Part 1: Study Abroad Before 50: Why This Nurse Decided to Go to the U.S. No6

<A harsh environment at my assignment and the reason for my resignation>

In 1999, I was ordered to transfer from a university hospital to a hospital in Tokyo. The circumstances led me to decide to study abroad before 50 as a nurse. I was told the purpose was to serve as the “Head of Nursing Education,” but the true intention was unclear. That marked the beginning of a long commute...: two and a half hours one way, changing four trains. I would take the first train around 5:10 a.m., and return home around 9 p.m. It was an exhausting routine both physically and mentally.

One day, I was called to meet with the hospital’s chairman. He pointed to the tea in his cup and said,“If I call this color red, even a doctor must call it red.”I could not fully grasp what he meant, but I understood it as: “Even if something is wrong, you must obey.” A deep disappointment spread through me.

The hospital chairman's words: "If I call this color red, even a doctor must call it red." This unreasonable environment was one of the major reasons I decided to study abroad before 50 as a nurse.

I consulted the administrative director and the chief nursing officer at the university hospital, but nothing changed. Finally, I decided to resign at the end of that fiscal year.

At the same time, on January 8th of that year, my older sister—who had long cared for her husband who became wheelchair-bound after a stroke in his 40s—suddenly passed away at the age of 52. My heart was filled with complex emotions.

<A past short-term training and concerns about the DPC system>

In 1993, I had participated in a two-week training program in the U.S. through the university hospital. My English was poor, and communication with local staff was difficult. Even so, I learned about DRG/PPS, the U.S. hospital payment system that classifies inpatients and pays hospitals a set amount per group.

Later, I heard that Japan was planning to introduce a similar system, which eventually became DPC (Diagnosis Procedure Combination). I raised concerns with my U.S. instructors:

“Would this system make hospitals reluctant to admit complicated casesor limit where such patients can be treated?”

The answer was:

“Yes, there is such a tendency.”

Japan introduced DPC in 2003 at advanced hospitals, and now the system has expanded widely.

<Taking on the challenge: handling the study-abroad process by myself>

I wanted to better understand the major changes occurring in healthcare. And honestly, I needed a “change of air” after such a painful period in my life. So, I decided to study again in the U.S.

I was approaching 50, dealing with menopausal symptoms, and knew this challenge would not be easy. Through a mutual acquaintance, I was introduced to an American woman living in Seattle who spoke fluent Japanese—she became the key to my relocation.

Unlike younger students, I had to handle all arrangements myself. I managed to contact a nursing professor at the University of Washington and shared my hopes, but I was advised:

“Strengthen your English skills first.”

Therefore, I enrolled in the International Programs of Bellevue Community College (now Bellevue College), where many international students prepare for university admission.

I researched and completed all the necessary documents myself, visiting the U.S. Embassy multiple times. Before moving, I visited Seattle twice to arrange my homestay. And in May of that year, I finally departed for the United States.

“That challenge became the foundation of my current work.I will continue sharing the lessons and encounters from that journey, little by little.”