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In , the Japanese Red Cross JRC was founded [3] and by had begun teaching and recruiting nurses for training.

Nursing was not an established part of Japan 's health care system until with the adoption of the Midwives Ordinance.

The Registered Nurse Ordinance was passed in which established a legal substantiation to registered nurses all over Japan. Up to that time, job training was the only requirement and there was no prerequisite for a high school education to enter training at most hospitals.

In , St. Luke's International Hospital became the first college of nursing in the country and based its training program on the one offered at Yale University in New Haven, Connecticut.

It established educational requirements, standards and licensure. There has been a continued effort to improve nursing in Japan. In the first university courses on nursing were introduced, requirements for assistant nurses were introduced, in regulations were passed for nurses working night-shifts, and throughout the s several legislative acts expanded training and employment protections for nurses.

Public health nursing is designed to help the public and is also driven by the public's needs. The goals of public health nurses are to monitor the spread of disease, keep vigilant watch for environmental hazards, educate the community on how to care for and treat themselves, and train for community disasters.

Midwife nurses are independent of any organization. A midwife takes care of a pregnant woman during labor and postpartum. They assist the mother with breastfeeding, caring for the child, and related tasks.

Individuals who are assistant nurses follow orders from a registered nurse. They report back to the licensed nurse about a patient's condition.

Assistant nurses are always supervised by a dentist, licensed registered nurse or physician. Requirements of nursing education in Japan are that candidates have completed twelve years of basic academic study and then three years of basic nursing education.

Public health nurses and midwives require a minimum of one additional year of specialized study. After completing their studies, students must pass the national licensing examination and obtain a license from the Minister of Health, Labour, and Welfare in the case of nurses, or from the prefectural governor, for nurse assistants.

Foreign nurses who wish to work in Japan are required to pass the licensing examination and obtain a Japanese nursing license.

To become a registered nurse in Japan, candidates must first obtain a high school degree and then either enroll in a nursing university for four years and earn a Bachelor of Science in Nursing BSN ; attend a junior nursing college for three years, earning an Associate of Science in Nursing ASN ; or study at a nursing training school for three years and obtain a diploma.

Both theoretical study and clinical practice are required. Upon completion of studies a national examination administered by the Division of Nursing of the Ministry of Health, Labour, and Welfare is required.

Licenses are issued for the nurse's lifetime and require no renewal [15] or continuing education. Colleges, junior colleges, nurse training schools or universities offer courses for the additional training which must be for a minimum of one year.

Additionally master's degrees are offered at some universities. The certification of nurse specialists is not legally specified in Japan, though the practice is widely accepted.

Certifications must be renewed every five years. Certified Nurses CN are required to take six months training in cancer and chemotherapy nursing , emergency care , hospice care , intensive care nursing , wound, ostomy, and continence nursing , and pain management nursing , [15] after completion of their basic nursing licensing.

As of July , nearly 16, CNs were working in Japan in various specialties including cancer care, chronic care , dementia nursing, diabetes nursing, dialysis nursing, emergency care, heart care, infection control, infertility nursing, neonatal care, rehabilitative care, respiratory care, and other specialized fields.

Other professional groups also provide certification for clinical specialties such as community health, diabetes, disaster nursing, emergency nursing, intractable illness, nursing administration, and psychiatric nursing.

These organizations predominantly emerged in the s. They include the Japan Visiting Nursing Foundation , which was founded in to create and improve home care services for the elderly; the Japanese Family Nursing Society , which emerged in to focus on the education, practices and development of theory for family nurse practitioners; the Japanese Nursing Diagnosis Association and the Japan Society of Nursing Diagnosis focus on nursing diagnosis.

Until , [19] nurses in Japan were required to work under the guidance of physicians. They were not allowed to diagnose conditions or prescribe medications without a doctor's directive.

Socio-cultural custom giving doctors higher perceived social status and nurses the role of caretaker, led to nurses' lack of autonomy.

The training curricula requires completion of study hours of common subjects and 15 to 72 study hours of subjects for specified categories of medicine.

Participants must attend both lectures and participate in practical applications. Upon completion of the coursework, applicants must receive a certificate of completion.

They may then perform specific medical interventions based upon those described in procedure manuals prepared by physicians. There is currently a shortage of nurses in Japan, in part due to the expanding population of elderly.

Other reasons for the deficit in nursing applicants are poor working conditions, an increase in assigned workloads, the low social status of nurses, and the cultural idea that married women quit their jobs for family responsibilities.

The majority of nurses were female with only around three percent of the field being male. These Centers provide placement, job training and recertification, if desired.

They monitor nurses who are unemployed and support those who may wish to re-enter the work force. Government programs to improve working environments have been on-going since One of the older unions that relates to nursing is the Japanese Federation of Medical Workers Union, which was created in It is a union that includes physicians as well as nurses.

This organization was involved with the creation of the Nursing Human Resource Law.

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