Thu Huong, a former EPA nurse, has participated in this project since its January 2020 kick-off meeting. She presented on nursing in Vietnam at the project’s September 2021 meeting, “Caregiving in Japan from Foreign Perspectives: Oral Swallowing Care.”
Since returning to Vietnam, she has been teaching at a nursing university and researching bedsores at the graduate level. During her stay in Japan as an EPA nurse, she was impressed by how bedsores were treated.
What made you decide to become a nurse?
In elementary school, my father became ill and was admitted to a hospital about seventy kilometers away from home. In Vietnam, nurses and doctors do not care for patients’ personal needs. Therefore, my mother accompanied him and was away for some time. From then, I gradually developed the desire to become a medical professional.
Can you talk about the circumstances that led you to apply for the EPA program?
After graduating from a four-year nursing university in the capital city of Hanoi, I returned to my hometown and started working as a nurse. About two years later, I happened to learn about the EPA program from a news report I saw.
Looking it up on the internet, I found out that participation is free, so I applied in October 2013. When I found out that it was free, I was surprised and even thought that was a lie.
Looking back, how do you feel about the pre-departure training?
It was a difficult, but in retrospect, good period where I could concentrate on studying without worrying about my financial situation.
What was your study schedule like?
Study from 8 a.m. to noon, then take a lunch break. After that, I would study from 1 p.m. to 5 p.m., and after dinner, some more from 8 p.m. to 10 p.m. I would then go to bed at 11 p.m. and wake up at 6 a.m. the next day. That was my studious dormitory life. Before tests, some of us would study until 3 in the morning. While taking classes and seminars on Japan’s nursing culture, I passed the N3 level of the Japanese Language Proficiency Test in six months and the N2 level a year later.
When did you come to Japan?
I came in May 2015 as part of Vietnam’s second batch of EPA workers. When I arrived at the airport, the air was clean, making me feel that things were different here from Vietnam.
When did you start working at a hospital?
In August 2015, at Showa Hospital in Yamaguchi Prefecture’s city of Shimonoseki. At my workplace, there were EPA nurses and caregivers from Indonesia and the Philippines who had passed the national exam. Two of my friends and I joined them from Vietnam.
I was happy and impressed that the hospital director, head nurse, and others created a group for us to interact with EPA caregivers and nurses. The group took us on a day outing once every two or three months.
How much time did you have to study at the hospital?
My employer gave me a lot of time to do so. Before I passed the national exam, from Monday to Thursday they allowed me to work only in the morning and then study in the afternoon. Only Fridays were full-day workdays. I had weekends and holidays off.
What was your experience like after passing the exam?
I passed the assistant nurse (LPN) exam in 2016 and the registered nurse (RN) exam in 2017. However, the time after passing the national exam was harder than before doing so. Once you become a nurse, you have to take on the same responsibilities as a Japanese nurse, and the work of caring for patients goes into full swing.
What were some of the specific difficulties you faced?
Communicating on the ground was the hardest part. Even though there are similarities in medical techniques, the communication methods are completely different, so they were hard to get used to.
First of all, I couldn’t understand the local dialect. Once, when I was about to show a patient to the shower, a colleague wanted to tell me that the patient couldn’t shower today, and used the phrase iken. In my Japanese class, I had learned “can’t go” in the standard dialect: ikemasen or ikenai. So I didn’t immediately understand what they meant. Also, when talking with patients who could not pronounce words clearly, it was sometimes difficult to understand exactly what they were trying to say.
I would get really nervous about the “conferences” where the hospital staff exchange information and opinions. I would report on patients’ conditions in front of all my colleagues and explain how they should be cared for from a nurse’s perspective. I was at a bit of a loss because such conferences do not exist in Vietnam’s nursing culture.
That sounds nerve-wracking.
I was afraid of using the wrong Japanese, but I also had a hard time in situations where I couldn’t convey exactly what I wanted to say. There were times when I could not clearly understand what people were talking about because of all the technical terms. I often consulted with some friendly colleagues to make sure I understood such conversations correctly.
Conversations full of medical terms are probably difficult for even Japanese people to understand.
Yes, that’s true. A Japanese friend of mine who was a new nurse also had trouble, saying she was afraid of the conferences.
What left an impression on you working at a Japanese hospital?
I was shocked to see an older patient who was bedridden recover to the point where they didn’t need a wheelchair and could walk.
Also, I was really moved when I saw a patient with severe bedsores improving. The patient had stage 4 bedsores, the most severe form, and at first even the lightest touch caused them to groan in pain. However, they recovered after treatment to the point of walking!
I was also impressed by the aseptic techniques, in other words, keeping equipment sterile and clearly distinguishing between clean and unclean areas. Working in Vietnam, the air was sometimes contaminated with dust, but aseptic techniques were strictly in place in Japan.
Please share what you have been doing since returning to Vietnam.
Since June 2018, I have been lecturing on nursing at Tokyo Human Health University Vietnam, which is affiliated with Saitama’s University of Human Arts and Sciences, a Japanese university.
In October 2019, I started doing research in a master’s program in Hanoi. I work at the university on weekdays and do research at the graduate school on weekends.
Please share your thoughts on the Toyota Project.
The materials on oral swallowing care for older adults created as part of the Toyota Project are useful in my lectures. I think it is new information for Vietnamese students―although in Vietnam the number of older adults is increasing, not as much emphasis is put on oral swallowing.
In Japan, there is specialized knowledge on how to use spoons and choose food to prevent aspiration, but in Vietnam, there is a deep-rooted perception that feeding can be done by anyone.
In hospitals in Japan, there are swallowing evaluations, and medical professionals make decisions about what patients should eat so they don’t choke from aspiration. In Vietnam, there are no such evaluations. Swallowing rehabilitation is also not as extensive.
How do you tell students about your experience in Japan?
Many students say, “I want to work in Japan.” I tell them, “If you have a chance, try out working there or in another foreign country. Then, return to Vietnam someday and put your experience to use.” I plan to continue to share with Vietnamese students what I learned and struggled with in Japan.