Foreign Nurses & Japan’s Immigration Policy

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    Japan has an ever-worsening shortage of nurses on its hands, and a new article in the Washington Post states that strict Japanese rules regarding the immigration of foreign nurses “may threaten Japan’s future.” The article focuses on the difficulties facing Filipino nurses who have come to Japan under a bilateral economic agreement:

    But the economic partnership program that brought Paulino and hundreds of other nurses and caretakers to Japan has a flaw. Indonesian and Filipino workers who come to care for a vast and growing elderly population cannot stay for good without passing a certification test. And that test’s reliance on high-level Japanese — whose characters these nurses cram to memorize — has turned the test into a de facto language exam.

    Ninety percent of Japanese nurses pass the test. This year, three of 254 immigrants passed it. The year before, none of 82 passed.

    For immigrant advocates, a pass-or-go-home test with a success rate of less than 1 percent creates a wide target for criticism — especially at a time when Japan’s demographics are increasing the need for skilled foreign labor.

    For many officials in the government and the medical industry, however, difficulties with the program point to a larger dilemma confronting a country whose complex language and resistance to foreigners make it particularly tough to penetrate.

    There has been talk of easing the exams for the foreign nurses, possibly by simplifying the Japanese used in test questions or changing the examination language to English. Those may seem like obvious solutions, but they leave in place several problems:

    • Nurses will still have to talk with Japanese doctors and nurses using the Japanese language, and knowledge of medical terminology is probably useful.
    • Nurses who are illiterate in Japanese might not be able to understand written instructions for medical equipment or medicine. They might not even be able to read medicine labels. As the Washington Post article notes, they also cannot record information on Japanese forms.
    • They will have to use Japanese to communicate with patients. Many of the patients will be elderly, and in areas outside of Tokyo they will likely speak non-standard dialects of Japanese that are not found in Japanese language textbooks.

    Even if the tests are made easier and some of the nurses pass and are allowed to remain in Japan, the language barrier will be a problem. As long as communication problems persist, the foreign nurses will likely be treated as second-class nurses who are not given the same tasks and responsibilities as nurses with native Japanese ability. Some of the immigrant nurses have years of experience back in their countries of origin, and such a situation would probably make them feel like their talents were being wasted. Changing the nurse exam system might help more nurses pass the test and get permission to stay in Japan, but the language barrier will make it hard for them to receive the treatment they are probably expecting.

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