Oncology Nursing in Japan
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Oncology nursing: A tale of two cultures
Marcia Limoges shares ideas for changing the culture of oncology nursing in Japan
A series of connections through Portland Community College and the Oncology Nursing Society (ONS) led to an invitation for Marcia Limoges, RN, OCN, BSN to spend a week with nursing faculty in Japan. "Hiroko Iwata, director of the nursing school, School of Medical Sciences at the University of Fukui, had been researching the state of advanced-practice oncology nursing in Japan. She received a grant from the Japanese Ministry of Health to bring guest speakers to give presentations about oncology nursing practices in other countries. I was asked to apply, sent my resume, and was invited to come."
As an oncology nurse in PeaceHealth Southwest's Regional Cancer Center for more than 20 years, Limoges has hands-on experience with changes in the profession. "There are only 104 Oncology Certified Nurse Specialists in Japan, with an aging population of millions. Institutionally, nursing lags behind practices in the US by about 30 years." She noted that cancer care in Japan was just as advanced medically, but several differences struck her, including:
- Hiring practices for nurses: "Japanese nurses don't have regular shifts — they might have a day schedule followed by night hours, so job satisfaction and retention are low and turnover is high. This makes it difficult for the profession to advance."
- Length of stay for cancer patients: "Japanese patients are accustomed to hospital care with stays of weeks to months, rather than having shorter outpatient services. This is really impractical when dealing with a shortage of nursing resources."
- End-of-life care: "Advanced directives, as a patient right, and the concepts involved in hospice care seemed somewhat novel in my meetings with hospital-based nurses. I was told that many elderly patients were still being protected from knowledge of a cancer diagnosis by family members."
As guest speaker, Limoges was in a unique position to describe PeaceHealth Southwest's 150-year history as well as our cancer care today. "The Japanese nurses were delighted by photos of our Firstenburg Tower with its beautiful architecture and private rooms. The Red Cross hospital we toured often had 2-4 beds per room, and infusion pumps for IVs were rare. They were impressed by the generosity of our community donors for the Tower, the Holtzman Twins Special Care Nursery in the Family Birth Center, and the Ray Hickey Hospice House. They were also impressed by the fact that we have hundreds of volunteers."
In addition to the week absorbing the Japanese nursing culture, Limoges also immersed herself in the beautifully presented foods, urban and ocean scenery, and historical sites. She renewed old friendships in Kyoto and forged new bonds of professional friendship.
What's next? Limoges says the experience in a teaching hospital is making her think again about getting a master's degree. "They have such a passion for education; it really inspired me." As a result of Limoges' visit, two professors from the University of Fukui nursing school will visit PeaceHealth Southwest's Regional Cancer Center and Ray Hickey Hospice House on March 20, 2009.
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| Fukui is located near the Sea of Japan. |
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| Marcia Limoges (standing, 3rd from right) notes that nurses wear traditional white caps, but cancer care in Japan is just as advanced as ours is medically. |
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| As an oncology nurse for more than 20 years, Marcia Limoges used her hands-on experience to describe changes in the profession to the University of Fukui nursing school's research team. |
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| Evergreen trees are tied to keep them straight and help prevent snowfall from breaking branches. |
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| In addition to Japanese nursing culture, Limoge also immersed herself in beautifully presented foods, urban and ocean scenery, and historical sites. |
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| Surrounded by the research team, Marcia Limoges (2nd from left) sits next to Hiroko Iwata, director of the nursing school. Iwata's research grant led to Limoges' invitation as a guest speaker at the University of Fukui. |
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