Guiding hand for Indonesian nurses

Program helps hospital ease assimilation for newcomers

by Mariko Kato

Cultural barriers faced by Indonesian nurses who come to this country to work are gradually being lowered, but the government has yet to help the Japanese hospital staff adapt, according to Keio University professors who recently launched an in-house training program to teach the employees how best to welcome the new additions.

Staff at Saiseikai Yokohamashi Tobu Hospital in Kanagawa Prefecture received training earlier this month from Naomi Sugimoto, a professor of communications studies in Keio’s faculty of nursing and medical care, prior to the arrival of two Indonesian nurses last week.

“The government runs training courses for the Indonesian nurses, but I saw that there was no training for the Japanese staff who are taking them in,” Sugimoto said. “The fact that hospitals are accepting foreign employees for the first time means that their staff have never worked with foreigners, so they are very nervous.”

In talking to hospital staff ranging from the medical to administration departments, Sugimoto referred to the experiences of hospitals and care homes that accepted the first group of Indonesians last year under the free-trade agreement between the two countries.

“I told them that (the Indonesian nurses) do not necessarily get used to Japan easily, and they are at a turning point in life like marriage or a career change,” she said.

Sugimoto advised the Japanese staff to actively help the Indonesians, many of whom are Muslim, to adapt to the work environment.

“In certain hospitals they take pork off the cafeteria menus, but it would be more empowering to help them acquire the skill to ask whether there is pork in a dish,” she said.

Another key issue is the Indonesians’ pride, according to Sugimoto. They were elite professionals in their own country, so they will likely be frustrated as they can only work as assistants in Japan until they pass the tough national exams, she explained.

Indonesian nurses must pass the national exams in Japanese within three years or they will be sent back home. None of the first batch who came to Japan last year has passed the exam so far.

“We shouldn’t treat them like children because they don’t speak the language. They can still talk about complex matters using simple language,” she said.

The training program uses research funds from Keio.

A total of 173 Indonesian nurses were accepted this fiscal year, according to the Japan International Corporation of Welfare Services, the semigovernmental organization overseeing the nursing program. Last year the number was 104. As many as 200 are expected next year.

Kiichi Inagaki of the project support division at the welfare services corporation said a hotline has been set up for Japanese hospital staff who want to discuss concerns related to the Indonesian employees. The organization does not visit individual hospitals, but hospital executives were invited to discuss the assimilation process at a facility in Hakone, Kanagawa Prefecture, where the Indonesians were trained in Japanese and nursing after their arrival in November.

Miho Suzuki, head of the skill training center of the general education division at Tobu Hospital and who set up the program with Keio’s Sugimoto, said the staff felt relieved after the training.

“We were lucky to be able to link up with a university. At facilities that accepted Indonesians last year, I saw that there had been no preparations made for the Japanese side” in terms of cultural awareness and adaptation, she said.

Meanwhile, Keio professors set up another project for the Indonesian nurses to become acquainted with Japanese students at the university whose classes include Indonesian, so they will have an informal network outside the hospital.

The first meeting between five students and Jeriana Pardede, 32, and Indah Agustina, 29, took place in the hospital on Jan. 22, just before the nurses were due to start work after a week of orientation.

The group chatted in Indonesian during the lively two-hour session, prompted by Japanese snacks and pop-up cards of ornamental dolls celebrating the Doll Festival in March.

“I was really happy. It’s been a while since we spoke Indonesian to anyone else,” Pardede said after the event. “I feel reassured that they can explain things to me when I don’t understand something.”

Pardede, the sixth of nine children in her family, said she came to Japan to learn about Japanese hospitals, which are renowned for using advanced techniques.

“I’m looking forward to visiting places and learning more about Japan,” said Agustina, who came to Japan for similar reasons. She has a husband and two sons, aged 5 and 1, back home.

The nurses agreed that getting used to Japanese culture was difficult. For example, Indonesians touch each other lightly when they talk, and chat with their bodies close together, unlike the Japanese, they said.

Aoba Niki, 20, one of the students who took part in the get-together, said she was surprised by the steep learning curve the nurses face.

“It seemed to be a much graver situation than I thought,” she said.

Student Shogo Tokami, 20, said he hoped the meeting leads to parties and outings.

“We were able to get to know each other just as friends. I hope to bring them to the university campus, and perhaps have a tempura party,” he said.

He added that he was glad to use his Indonesian, which he wanted to learn because he eventually wants to work in trade and feels Southeast Asia will be a key region.

Toru Nomura, a professor of policy management at Keio’s Graduate School of Media and Governance and head of the university’s Indonesian program, also talked to the nurses in their mother tongue about their concerns.

During a two-hour discussion, the nurses appeared most anxious about the money they could send to their families, according to Nomura.

“They asked specifics about the costs of insurance, tax, heating and lighting, and food, and how much would be left over from their salaries to send home,” he said.

Nomura estimated that the nurses would be able to send about ¥50,000 a month, although with costs of settling in it would initially be about ¥20,000 to ¥30,000. This would be worth somewhere between ¥100,000 and ¥200,000 when adjusted for Indonesia’s cost of living, he said.

“I also told them about what happens if they are late or absent, but since they’ve been working as nurses for over 10 years, they already know these things as common sense,” he said.

Communication problems between the Japanese and Indonesians in part are due to a cultural hesitancy to clarify matters of pay and penalties, according to Nomura.

“Both sides need to make one step toward each other,” he said.

The program’s organizers will continue to be in touch with the hospital staff to help them make the Indonesians feel welcome and hope to visit other hospitals that have Indonesian nurses, according to Sugimoto.

Despite some concerns, the Indonesians will be an asset to the workforce, the hospital’s Suzuki predicts.

“There may be differences in medical safety and hygiene, and I’m concerned about how the patients might react,” she said. “But I’ve heard that the Indonesians who arrived last year have a high reputation for being kind to the elderly, so I have great expectations.”