from the viewpoint of frontline nurses.
We are very grateful for the warm messages and thoughtful donations from national nurses associations andother colleagues around the world since the Great East Japan Earthquake, as well as steadfast support of theJNA relief activities. We have completed the direct dispatch of disaster relief nurses to the affected areas, andare now working in close cooperation with the affected prefectural nursing associations concerning mid- tolong-term assistance, setting up The Office of the Reintegration Support, The Great East Japan Earthquake atthe JNA Headquarters.
As the President of JNA, I, together with the new Board members, will make every effort to overcome this majordisaster, and to carve out an outstanding new age of nursing.

JNA General Convention
Japanese Nursing Association held its first Generalsafe and secure health and nursing care, gathering

Convention as a Public Interest Incorporated

nursing expertise and strength: contribute to theAssociation on June 6 and 7, 2011. Attended byrehabilitation and reconstruction after the Great East

750 representatives, the Annual Report and theJapan Earthquake.”

Project Proposal were approved as proposed,a new President and other members were elected to

together with the FY 2011 JNA Resolution, “Provideestablish the new regime.■

At the Board member election,

Report on the “2010 Survey on Demand and Supply of Hospital Nurses”
JNA conducted the “2010 Survey on Demand and Supply of Hospital Nurses” in October 2010. To understand thetrend of demand and supply and the work situation of nursing personnel on a nationwide scale, this survey of1|

JNA News Release2011 July Vol.6

hospital nursing managers has been conducted annually since 1995.

This year, in addition to the usual focus on

the turnover rate and the average salary of nursing personnel, the survey included the actual conditions of night
shifts and actions to address the heavy burden of night shifts. The following is a summary of the results.
<Turnover Rate of Nursing Personnel>

two-shift system. For nursing personnel working at

This year’s survey indicated that the turnover rate ofcertain ICUs, it was 8.9 times and 5.8 times,

full-time nursing personnel in FY 2009 was 11.2%,

respectively. Those ICUs nursing personnel tend toshowing a 0.7 point decrease from the previous year.

have more night shifts than general wards nursing

Thenursing

personnel. It is necessary to survey and examine thepersonnel was 8.6%, which showed a 0.3 point

reality of the staffing level and work contents of night

decrease.

Thisshifts at those ICUs.

maintained.

We consider that this trend is due toturnover

rateofnewly-graduateddownwardtrend

hasbeen<Efforts to Reduce the Burden of Night Shifts>

various retention measures by JNA, and workplaces

Only 20% to 30% of the responding hospitals had aas well as hospital associations.

clear provision on the frequency and working hours of<Working Hours in Night Shifts>

night shifts, the spread-over and the interval between

The results showed that 26.9% of nursing personnel inthe shifts in a working regulation, and 70.2% had ageneral wards worked 48.1 to 64 hours in night shifts

guideline for the creation of work schedules. Amonga month, which was the largest proportion, 15.7% of

those hospitals that had provisions for shift rotations,the respondents worked more than 80 hours in night

shift intervals, legal break times or other procedures toshift per month.

This implies that some nursing

reduce the burden of night shifts in their guideline,

personnel work a disproportionate amount of night

80% to 90% reported the successful implementation

shifts, and that urgent countermeasures are required.

of these procedures (at the time of creating a work

The average frequency of night shifts per month forschedule for September 2010). Therefore, we neednursing personnel working at general wards was 7.8

to promote the application of such procedures in thetimes in the three-shift system and 4.6 times in theemployment regulations.■

Proportions of Two- and Three-Shift Systems
According to a survey by the Ministry of Health, Labour and Welfare(MHLW), in 1984 almost half (52%) of thenursing personnel working in hospitals worked on a three-shift system and 17% on a two-shift system.

In2008, the same survey series showed that those working on a three-shift system decreased to 31% and thoseon a two-shift system increased to 66%.

Report on the “Baseline Survey on the Basis for Public Health Nurse Activities”
Public health nurses are involved in a wide variety of health issues such as the prevention of life-style relateddiseases, long-term care, abuse, depression and suicides as well as the promotion of health risk management, incommunities or industry health settings.
JNA conducted a nationwide survey on the working environment, work contents, employment conditions andin-service training of PHNs, aiming to address the diversifying needs and to determine our direction in order tostrengthen their expertise. The survey revealed the challenges to facilitate the expertise of PHNs. Here is theoutline of our challenge.
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JNA News Release2011 July Vol.6<Challenge 1: Need to Systematically Train Public Health Nurses Who Can Take a Leading Role>
Public health nurses who can take a leading role

between departments, giving technical instructions for(hereinafter referred to as “chief PHNs”) are thosepublic health activities, but could not get satisfactorily

who can take overall leadership providing technicalengaged in human resource development andadvice while coordinating other health professionals

personnel placement.

with a view of clarifying problems in human resource

about 30% of the chief PHNs had not undergone

development and community health. In this survey,

mid-career training that could be useful for their role

18.5% of the respondents reported that they wereas a PHN, and about 50% had not received nursing

chief PHNs. The results showed that more than 60%

administrator training.

of these chief PHNs took the responsibility ofneed to develop a systematic human resource

consulting staff members, liaison and coordination

development and training scheme.

