Hannah, Louise and Megan, second year student adult nurses, have learnt a lot from their study tour to Japan
We are second year student adult nurses, privileged to have participated in a study tour to Japan in June 2017. One specific highlight was a day at Nishinomiya Keiaikai Rehabilitation Hospital in Kobe. The attention to detail in the hospital’s design to promote independence was apparent. The Occupational Therapy Suite was state of the art and the floor to bath depth could be adjusted based on the resident’s own home dimensions. This level of personalisation was also demonstrated in the staff attitude to holistic care. Bathing is an integral part of Japanese culture, beyond maintaining hygiene needs. They do it because they believe it benefits their emotional and psychological well-being. Onsens are community bath houses where people can get together, but even in private homes a daily bath is an important ritual. This hospital has been designed to facilitate this daily practice by using trolleys that become baths at the press of a button. For patients who really cannot bathe for whatever reasons, foot and hand baths become an important holistic therapy. it is a lovely ritual which should be promoted in this country.
The hospital also addressed the real challenges, which could be faced after discharge. For example, the hospital has been built to incorporate outside exercise areas that are used daily by the residents. Learning to walk again after a stroke in a safe internal environment is different to mobilising outside in the wind, rain and snow. Following on from this, the rehabilitation journey is further enhanced by the staff taking the patient to the nearby shopping centre. This is a routine part of every patient’s care and increases confidence and eases their transition back home.
Careful thought has also been given to quiet areas where patients can sit and enjoy nature. The hospital is in a very urban location, but careful planting of a garden has attracted wildlife that can be watched. The plants have been chosen because they grow naturally on a nearby mountain, which is visible in the far distance. The mountain can be meditated upon as an inspiration of strength and power and birds and butterflies visit the hospital attracted by the plants.
The Japanese believe that good food helps to provide a feeling of wellness, communal mealtimes and sharing food are also important social activities. Festival days are important in Japan and the traditional food served is believed to enhance emotional wellbeing. This special food is also made available to the patients within the hospital as part of their holistic care. If the texture of the food needs modifying due to swallowing difficulties then “Jello” is used: this then enables the original taste, smell and much of the original appearance of the food to be retained. When the residents eat together the similarity in the different meals reduces the feeling of isolation or embarrassment of having to eat modified food.
We have learnt a lot from this experience and have found ways we can enhance our own practice to assist our patients in a more holistic fashion. It has made us question whether our own rehabilitation services provide all the skills patients need to return to their physically active lives. The staff in the hospital were inspirational, they were focused and passionate about their work. We have not only made new friends but also met inspiring role models.
Hannah Duffy (2nd year adult nursing student)
Louise Rogers (2nd year adult nursing student)
Megan Squires (2nd year adult nursing student)
Supported by Andrew Southgate (senior lecturer; adult nursing)