Do you think bringing foreign nurses and caregivers to work in Japan is a good idea?

Does anyone have any other viable alternatives? There are already less nurses in the whole country across all specialisations than there are elderly dementia patients, and that's just one disease. There are numerous conditions that require special attention.

Either bring the nurses to Japan or send the elderly to other countries to be nursed there.

Not if they pull the same "use and toss" approach they used for the Indonesian and Philippino nurses as they did four or five years ago.

They gave them 3 years to pass the medical exam but with very difficult kanji written on them that many couldn't read or understand.

If I remember correctly, only three out of a few hundred passed the first test. Many never did and were sent back home.

Japan needs nurses pronto but the government sets the barriers too high and the elderly here will suffer for it.

Yes. They should also offer the National Nursing Examination is other languages besides Japanese and instead require a Japanese language interview instead.

other then the skills for nursing and to care for the patients and seniors, the utmost importance is communication and language. they need to be fluent in Japanese, as well as understanding of Japanese customs and culture.

Better let them in, and hurry! I want to make sure there are enough young Philippina nurses to take care of me when I get old here.

[planning for retirement outside Japan intensifies]

It's plain and simple. Japan has no choice but to accept more foreign nurses due to demographics. Japan needs a major overhaul of their present system to invite more people from other countries and those responsible for neglecting the need to improve the program need to take more aggressive action. The strict Japanese rules concerning the immigration of foreign nurses in addition to the difficulty of passing the national examination with certification including the language barrier has made the reality of becoming a nurse for most foreigners too hard.

It works in other countries so why not? They just have to open their minds a bit.

It has worked in other countries where they have colonial subjects to call up already in some way attuned to the language and culture, e.g. English speaking Indian, African or Caribbean citizens, Spanish speaking Filipinos etc, if not entirely fluent. Japan was not allowed to have its own Empire.

Do I want to go to a hospital where the staff cannot read the contents or instructions on a bottle or doctor's note, or respond accurately in an emergency situation ... please the gods, no thank you. Non-professional orderlies? perhaps; medical professionals, no.

Near where I live they have flirted with some Muslim Indonesians and then found themselves having to pander to their religious demands. The last thing Japan needs is Islamification via the backdoor ...

Are the demographics really that bad?

It strikes me that if only a tiny fraction of all the hair stylists in Japan were to grow a social conscience and want to take care of obaasan there'd be more than enough, so there are other issues at play.

Does Japan need or want to go down the route of immigration? No.

It can work, as this NPO has demonstrated. 97% of its 130 candidates thus far--all graduates of four- or five-year nursing colleges in their home countries, all having passed the JLPT Level 1--have passed the national nursing exam and are working full-time as the equivalent of RNs and LPNs, with the opportunity for unlimited renewal of their five-year visas. Most of them intend to stay.

(Being mostly from China and South Korea, they have something of a language advantage over prospects from Indonesia and the Philippines, who may otherwise be just as qualified in terms of education and medical training.)

http://insnpo.org/index.html

At the same time there is an English requirement in the Japanese Nursing Certificate Examination, so they are hoping to build the other end of the bridge with Japanese M & F nurses who understand some English, I guess for communication both with foreign patients and with international, ie non-Japanese nursing staff coworkers.

Mister EdMay. 01, 2014 - 03:41PM JST Do I want to go to a hospital where the staff cannot read the contents or instructions on a bottle or doctor's note, or respond accurately in an emergency situation ... please the gods, no thank you. Non-professional orderlies? perhaps; medical professionals, no.

Have you been in a hospital? I suspect not. All of the medication names are bad katakana translations of the medications' English names. The instructions are likewise translated (often VERY badly) from English. It would actually be easier and safer to use the English names and English dosage instructions.

Near where I live they have flirted with some Muslim Indonesians and then found themselves having to pander to their religious demands. The last thing Japan needs is Islamification via the backdoor ...

Religious intolerance much?

Are the demographics really that bad? It strikes me that if only a tiny fraction of all the hair stylists in Japan were to grow a social conscience and want to take care of obaasan there'd be more than enough, so there are other issues at play.

23% of Japanese people are over 65 today. Under 60% of the population are working. Do the math. And the percentage of elderly is set to rise dramatically in the next two decades.

Does Japan need or want to go down the route of immigration? No.

