#18 Us in the School Infirmary

I used to be a school nurse.

Suzuki
Before taking this job, I worked as a school nurse at an elementary school. Shibuya-san, you were at a junior high school, right?
I think the atmosphere is quite different between elementary and junior high schools, but at the elementary school where I worked, the school had a policy of aiming for independence and encouraging students to act with initiative, so I was always conscious of that when interacting with the children. I feel that the way I interacted with them and that stance are very much connected to my current work in supporting students with disabilities.

Shibuya
I understand. How did you handle things at the elementary school?

Suzuki
During the physical measurements in April, I would provide health guidance so that if children got injured and came to the infirmary, they could first explain it themselves. I would have them explain when, where, how, and what part they injured in their own words, even if it took them a while. Above all, I would wait for the child to start speaking. Of course, there is a difference in language ability between first graders and sixth graders. So, to ensure even first graders who couldn't express themselves well yet could communicate, I kept a paper with a drawing of a human body posted in the infirmary, and I had them explain it themselves, even if it meant pointing at it.
What was it like at the junior high school?

Shibuya
Since the developmental stage changes when they become junior high students, I had the impression that there were a lot of children suffering from poor mental health. There were even children who would engage in self-harm. Sometimes those children would use it as a sign and confide in me in the infirmary, saying, 'Teacher, I did it.' Those experiences became the catalyst for my interest in mental health and psychological support.

Suzuki
They wouldn't show those signs easily if there wasn't a relationship of trust, would they?

Shibuya
That's true. But back then, I was called the 'fighting school nurse' by those around me (laughs). I also taught judo as a club advisor, so students would sometimes say I was scary. Of course, I didn't want to be known for being scary, but junior high is a stage where they are gradually becoming adults, isn't it? Since it's the final three years of compulsory education, just like you, Suzuki-san, I was conscious of having them explain their condition clearly in their own words. Perhaps that way of thinking is something common among school nurses.

Suzuki
I can really relate to the 'fighting school nurse' (laughs).
Actually, being a school nurse is a job you can't do unless you're a bit pushy. I'm not sure if 'pushy' is the right word, but there are moments when you can't worry about appearances if you're thinking about the child.

You have to say what needs to be said, and if I think I should take action, I dive right in without hesitation (laughs). I was listening to you thinking that your 'fighting' must be the same thing, Shibuya-san.

The stance of acting for the sake of the child is something that has been ingrained in me since my days as a school nurse, so even now at the university, I take action if something comes up (laughs). That part hasn't changed.

The limitations I felt as a school nurse

Suzuki
When I was working as a school nurse at an elementary school, I had the impression that the number of children with disabilities or those requiring reasonable accommodations coming to the infirmary was increasing year by year. However, I felt I lacked the knowledge, and I spent my days working while constantly worrying about what kind of safe space the infirmary could provide and how I should interact with children with disabilities.

Since I had worked as a public health nurse in government administration right after graduating from the nursing department of my university, I had many opportunities to interact with people with disabilities, but I felt that the knowledge I had studied at university was not enough and I lacked confidence.

Shibuya
I also graduated from a nursing-related program, so I understand that worry very well. When I started at my current university and saw the term "reasonable accommodation," I had heard it before, but honestly, I felt like, what on earth is that?
When I first started, the pandemic hadn't ended yet, so there were quite a few cases where students with developmental disabilities were experiencing mental health issues and applying for accommodations. However, I only had experience as a school nurse in junior high school, and I struggled a lot because I didn't really understand how to interact with young adults.

While doing so, my interest in developmental and mental disabilities, which I had from before, grew, and since I was also eligible to take the certified public psychologist exam, I studied for it during my first year and took the exam.

Suzuki
I had a similar experience, and I decided to go to graduate school to study education for children with disabilities.

Shibuya
That's amazing! Wasn't it difficult?

Suzuki
I managed to get my master's degree through a long-term study program, taking four years instead of two.
However, I'm not sure yet if I'm fully utilizing what I learned there. But of course, I don't think it's a negative, so I hope there's some kind of plus factor.

Shibuya
I really understand that feeling too. I studied to get the qualification, so that knowledge is a foundation. But there are times when it's hard to link that knowledge with what I'm doing in the field, and I've actually started to feel various conflicts.

Suzuki
In what ways?

Shibuya
For example, based on the name of a disability, I think there should be certain characteristics, but since personality and temperament are also involved, it naturally doesn't always go that way. There are various ways to respond, and at such times, I think it would be great to have someone nearby who could listen to me, but at the time, there weren't many people I could consult with, so I felt like, well, I got the qualification but... That's why I started participating in AHEAD JAPAN and various other training sessions, and I've been learning little by little. Even so, I'm still constantly anxious about whether I'm making good use of my qualification.

Changing the university from the field

Shibuya
One of the things I wanted to ask you about today, Suzuki-san, is the "cross-functional team" at Otani University. I was very interested to hear that you are providing support through a team that spans different departments. I would love to use it as a reference.

Suzuki
Thank you. We provide support through a "Disability Student Support Team" that spans various departments. Staff members from various departments such as the Academic Affairs Division, Student Support Division, Admissions Center, Career Center, Educational Research Support Division, and Library/Museum Division participate in it. We call it a cross-functional type, and originally there was an item in the university's regulations regarding administrative organizations that stated, "a team spanning multiple departments can be established." The management at the time applied this part when creating the disability student support team.
As another idea, there was talk of creating a "box" called a Disability Student Support Office. However, considering the scale of the university, it was decided that it would be better for staff from each department to be involved as a whole university rather than creating a specialized department. I've heard that if you create a specialized department, it can sometimes lead to leaving things to others, like "let's have the specialized department handle support for students with disabilities," and so it was decided that staff from each department would be involved in disability student support in parallel with their assigned duties.
We had already been holding monthly meetings with representatives from each department to share information. Since we had that accumulation, it felt like we were able to transition smoothly to the cross-functional team.

