Why is the Turnover Rate High in the Medical and Welfare Industries? Analyzing the Structure of “Overwork Due to Staff Shortages,” “Mental and Physical Strain,” and “Night Shift Burden”

The Medical and Welfare industry provides essential services supporting social safety and life but faces a high turnover rate compared to other sectors. This is due to the heavy responsibility involving human life and well-being, severe overwork resulting from staff shortages, irregular night shift systems, and the significant mental and physical burden of the work.

This article provides a detailed explanation of the factors leading to high turnover in this industry, examining them from four perspectives: working conditions, compensation/benefits, workload, and career development.

Turnover Rates in the Medical and Welfare Industries (Reference Data)

The turnover rate in this industry, particularly in the nursing and welfare sector, remains at a high level, exceeding the all-industry average.

1. The Issue of Working Hours (Night Shift Burden and Irregular Work)

Medical and care services operate 24 hours a day, and the resulting irregularity and staff shortages are major drivers of turnover.

Burden of Night and Shift Work:

• Irregular Life Rhythms: Night shifts and late-night shifts are mandatory in hospitals and care facilities, disrupting biological rhythms and leading to the accumulation of mental and physical fatigue.
• High Frequency of Night Shifts: Due to chronic staff shortages, the number of night shifts per individual increases, often leading to excessive strain.

Normalization of Long Working Hours:

• Documentation and Handover: Even after the scheduled shift ends, time is required for recording patient/user data and performing handovers to the next shift, often resulting in overtime.
• Emergency Responses: In medical settings, unpredictable overtime occurs due to emergency surgeries and sudden changes in patient condition.

2. The Issue of Compensation and Benefits (Wages Not Commensurate with Workload)

Despite the high level of specialization and responsibility involved in supporting human life and well-being, many, especially in the welfare sector, feel that wage levels are low compared to other industries.

Relatively Low Wage Levels:

• Nursing and Welfare Staff: Many feel that the wage level is low relative to the heavy responsibility of physical assistance and emotional support, along with the wide range of duties, making this one of the biggest factors for turnover.
• Limited Opportunities for Raises: As the industry is often constrained by public prices and regulatory frameworks, individual effort and skill may not be easily reflected in salary increases.

Burden of Qualification Acquisition:

• Some facilities require employees to cover the costs of necessary career development qualifications (e.g., Certified Care Worker) and training attendance, posing a financial burden.

Difficulty Taking Paid Leave:

• Due to severe staff shortages, employees are often reluctant to request paid or long-term leave, knowing it would place a significant burden on their colleagues.

3. Workload and Mental Stress (Life-Critical Responsibility and Emotional Labor)

Because the work directly involves human life and well-being, it entails mental pressure and heavy physical labor incomparable to other service industries.

Mental and Emotional Stress:

• High Responsibility: Dealing with life-and-death decisions, or confronting the death of patients/users, creates immense mental pressure.
• Burden of Emotional Labor: The work requires constant mental consideration and empathy when dealing with requests and complaints from patients, users, and their families.

Heavy Physical Labor (Especially Nursing and Welfare):

• Physical Assistance: The work involves heavy tasks like bathing assistance, toileting, and transfers (moving a user from bed to wheelchair), which frequently lead to injuries to the back and joints.
• Infection Risk: There is constant anxiety about being exposed to infectious diseases.
• Harassment: Cases of harassment (Customer Harassment) from patients, users, or their families are increasing in medical and care settings.

4. Issues with Career Development and Training Systems

Despite being a specialized profession, insufficient training systems and complex workplace relationships often contribute to turnover.

Complexity of Human Relations:

• Interprofessional Dynamics: Multi-professional collaboration (involving doctors, nurses, physical therapists, care workers) is essential, leading to frequent issues with interprofessional relationships, as well as friction within the same profession.
• OJT and Personalization of Training: Due to the busy nature of the workplace, guidance for new staff is often insufficient. On-the-Job Training (OJT) relies on the capabilities of individual senior staff, leading to inconsistency in education.
• Stagnation in Career Paths: When the path to management or certified specializations is narrow, or evaluation criteria are unclear, specialized staff may lose sight of their self-development and career goals.

The Structure of the Vicious Cycle

The Medical and Welfare industry is trapped in a severe vicious cycle: “Low wages and high responsibility → Mental and physical exhaustion from night shifts and long hours → Staff shortages become more severe → The burden on remaining staff becomes excessive.” Due to the nature of the work—entrusting human lives to the staff—this vicious cycle accelerates the exhaustion of personnel.