Does it want to? Clearly no. Does it have to? Give me a better alternative than taking 20% of Japan's working population and reassigning them to be nurses.

It's going to happen unless the situation gets better. With actual facts as of late and more and more of the overall Japanese population aging faster than there are young ones being raised, I don't see Japan having any other choice.

Absolutely! No doubt about it!

The alternative is to train more Japanese nurses. There is not a shortage of people who could do the work. You may need to raise pay levels to encourage more to join the profession.

Correct, there is no shortage of people who could do the work and, as Ah_so writes, the answer is to pay them more and treat them better (more reasonable hours, more equal doctor/nurse relationships).

What the government needs to do is study why more individuals don't want to be nurses. The poor pay and the excessive demands made of them are the reason. I suspect they know this and cannot or do not want to change and, hence, are looking to fill slots with needy immigrants who will take more **** for less pay. As in, exploit individuals who will take it for a few years, because sending money back home is so much more valuable for them.

Over-employment is common in many spheres within Japan. It's also a fact of life for all developed nations that with individuals living longer and remaining much healthier, and the economics of early pensions becoming as impossible as they were predicted to be for most, all of us will be working for much longer.

I am not sure why immigration is being foisted on Japan as an unquestionably good thing, which is really what this issue is about as, say, a perpetually growing economy is. Both should be questioned.

The last thing the Japanese working classes and those already in insecure short-term contracts or unemployed need are waves of migrants willing and able to work at less than it costs to have a decent life in Japan. It may not be apparent to some of you, but for many individuals, being able to afford a decent life in Japan (including home owners) is become increasingly hard to impossible.

Immigration is great for short to mid term capital interests as undercuts the value of labor and makes it insecure and hence easily to exploit (more profit). However, they do not pay the long term social cost.

@Frungy

Yes, Asian Islam is a highly volatile and intolerant religion. Perhaps you should study up on what happens and has happened across the Indonesian archipelago over the last few decades, where they targeted the first wave of oversea nurses. Japan just does not have the "antibodies" to deal with it. Funnily enough, I would not write the same thing if it were the Balinese. There's some kind of problem in the culture and mentality of mono-theistic religions who believe only they have the one god and one way.

Mister EdMay. 01, 2014 - 10:41PM JST Correct, there is no shortage of people who could do the work and, as Ah_so writes, the answer is to pay them more and treat them better (more reasonable hours, more equal doctor/nurse relationships).

Did you not pay attention to the statistics? There just aren't enough young people in Japan to meet the demand. And one doesn't just walk around with a set of stickers saying, "Congratulations, now you're a nurse" and stick them on people. They need to be trained. You're talking about taking 7% of the working population out of their current jobs, training them for a minimum of 5 years before you can get them back into jobs.

What the government needs to do is study why more individuals don't want to be nurses. The poor pay and the excessive demands made of them are the reason. I suspect they know this and cannot or do not want to change and, hence, are looking to fill slots with needy immigrants who will take more **** for less pay. As in, exploit individuals who will take it for a few years, because sending money back home is so much more valuable for them.

Yes, nurses are badly paid, but even if it paid better it still wouldn't attract enough people.

I am not sure why immigration is being foisted on Japan as an unquestionably good thing, which is really what this issue is about as, say, a perpetually growing economy is. Both should be questioned.

Because by 2055 38% of the population will be elderly. 38%. That's almost half the people in the country will be using walkers and yelling at you for standing on their lawn. No economy can support that. No economy in the world.

The last thing the Japanese working classes and those already in insecure short-term contracts or unemployed need are waves of migrants willing and able to work at less than it costs to have a decent life in Japan. It may not be apparent to some of you, but for many individuals, being able to afford a decent life in Japan (including home owners) is become increasingly hard to impossible.

Because the economy sucks. Less people means the companies are outsourcing jobs to overseas because they simply can't get workers in Japan. This means companies reducing in size. Which means an economic death spiral.

Immigration is great for short to mid term capital interests as undercuts the value of labor and makes it insecure and hence easily to exploit (more profit). However, they do not pay the long term social cost.

If immigration creates labour surplus to demand then the price of labour goes down, but if it merely matches demand then you end up with labour being paid a fair market rate. Supply and demand 101. Not that it applies to government workers, who will be paid the government rate regardless.

