“I became unable to sleep or eat. I couldn’t stop tears from falling,” says Plusbase co-founder Sakura Wim, remembering how she felt when she worked in an emergency room in her first year as a nurse. Wim was cheerful and highly-motivated when she started working at the hospital. It was her dream job. And yet, within a year, she stopped smiling as she found herself deep in depression.

Plusbase is a startup Wim launched in January 2022 after recovering from that depression. Her former sharehouse mate Yoshino Ujike joined her as a co-founder. They are currently developing “Nurse-be

,” an online mental healthcare service for nurses.

“I realized I learned many things about how to ‘protect patients’ but learned little about how we nurses should ‘protect ourselves’ at work,” Wim says about her motives for starting this venture.

Healing Nurses in Three Steps

Nurse-be is designed for nurses to take care of their mental health in three steps: visualizing their state of mind, self-care training and consulting experts. Wim says there are some specific thinking habits nurses tend to have and her service reveals those habits using a checklist.

Then nurses can use a range of self-care training programs, including cognitive behavioral therapy and meditation to break their thinking habits and become more flexible thinkers.

“Rigid thinkers are more likely to feel their life is difficult. So, it’s important to become able to think in different ways,” Wim says.

Plusbase, if necessary, refers nurses to mental healthcare experts. Wim herself studied psychology after she quit her job due to depression. After coming back to the medical field as a nurse and a certified psychologist, she saw her coworkers going through burnout just like herself in the past.

“I had a great dilemma,” she said. “I wanted to change that situation but I felt it was difficult to make changes while working inside (the medical industry).”

Psychological Stress

Figures also suggest how serious nurses’ mental health problems are in Japan. Plusbase conducted a survey of about 600 nurses. Nearly 50 percent of them said they have psychological stress. About 24 percent said they regularly take sleeping pills, compared to the nationwide average of 7.8 percent.

The survey also revealed that relations with coworkers is a major factor why respondents leave their workplace. Ujike, who herself once had mental problems when she worked at a human resources company, says that a lack of sleep and psychological pressure make nurses more irritable and affect their relations at work.

Wim and Ujike both admit that medical doctors are also under pressure from working overnight and having people’s lives in their hands. However, they think the biggest problem for nurses is that they tend to be required to do a wide range of tasks, as the scope of their duties is pretty vague.

“Besides responding to nurse calls and doing as instructed by doctors, they are often asked by patients to change their bedsheets or accompany them to the restroom. Things that even people without a nursing license can do,” Ujike explains.

Wim also notes that Japan’s “customer-first” practice is pressuring nurses to offer excessive services to patients.

“Harassment by patients against nurses is becoming a major problem,” she says, stressing the need to draw a clear line between what nurses are supposed to do and what they aren’t. “I hope there will be more task shifting.”

A Chance for Change

Heavy burdens on healthcare workers have come under the spotlight amid the coronavirus pandemic. Wim welcomes recent government moves to improve their working conditions, including a phased pay raise for nurses.

“Some nurses are voicing their hopes for a bigger pay raise. I think it’s good that people from outside the industry are paying attention to problems we face,” she says.

Plusbase is currently testing Nurse-be with individual nurses. By the end of the year, they’ll offer it to medical institutions to use as an Employee Assistance Program (EAP). In the long run, Wim and Ujike want to develop similar services for workers outside the medical industry.

The World Health Organization (WHO) defines health as “a state of complete physical, mental and social well-being.” Of these three, Wim feels initiatives to protect people’s mental health are weak in Japan. Especially compared to Sri Lanka, where her parents were born and there’s a practice of preventive medicine.

“Nurses work in the closest proximity to patients and they are the biggest in number at hospitals,” says Wim. “If nurses can work happily, it will enhance the quality of the country’s medical services as a whole.”