What Is the Current State of Labor Shortages in the Nursing Care Industry? Issues and Solutions

What solutions can be considered for this declining birthrate and aging population problem? The government is examining various approaches, one of which is hiring international talent. In 2019, to address deepening labor shortages, the status of residence “Specified Skilled Worker” was newly established as a system to accept foreign nationals who have a certain level of expertise and skills and can contribute immediately. Under this system, foreign nationals who have already demonstrated sufficient skills and Japanese-language ability through examinations in 14 fields, including nursing care, may stay in Japan for up to five years in total. Creation of this system has made it possible to accept nursing care personnel from overseas and address labor shortages.

Reference: What Is the Status of Residence “Specified Skilled Worker”? | JITCO – Japan International Trainee & Skilled Worker Cooperation Organization

Difficulty Hiring

The second cause is that, as the active job openings-to-applicants ratio shows, there are fewer than one-third as many job seekers as openings, so employers compete with peers for that limited pool of candidates, making hiring difficult. In fact, in the “FY2020 Nursing Care Labor Actual Conditions Survey Results” conducted by the Care Work Foundation, 86.6% of establishments cited “difficulty hiring” as a reason for labor shortages—a very high share. Taking difficulty hiring as a given, one solution at the care site is to actively advance IT in operations, thereby shortening working hours and reducing burdens.

High Turnover

Third, even when personnel can be hired, many leave for various reasons and do not stay. In the Ministry of Health, Labour and Welfare’s 2020 Survey on Employment Trends, the average turnover rate across all industries was 14.2%, while the rate in social insurance, social welfare, and nursing care services was 14.7%. In a survey focused on nursing care businesses, the aforementioned FY2020 Nursing Care Labor Actual Conditions Survey Results reported 14.9%. In any case, turnover in nursing care is somewhat higher than in other industries.

Nursing care work often involves small teams spending long hours engaging with users’ bodies and minds, making it prone to stress. Compensation that matches the demands is also often hard to obtain. The primary solution is improving working conditions. The government, in the above “Required Number of Nursing Care Staff Based on the 8th Long-Term Care Insurance Business Plan,” also lists the following items as measures to prevent turnover.

Source: Created by adapting Ministry of Health, Labour and Welfare, Social Welfare and War Victims’ Relief Bureau, “Required Number of Nursing Care Staff Based on the 8th Long-Term Care Insurance Business Plan” (https://www.mhlw.go.jp/content/12004000/000804131.pdf)

Negative Image of the Nursing Care Industry

Fourth—and a root cause that also affects the high active job openings-to-applicants ratio and turnover noted above—is the strong negative image of nursing care work.

Source: Cabinet Office Regulatory Reform Promotion Council, Medical Care, Nursing Care, and Infectious Disease Countermeasures Working Group, 6th Meeting materials

The figure above is quite striking, but it was submitted by an industry association itself and can be said to reflect actual conditions. Overturning this image quickly is difficult, but improvements are being advanced through initiatives such as the following.

Introduction of Unit Care

Unit care is a nursing care approach in which users live together in groups of about ten. In a home-like environment, with staff also sharing daily life, care that respects each person’s individuality and daily rhythm becomes possible. Living in such an environment also reduces users’ stress and can help suppress harassment incidents.

Improving Pay and Working Conditions

The nursing care industry has a strong image of low pay relative to heavy labor, and in many cases that is true. Raising pay first is therefore effective for increasing applicants and lowering turnover. As a countermeasure, the government has allocated an annual budget of 200 billion yen to promote wage increases for nursing care personnel.

SNS-Centered Outreach to Improve Image

To prevent only third-party negative images from spreading, the nursing care industry itself is increasingly communicating via SNS and other channels about the rewards of the work and initiatives to raise productivity.

Case Examples of Initiatives to Ease Labor Shortages

So far we have described the current state and causes of labor shortages in the nursing care industry, along with various countermeasures. Here we summarize again which initiatives are effective.

Accepting International Talent

As noted above, creation of the Specified Skilled Worker system has expanded acceptance of international talent in the nursing care industry. Overseas as well, education programs that teach Japanese and nursing care skills with a view to working in Japan are offered, and as of December 2021, 5,155 people were already residing in Japan as Specified Skilled Worker (i) foreign nationals in nursing care (source: Immigration Services Agency of Japan, “Publication of the Number of Foreign Nationals Residing under Specified Skilled Worker Status”). Actively accepting Specified Skilled Worker talent can help address labor shortages driven by the declining birthrate and aging population.

Introducing Monitoring Sensors

Actively introducing IT into operations can also raise productivity and ease of work. In nursing care facilities, sensors that detect the movements of users lying in bed are being installed to prevent accidents before they occur. The government is also running various subsidy programs under keywords such as promoting ICT use in nursing care settings and nursing care DX. Using sensors and other IT in nursing care work can reduce waste and increase time spent engaging with users.

Source: Ministry of Health, Labour and Welfare, “Promoting ICT Use in Nursing Care Settings”

Introducing Operations Management Systems

Nursing care is a 24-hour, 365-day service involving staff in many roles—full-time employees, part-timers, and temporary workers. Managing labor affairs and sharing user information in one place with IT systems can improve efficiency and reduce errors. Costs for copy paper, writing supplies, and the like can also be cut. When multiple staff members record and share information about users, explanations to families become richer, raising satisfaction on the user side as well.

Source: Ministry of Health, Labour and Welfare, “Promoting ICT Use in Nursing Care Settings”

Consult YourBright on Hiring Specified Skilled Worker Talent

This article introduced the reality of labor shortages in the nursing care industry and initiatives to address them. Among these, hiring Specified Skilled Worker foreign nationals is especially promising. By welcoming young talent with specialized nursing care skills and a certain level of Japanese-language ability, organizations can enrich services and ease staffing shortfalls.

At YourBright, we provide a wide range of services—from consultation on hiring Specified Skilled Worker talent, through actual hiring, to post-hire support. Please contact us first by phone or via the form on our website.