Importing nurses and care givers is not the same as for factory workers. The former need to be highly trained for the job and in the Japanese language. This takes time and money. A lot of it. Offer better pay for Japanese who won't have a language problem and training for the foreigners, equipping them with skills they can use when returning to their native countries.

It's really bad idea if Japan only intends for it's foreign workforce to 'know it's place in Japanese society'. Granted Japan is looking to low tiered nations for labor, but without clear hiring/immigration/discipline practices the only thing Japan will be doing is training a work force that will go back to their home country or move one to a better paying employer (Dubai/Qatar).

What the government needs to do is study why more individuals don't want to be nurses.

Really? What's to study?

Low wages. Low-esteem of the job in society. Long hours. Stressful labour conditions. Heavy lifting. Shift work. Cleaning up the gross bodily messes people make. Dealing with people who can be abusive (especially the dementia patients). Dealing with hazardous waste. Facing the risk of contagion and super-bugs all the time. Needing as much medical savvy as a doctor but not being acknowledged as a highly-valued and well-paid co-equal partner.

How long a list do you require?

To get bilingual nurses in 4 to 6 yrs, that's technically easy. They should bring in selected high school grads. Give them a training in nursing and Japanese (an initial language crash course, the basics of med in their language, then teach subjects directly in Japanese from the second year). They will all be fluent in Japanese and trained. That should come with a requirement to work 6 years in a Japanese public hospital after graduation (otherwise repayment of education fees). And at graduation, permanent residency. That way, they can normally settle as adults, buy a house, get married, start a family and choose to stay over the 10 yrs.

in the Japanese language. This takes time and money.

Not so much if that's part of initial training of uni students living in Japan, while they do home stays or have Japanese room mates. And you have, among others, 500 000 Chinese teens learning Japanese second language and getting JPLT 2 or 1 at age 18. They are not nurses, but they could enter Japanese nursing schools nearly directly (what holds them back is the visa and tuition fees, not the language). The failure of current program, I would have predicted it since they chose nurses trained in their language, with no level in Japanese, and they told them to self-study at night while they work 60h/week.

Japan will be doing is training a work force that will go back

So far, most migrants given PR do stay, and some even bring in spouses that will work in Japan (maybe not as nurse, but other industries need staff). Many apply for Japanese citizenship, even if countries of origin like urban China and South-Korea are now economically on par with Japan.

to a better paying employer (Dubai/Qatar).

How many Japanese speaking nurses do they need there ?

study why more individuals don't want to be nurses.

Let's study why Japan has 1 teen for each 100 granpas waiting for the services of a nurse...To feel the need in medical professions, you'd need to convince 95% of the high schoolers to choose to work as nurse or carer. 5% left for all other jobs ?

Until Japan gets the elder-care robot perfected, its the only choice!

Prince CharmingMay. 02, 2014 - 07:04AM JST Until Japan gets the elder-care robot perfected, its the only choice!

I can amuse myself by saying, "Domo arigoto Mister Roboto", to my robot nurse.

I dont mean to be negative... but they don't need nurses as much as they do elderly carers.

In a large nursing home for the elderly, they usually only have one, or two, nurses on at all time. The help needed is not just in hospitals - its things like home helpers, and day service workers, and people to do the dirty work.

IMO, they need to get more Japanese people into the caring profession fullstop. They need to pay them decent wages. They need to make it a career option for those who want to do it. Otherwise I suspect the whole country will be in turmoil in about 30 years time.

Did you not pay attention to the statistics? There just aren't enough young people in Japan to meet the demand

So you are saying that there will actually be more nursing vacancies than young people? Wow! Everyone must become a nurse then.

Or do you mean that that there will be quite a lot of nursing vacancies relative to the number of young people? In that case it can be one of the most common jobs for young people, much as working in factory was 40 years ago, or working in a farm was 100 years ago. There are more than enough young people to train and fill the vacancies, they just need to be incentivised to do so.

Ah_soMay. 02, 2014 - 07:56PM JST So you are saying that there will actually be more nursing vacancies than young people? Wow! Everyone must become a nurse then. Or do you mean that that there will be quite a lot of nursing vacancies relative to the number of young people? In that case it can be one of the most common jobs for young people, much as working in factory was 40 years ago, or working in a farm was 100 years ago. There are more than enough young people to train and fill the vacancies, they just need to be incentivised to do so.

