Tuesday, June 10, 2008

Nursing Crisis

Asahi Shimbun notes that there is a real, serious and increasing nursing care - home care and daily life assistance especially - staff shortage in Japan, one with potentially disastrous consequences as the aged population in need of care increases, and the pool of potential staff decreases along with the number of young people. In order to swiftly and decisively rectify this situation, the current government has just enacted its solution into law.

The solution? To "take necessary measures" by April next year. The actual measures deemed necessary are left undefined. I'd love to have a job where this kind of declaration can be passed off as having done actual work. Perhaps I should adopt the same work mode: instead of doing actual research, analyze the results and spend months getting a paper into shape and published, I'll just occasionally send out a declaration that a paper with "appropriate scientific content" should be published sometime in the future. I think I'll use the freed-up time to learn golf perhaps, or crochet.

But I digress - why is there a shortage of workers? As Asahi Shimbun points out, the nursing schools aren't even close to filling their quotas of students and 20% leave the profession every year. As it turns out, pay has a lot to do with it. The average - not starting - salary is 200000 yen per month; a Swedish junior nurse has an average of 320000 yen (11000 and 18000 crowns respectively). You work long hours (lots of unpaid "service overtime"), nights and weekends, with up to 16-hour shifts. Oh, and you need a license to practice, so you need a year or two at a vocational school minimum, which you (or your parents) have to pay tuition and living expenses for.

How bad is this? If I were to shift careers from research into something more hands-on, would this be a choice worth investigating, or would I be better off economically with - let's say - the fast-paced glamour of convenience-store clerking or chain restaurant management? Let's see!

Just yesterday a local branch of the Yoshinoya chain was looking for temporary workers; the hourly rate was 900-1100 yen depending on experience, rising to 1100-1300 yen an hour for night shift work. Convenience stores have similar rates. Let's assume 50 hours a week of work for the nurse; with a nominal 40 hour workweek and unpaid overtime this sounds approximately right. With 200000 yen a month that comes out to just about 1000 yen an hour; pretty much exactly what I'd make as a convenience store clerk with some experience and occasional night-shift and weekend duties. But of course, there's differences too:

The nursing care worker has professional responsibility for elderly and ill people, and can get into very big trouble if she (I'd write "he or she" but who would we be kidding?) mixes up medications or fails to recognize early signs of acute distress. The convenience store clerk, on the other hand, has professional responsibility for little more than the till and the sale time limits on the onigiri and reheated sausages. The nursing care worker is licensed and has spent a fair bit of money on the studies needed for their profession. The convenience store clerk and the restaurant worker, well, hasn't.

But of course, the clerk is facing limited-time contract jobs with low pay and few prospects of advancement. Which, it turns out, is usually the case for the nursing care worker as well, with a majority not being regular employees, but working under the same kind of dead-end temp contracts as the clerk.

I'm not surprised 20% leave the nursing profession every year in Japan; I'm surprised the number isn't much higher.

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