Hospitals and the nursing profession : Lessons from franco-japanese comparisons

Book excerpt: Hospital systems throughout the developed world are undergoing waves of reform which seek to address multiple challenges of intensifying acuity, such as population ageing, technological advance, heightened expectations on the part of increasingly informed patients, the reduction of public spending deficits and the specialisation of staff, especially nurses, as well as the difficulty in establishing appropriate incentives for change and improved performance. Within such a context, the purpose of this book is to analyse the interaction between the nursing professions and hospital institutions in France and Japan, taking as its starting point the conviction that comparative analysis of empirical reality in each of these countries will provide new insights into the transformations currently taking place. To that end, the material in this study has been contributed by an international, interdisciplinary team of experts, combining economic, sociological, political and historical perspectives, which are brought to bear upon evidence from original research carried out in both countries. The findings reveal that the relationship between the nursing profession and hospital structures in Japan is characterised by the predominance of a domestic logic, rooted in dependence upon the institution and the promotion of supposedly "feminine" qualities, in sharp contrast with the French situation, where industrial and professional logics prevail, entailing specialisation, independent initiative and increasing workloads. From this perspective, the future development of the nursing profession in Japan is inextricably linked to the forms taken by the process of women's emancipation, whereas in France, it is the evolution of hospital structures, of the position of nurses in the healthcare system and of the division of labour within the world of medicine which emerge as the determining factors. In order to highlight French and Japanese particularities for the Anglophone reader, the book also features numerous socio-historical points of comparison with developments in the United Kingdom.