Well, if you're happy with a 90% tax rate that would probably be the outcome. Most nurses are paid from the national health insurance, so the number of positions is capped by the amount the national health can pay. More nurses means more tax, taken from a smaller working population as the number of non-working aged who need to be supported increases. Its already 23%, and is only rising.

Do you see the problem? And don't try getting more money from the elderly, they're on fixed income pensions, which are also taken from the working population's taxes... a system that is also likely to fall apart as the number of elderly non-working surpasses the working population. The pension system is pretty much broke now, and will collapse unless the country somehow gets more working age people.

Do you begin to see why immigration is the only solution? That or clones .. I'm completely behind clone troopers, that would be cool too. Either way the problem is not simply the lack of nursing/elderly care staff. The problem runs much deeper than that to the ratio of working vs non-working people and the economic impact of that ratio shifting radically.

.... but if we're going the clones route then I vote that they be female clones. Cloning a bunch of guys just seems like a waste and wouldn't do much in the long-term to alleviate the underlying problem.

Most nurses are paid from the national health insurance, so the number of positions is capped by the amount the national health can pay.

Actually, you probably meant to specify public hospital nurses, but just in case: nurses that work for public hospitals are considered civil servants and, as such, are paid with government money, ie: tax money. But, this is not true of nurses in private hospitals. Although private hospitals do also get some support from the government, they pay their nurse's salaries from their own funds as any organization would pay their employees.

In addition to offering the National Nursing Examination in other languages, it is time for Japanese hospitals to serious think about how to keep the nurses they've already got in hospitals from quitting. It is a little known, but very important fact that nurses are quitting their jobs in very large numbers in Japan. In 2012, the rate of nurses leaving the profession was about 10.9%. In the Kanto and Kansai areas, these numbers jumped to around 12 to 14%. Many of these people are quitting in their first year of nursing. Although some hospitals are attempting to make changes to lessen the work load and hours to stop this trend, this is a huge impact that has largely been ignored by the media.

There are many reasons why they are quitting in such large numbers. Ironically, it is because of the lack of nurses that nurses, especially young and new nurses, are under conditions that causes them to want to quit. Some include the fact that because of the shift system and because they are requirred to attend study sessions on their days off, they basically have no free time for themselves. There is also the matter of how new nurses are trained and treated. Most that quit complain of the stress of not being able to get along with or being treated badly by their head nurses.

So, adding nurses from foreign countries could also help to alleviate bad conditions that are causing so many Japanese nurses to quit, as well.

slumdogMay. 04, 2014 - 09:29AM JST

Most nurses are paid from the national health insurance, so the number of positions is capped by the amount the national health can pay.

Actually, you probably meant to specify public hospital nurses, but just in case: nurses that work for public hospitals are considered civil servants and, as such, are paid with government money, ie: tax money. But, this is not true of nurses in private hospitals. Although private hospitals do also get some support from the government, they pay their nurse's salaries from their own funds as any organization would pay their employees.

Actually, I included both public and private hospital nurses. The public hospital nurses are paid directly by the government, but private hospitals funds also come mostly from the government, specifically from health insurance payments. The money to pay both public and private nurses is coming from the same place, just directly for public nurses (government -> nurse) and indirectly for private nurses (government -> hospital -> nurse).

but private hospitals funds also come mostly from the government, specifically from health insurance payments.

No, you are mistaken. Private hospitals are private organizations and the pay for nurses is not paid by health insurance. It is paid by the employing private hospital. What you are trying to say is the equivalent of claiming that private school teachers are paid by the government because they receive some funding from the government. They receive financial assistance, but not nearly to the degree that you are alleging. with tax money and this is not the case. Public hospitals are fully funded by the government. Private hospitals are not.The money provided by the government to some (not all as you seem to be saying) private hospitals is not anything like the amounts provided to public hospitals. The difference is so great that it is not worthy of comparison. In fact, some private hospitals do not receive any money from the government and if business is bad, they go under. Private hospitals are not under the same obligations to limit how many nurses they hire as far as money received from the government is concerned by the very fact that they are private organizations. You were trying to make the point that there were limitations on how many nurses could be hired. With private hospitals, their own budgets decide how many nurses they can and will have, not the government. If they have the money, private hospitals can hire as much staff as they want and they do.

Prices at private and public hospitals are set by government. This means that for the same number of patients a public hospital and a private hospital are making exactly the same amount of money.

