Questions from Japan for Nurses in the United States

SmilingBluEyes · Nov 5, 2004

Hello, from the USA.

I am not a hospice nurse, but I will make an attempt to help you here:

In the USA, most nurses no longer wear caps on duty, except at ceremonies when they have graduated. They are considered more of an infection control problem than an asset by many. There are some who do, but they are few and far between nowadays.

Families are encouraged and welcomed to participate in the terminal care process...they are included in care planning and helping nurses work to respect the wishes of the dying person. They (loved ones) are the people, after all, the dying person is most attached to, so it would be logical to consult with family and loved ones on how best to care for this person. At times, people who are terminally may remain at home when dying, and the family is often VERY involved in end-of-life care this way. Most hospice nurses are wonderful resources to family and friends of loved ones who are terminally-ill and they work VERY closely with them, in the best interests of their clients.

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Most nurses at the hospitals work 8 or 12 hour shifts, some as much as 16 hours. In clinics and out-patient surgery centers, they may work 8-10 hours average per day. This can vary dependent upon hours of the clinic, as well as whether a nurse works full or part time. Nursing, as you know, is a very diverse occupation and nurses work many places, not just clinics or hospitals. They can be found working in industry, schools and in churches (parish nursing). So, you can expect their hours will vary accordingly.

Men are very much outnumbered by women in nursing, but the numbers of men joining our ranks are rising each year. I am sorry; I don't have immediate access to statistics, but will look and see if I can find anything reliable to quote for you.

Hope this helps, and welcome to Allnurses.com!!!!

suzanne4, RN · Nov 6, 2004

One of the major differences in nursing in the US, vs. Japan or any of the other asian countries is that un the US, the nurses are responsilbe for doing an assessment on their patients at least every 8 hours. This will vary with the type of unit, may me as often as every hour. In Asia, it is the physician's responsibility for the assessment.

I have been teaching over in Bangkok, and this is probably the most different thing from anything else.

Another thing that comes to mind, in the US, the nurse is considered part of the healthcare team for the patient, and their input is valued. In many of the other countries, the physicians rule and little, if any, input comes from the nurses.

Hope that this helps...................... :balloons:

Antikigirl, ASN, RN · Nov 7, 2004

1. In the US do nurses wear nurse caps? I wouldn't at all...and have never seen any unless it was a personal choice..which I have only seen once! My facility almost had us wearing them as part of the uniform and got such a complaint from us nurses they dropped the idea fast...we even made up mock 2 week notices!!!!

2. Do the families participate in the terminal care process? If so, what do they do? You get a very wide range, most I see are involved either too much (making things difficult for medics by demanding too much, or doing things and not telling the medical staff) or not at all unless the patient is close to death then they overdo it out of guilt. I work with geriatrics on hospice...so others experience may differ. I find few that are involved and communicate well with the staff and really have the patients best interests in mind..but when they are there..they are wonderful! Good communication initially with family helps...and seems to make the whole experience better for all. Continuity also is helpful in establishing good working communication and teamwork!

3. Are all "Hospices" oriented towards terminal care? In my state hospice patients must fall into a criteria, all being terminal. 6 months to live is about norm for entry to hospice, but can be extended if they can say within a reasonable time period that person will die. I have had several patients get onto hospice care, make it past 6 or so months, and hospice services were terminated. We have a shortage of hospice in our area, very hard to get people onto the program so they have to be very exact about whom they will serve.

4. How long do nurses work a day? Hospice services themselves vary, and I am uncertain of the norm. I call and get a different person more times than not...

5. Are there more men nurses or women nurses in the US (any statistics would be very helpful)? I would say not as many male nurses but don't have the numbers for you. I rarely see them in my area (assisted living), and only met a few while I worked in hospital. We had 6 in my graduating class and they said that was a record (graduated 2000).

Something that may be interesting to discuss also is the area of personal space between patients and your nurses! I have worked with several nurses from Japan (most working as CNA's till their RN is okay to work in the States), and I find they are most uncomfortable with the physical closeness of Americans in regards to nurse/patient care. They had difficulty with the closeness of transfers, and how close a patient wants a nurse by them (as in almost touching with some!) and eye contact big time! They brought that up to me as a very big difference, and I found that to be very interesting! Maybe that would be a good thing to discuss as well. Hospice nurses here do lots of hands on, holding hands, being very close (physically) to their patients...a good thing to know if nurses wish to work with Americans or in the US.

Also Americans are a bit more open in communications about bodily functions I hear...another area my Japanese friends told me! They found it difficult to respond to a patient when the patient is all loud about their BM patterns like it was talking about the weather or something! LOL! A friend of mine, Noriko told me "in Japan we don't consider bodily functions a real topic of dinner conversation, here it is no problem! Very hard to adjust to that without having a ill look on my face!". I thought that was really interesting...something I just didn't think about!

Good luck with your discussion! If I can be of any help feel free to ask...I would be very happy to! :)

(I am just starting to take Japanese language...I am very slow to learn it, but I keep trying! Both my children are taking it and way beyond me in two weeks already! LOL!)

cab631 · Nov 7, 2004

I agree with most everything said here. It seems that the men who come into the nursing profession gravitate towards the more technical areas such as critical care, cardiac cath, OR, ER. Nursing shifts are long, even on an 8 hour shift, it is usually 9-10 hours before you leave, by the time you finish with report and paperwork. I find that other cultures I have worked around (Vietnamese, Native Americans, East Europeans) all look at nurses differently, but a common thread seems to be that a nurse is there to perform certain duties and not interact with the patient on a personal level the way we tend to do in the American culture. In the American culture we like to touch, caress a child perhaps or hold a hand. I like to give back rubs and to tend a patient's more "personal" needs when they are too ill to do it themselves and are uncomfortable having family do it for them. It makes me feel needed on a level that even family can't attain. I would be interested in knowing how different this is from nursing in Japan.