Julia Meno is a first year BSN student. During winter quarter in 2020, she traveled to Japan as part of the Keio University Short-Term Nursing and Medical Care Studies Program to learn about challenges of an aging society. UW students attending the program were supported by the Center for Global Health Nursing and the de Tornyay Center for Healthy Aging.
All interviews have been edited for length and clarity.
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Why did you choose nursing?
Many people say it’s because they want to take care of others, and that’s definitely true for me too. But I was really inspired to become a nurse because of the health inequities in Guam, which my family has directly experienced. I’ve always wanted to go into healthcare to try to mitigate those barriers and be part of a system where I can have an impact.
How has your experience at nursing helped you with your career trajectory?
There are so many networking opportunities! I feel humble to be in this program because I’m learning so much from my peers. It’s exciting because everyone’s not coming in with the exact same background, so we constantly collaborate with one another and with the faculty, too. The faculty are so supportive of us, and very approachable, which has been helpful because the program can feel very stressful and intimidating.
What’s been an unforgettable experience during your time at the school of nursing?
The Keio University Short-Term Nursing and Medical Care Studies Program.
What interested you about the Keio University program?
The exchange program sounded really awesome because I was interested in learned about Japan’s “super-aging society”. I did a Japanese language immersion program in Seattle from kindergarten through eighth grade, but I’ve lost touch with my language skills. And there’s a lot of cultural similarities that Japan has to Guam, where my dad is from. I thought this would be a great opportunity to hone into these parts of my identity again while learning about a global health concern.
What interests you about healthy aging?
I have experience at an assisted living facility in Los Angeles, and the population that we were serving was affluent and white. I was forced to think about how other people are getting care at this age. I also think about my family in Guam, where there aren’t very many resources for the elderly population because most people take care of their elderly from home. But it’s important to have those resources, and I’ve always had that in the back of my mind. So I was excited learn more about healthy aging in this program and see how Japan is doing it.
What did you learn about how they’re doing it?
We got to see a traditional nursing home. Similar to the U.S., there’s a lot of resources provided in assisted living facilities, but it’s very expensive. We also saw how in-patient care works at the Keio Hospital.
But the best thing I saw was the home nursing station. The way the system is organized seems to optimize very compassionate care. The nurses see about four patients a day in the surrounding neighborhood, and they bike to each of their homes. I was really impressed with the way that the nurses took care of the adults and promoted their independence and dignity. I think the culture definitely influences that too. The way Japanese nurses show respect for their elders was apparent as soon as we walked in the house.
In Japanese culture, when you enter someone’s home, you bow to your superiors, which elders are considered to be. The nurse had a full assessment and health interview with one of her patients, and it was a lot more conversational and respectful. The patient was included in their care and had input in conversations about how they can improve their health, instead of the nurse just coming in to their space and having a set care plan.
Did anything surprise you while you were there?
The nurses in Japan have a seven to one nurse to patient ratio, which is more than the average here. There were also little things that I noticed were done differently but are not necessarily bad practices. For example, the patient beds at Keio Hospital were extremely low to the ground. I asked the nurse about why that is, and she said it’s mainly for fall risk purposes but also it simulates the futon mattress, which is the traditional mattress in Japan. But because it’s so low to the ground, I saw the nurse have to crouch over to insert an IV. There are also four beds to one patient room, which I don’t think is typical here either. Overall, they were mostly small differences but definitely noticeable.
What was your previous experience working with older adults like?
I was a CNA at an assisted living facility and they would typically assign me to just one person for the whole shift, but sometimes I would float and be with many different residents. I had great interactions and relationships with the residents there. I liked that the facility tried to format their care so that the residents weren’t overwhelmed with so many new caregivers all the time. It was exciting to get to know the residents and learn new things about them so I could incorporate it into how I took care of them.
What are your plans after graduation?
I’m still thinking about where I want to live, but as of right now I’m interested in getting a nursing job in pediatrics and seeing where that takes me.
I would definitely recommend this exchange program to any BSN or ABSN student. I heard a lot of people were not interested because of the unfortunate timing of the program. It was a stressful time to leave school, but completely worth it. I made some great friends from Korea, UK and Japan, and I intend to keep in touch with them.