As for in-service training,This indicates an essential<Challenge 2: Urgent need to Establish an In-Service Training Scheme >Only 30% of the respondents in this survey reported

respondents have not taken training. As the reasonsthat they had some in-service training system. Thus,of this lack of training, they pointed out “non-existenceit is hard to say that there is systematic humanof such training programs” (40% to 50%), and few

resource development in place. We need planned

mentioned personal reasons.

humanbasis of in-service training of PHNs is quite weak.

in-service

resource

developmenttraining.

JNA will incorporate the results of this survey into its

about 80%

future agenda and policy recommendations toanswered that they had received such training,

strengthen the expertise of PHNs. While improving

leaving 20% without any postgraduate training at all.

the basis for public health activities, we will focus on

About 60% answered they have not had a chance toreinforcing the planned development of chief PHNs

be supervised by a preceptor PHN during their training

and industrial PHNs, and work for the reconstruction

as new graduates.

of the in-service training scheme.■

nursingfororganizedfor

newly-graduatedAsandtraining

It is clear that thepersonnel,

As for mid-career training andnursing administrator training, as many as 40% of theWhat is a “Public Health Nurse”?
"Public Health Nurse" is a person who use this title based on a license from the Minister of Health, Labour andWelfare, and who engage in providing public health guidance (Article 2 Chapter 1, Act on Public Health Nurses,Midwives and Nurses).

To obtain the public health nurse license, one has to complete a four-year course at anursing university or graduate school (master’s degree), as well as a six-month (at least) program at a specialized
school after obtaining the license.

News Topics in Japan
Member Survey on the Victims of the Great East Japan Earthquake
On June 7, JNA reported an update of disaster-affected members as of May 1 at the General Convention.
According to the survey conducted by JNA on healthcare facilities to which JNA members belong in three affected
prefectures, namely Fukushima, Miyagi and Iwate, 252 nursing personnel had resigned due to the earthquake, and203 were on leave. Among those on leave, 22 were under medical treatment and 138 had been evacuated. We
plan to continue this survey up to the end of July, and the final results will be published on the JNA website
http://www.nurse.or.jp/jna/english/earthquake.html.
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JNA News Release2011 July Vol.6

Nursing in Japan

News Topics in JapanQ What are the roles of public health nurses?
Public health nurses (PHNs) are engaged in a wide variety ofhealth issues.

Governmental PHNs, working for a

Project of Pilot Trial of Specific Practice
Nurses(tentative name) Commenced atThree Facilities
On April 26, the Ministry of Health, Labour

prefectural or municipal government agency (e.g. publicand Welfare designated three healthcare

health center), provide various services to local citizens,

facilities as the sites for the Pilot Trial ofincluding maternal and child health services such as medical

Specific Practice Nurses (tentative name).

checkups for infants and mothers’ classes,

The aim of this trial project is to collectdemonstrative data required for further

vaccinations,cancer examinations and measures for preventing life-style
related diseases and long-term care.

Industrial PHNs,

working for a company, are responsible for the healthmanagement of employees. PHNs also work for schools tokeep students and teachers in good health or for hospitals

discussion on the introduction of “Specific
Practice Nurses” (tentative name), andpractice trials are conducted in actual
healthcare settings with the cooperation ofand welfare facilities in Japan. Some PHNs work overseas tonurses who have completed theeducational program of the “Pilot Trial ofpromote maternal and child healthcare services and healthTraining

education. In recent years in particular, there have been(tentative name).

high expectations of the active role of PHNs in associationcollected on how they are utilised in thewith the increase of urgent and difficult cases of life-style
related diseases and measure to prevent suicide. Disaster
relief activities are also part of the PHNs’ role. As a part of
the relief activities after the Great East Japan Earthquake,ofSpecific Practice Nurses”
Information will beworkplace and what medical actions they
actually perform.
Special Ministry Ordinance Enacted forPHNs were dispatched from all over Japan to the affected

Single-Person Practice for the Visiting
Nursing Stationarea, and they worked to prevent secondary health damage

On April 22, the Ministry of Health, Labour

and infectious diseases. According to the survey in 2009 byand Welfare promulgated and enacted a
special ministry ordinance concerning

the Ministry of Health, Labour and Welfare, there are 53,212

visiting nursing stations in areas affected

practicing public health nurses.

by the Great East Japan Earthquake,
which allows municipal governments toreimburse special home care service fees
What are “Specific Practice Nurses”?

at their discretion to any station with at

The “Specific Practice Nurse” (tentative name) is aleast one full-time member of staff. Under

new framework for nursing with the aim ofnormal conditions, a visiting nursing station

authorizing nurses with special clinical competency

can only be established with at least 2.5
full-time equivalent nursing personnel.

toprovide,

underthephysician’sorders(“comprehensive orders,” as appropriate) , a wide

But under this special ordinance, so long

variety of medical actions that have generally beenas the local government (excluding Tokyo)
to which the Disaster Relief Act applies

regarded as outside the scope of nurses.

authorizes it, a station may be functioning
with only one nursing personnel until
February 29, 2012 at the latest.

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