Japan has universal health care. This means that everyone who comes in is covered by national health insurance and that the government is paying 70% or more of the bill. For the elderly the government pays 80% or more of the bill. For those with major procedures that exceed the cap the government pays more than 70% as well.

Private hospitals are legally required to be NPOs (not for profit organisations), and must be run by doctors. They are forbidden from owning or operating any profit-generating organisations. While some private hospitals may have linked schools these schools are also NPOs. Outside sources of funding may provide a temporary boost, such as to buy an MRI machine, but are generally one-off donations, and couldn't be used to pay staff reliably for years on end.

Private hospitals are surrounded by a mass of legislation, ethical codes of conduct, standard of care guidelines, and other rules that mean that they have very little room for discretion in their expenditure.

Nurses alone are very limited in what they're legally allowed to do. Hiring a mass of nurses would result in most of them standing around waiting for instructions from a doctor.

When you add up all these factors this means that in Japan public and private hospitals are very nearly identical in terms of staffing and standard of care. This was the intention. There may be the odd exception, such as very famous private hospitals which attract the very wealthy and very powerful, but on the whole the system aims to make most hospitals in Japan pretty much equal.

One of the ways it does this is by ensuring that Private hospitals receive 70%+ of their revenue from government sources. Which means that staff are indirectly 70%+ subsidised by the government. A hospital that decides to breach the staffing norms of 4 to 6 nurses per doctor, would be subject to inspection and questioning, and would be "encouraged" to return to the norm. When the people encouraging you are paying you 70%+ of your revenue only an idiot wouldn't listen carefully.

Therefore, a private hospital cannot just hire as many nurses as they like for multiple reasons. Because it would be bad business sense (the nurses can't do much without doctors), because of budgetary constraints (same fees for procedures = roughly same staffing levels), because the hospitals are run by doctors who have to make difficult decisions on whether to buy a new MRI machine or hire two new nurses, because of legal and ethical limitations of how hospitals can spend their money, because ... because ... because ...

Anyone who has ever sat in a hospital budget meeting (and managed to stay awake) would know all of this.

3.Private hospitals are legally required to be NPOs (not for profit organisations), and must be run by doctors. While some private hospitals may have linked schools these schools are also NPOs. Outside sources of funding may provide a temporary boost, such as to buy an MRI machine, but are generally one-off donations, and couldn't be used to pay staff reliably for years on end.

You are mistaken in what you think NPO means. It does not mean the organization does not intend to make a profit. It merely means that any profits made must go back into the organization in some way, be it buying new equipment, hiring staff or other things. While public hospitals are not aiming for profit, private hospitals are indeed profit driven. It is just what is required to be done with any profits that makes an NPO different.

5.Nurses alone are very limited in what they're legally allowed to do.

Actually, the work that nurses are allowed to do in Japan generally exceeds that of what they are allowed to do in many other developed countries. In addition, the general shortage of doctors also requires patients to be seen and check by nurses rather than doctors on a greater frequency than that of many other developed countries.

Private hospitals pay much, lowers salaries to their doctors, pharmacists, nurses, etc. So, they can afford to hire more doctors, pharmacists, nurses, etc, as needed and do. The difference in salaries for nurses in public and private hospitals is approximately between 1,000,000 to 1,500.000 yen. The difference in the salary for an internist is approximately 5,000.000 to 10,000,000 yen.

Lastly, your premise that the reason why there are fewer nurses is because there is no money to pay them is incorrect in my opinon based on the fact that there are work listings all over Japan looking for nurses at both public and private hospitals. The hospitals want more nurses and are actively searching them out. There are just not enough people willing to do the work to fill the positions. That is why Japan is now considering bringing in foreign nurses.

I am a portuguese nurse working in the UK, not by choice but as a necessity. I came here to earn enough money that enables me to go and work as a nurse in Japan as this is my dream. Unfortunatly that seems like a unreachable goal since Japan has really strict regulamentations for foreigners to work and live long term in Japan. Japanese don't want emmigrants living and working in Japan. In their minds, single people can eventualy marry japanese people and therefore "corrupt" their descendency...there would be more mixed children and less "pure" japanese kids, no mather how much they need children in their country for the continuity of the growing economy, japanese governemnt still has ideals of racial purity from WWII in my oppinion, and this ideals are supported by older generations which make the most part of Japan's population.