Shibuya
I see. What kind of role do you play there, Suzuki-san?

Suzuki
I act as a coordinator for the support team. In practice, it's more like a connector, I suppose.

Shibuya
Are you a connector?

Suzuki
I think this is very similar to how a school nurse operates. Having worked in the education field, I have a sense that everyone working in the same organization is family, and I’ve always felt that 'sharing across the entire school is what matters.'

I think it’s the same for you, Shibuya-san, but school nurses are very agile, aren't they? Right now, I am a staff member in the health room, and I make it a point to visit each department to talk about various things. By doing so, what I hear and see accumulates, and I end up in a state where a lot of information gathers with me. Since time and frequency are limited in departmental meetings, I cannot input or share all the information there, so I consider daily interactions to be very important. I believe that kind of movement is essential for connecting departments.

Shibuya
I understand that very well, and I think it is important.

Suzuki
And another thing I think is important for cross-functional teams is having an 'initiator' in each department. Because they are appointed by the university, they become the main players in the sense that they can think and act with responsibility. That is precisely why I also act as a supporting player, and I am very conscious of not always being the one at the forefront. Of course, I think together with them, and conversely, there are many times when I am helped by them as well.

I think what is important for team building is both strengthening horizontal connections and having a vertical chain of command for responsibility.

Support for students with disabilities from the perspective of the health room

Shibuya
Like at Otani University, until two years ago, the health room was primarily responsible for supporting students with disabilities, but from the 2025 academic year, the student counseling office took over that role. There is a door at the back of the health room, and when you open that door, there is the student counseling office. I hold a concurrent position in student counseling, so I am often in the back room, but if there are no counseling appointments, I keep the door open so that we can always have conversations between the counseling office and the health room.

For example, if a student who is feeling unwell comes in, I handle it as the health room along with the nurse, or if a student is having mental health difficulties or has a delicate matter to discuss, we talk in the back room. It’s like a door-to-door transition to proper counseling. In that sense, I feel that the current situation makes it very easy to coordinate between the student counseling office, which includes support for students with disabilities, and the health room.

Suzuki
I think the advantage of health room staff being involved in supporting students with disabilities is that they can gather various information about the students. If information is scattered, it becomes difficult to see the students from a multifaceted perspective, doesn't it?

Shibuya
While I strongly agree with the benefits of gathering information, on the other hand, I feel that the students who come to the health room and the disability support office are different. I sometimes get confused myself, but the worries and consultations are also different, aren't they?

Suzuki
As you say, there are times when it is good that they are together, but the health room is a place that has a certain level of leniency, or kindness, or a place that provides support. However, I feel that if that is too prominent in supporting students with disabilities, it might be a bit different. I don't deny it entirely because I think there are students who are saved by such responses, but that is precisely why there are times when I think we should watch over them quietly.

Shibuya
That is true. Since the provision of reasonable accommodation became mandatory, the number of students saying, 'I want to apply for reasonable accommodation,' has increased. But when I listen carefully to what they have to say, I often feel that it is not necessarily something that requires an application for reasonable accommodation.

I wonder if things that could be solved by asking a professor through soft adjustments rather than hard adjustments are being pushed forward as reasonable accommodations. Of course, I don't deny submitting an application for reasonable accommodation, so in the end, most cases lead to that, but even if they do apply, I tell them, 'That’s not the end of it.'

I will certainly provide support and do everything I can, but I also tell them that they need to speak up for themselves, and that I will also send follow-up messages, so they need to make sure they can be reached.

Reasonable accommodation is not a magic bullet, so it doesn't mean that everything is okay just because you apply for it. I think that is something I place great importance on when dealing with students.

With agility

Suzuki
I used to think that university students would be very mature after seeing elementary school students. However, what I felt when I came to the university was that they were generally immature, not just the students who visit the health room.

When I wondered why, I thought it might be because their self-understanding is poor. Perhaps they have had few opportunities to think for themselves because someone was always speaking on their behalf or anticipating their needs.

It is no longer a matter that can be contained within the university, and I have recently felt keenly that we must also coordinate with primary and secondary education.
So, thinking that I could at least do something in my own area regarding students with disabilities, for students who have submitted applications for reasonable accommodation, I have created a sheet to encourage self-understanding and have them reflect on it. It is a small thing, but I think it is important first to 'write about oneself' or 'express oneself in one's own words'.

Furthermore, I would like to approach students who are so-called 'gray zone' students who have not applied for accommodations, and I am currently in the process of starting initiatives while consulting with other departments and students.

Shibuya
Listening to what Ms. Suzuki just said, I realized that while the system of reasonable accommodation has been established and is being implemented relatively well at universities, it still feels like a process of trial and error in elementary, junior high, and high schools. Even when I was a teacher myself, there was no training on reasonable accommodation.
We are in a truly diverse era now, where children have various difficulties and parents have strong needs, so I think teachers on the front lines are having a hard time. Despite that, it is supposed to be handled within the scope of educational consideration, and the situation is almost entirely left to the staff on the ground.

Because of that, I get the impression that teachers are actually providing very thorough support. But then, after graduation, students just say, 'I had this done for me before,' and there are cases where the student themselves doesn't understand the basis for it or why it was done.

We can only interact with the students in front of us at a single point in time, but I thought it would be great if there were more opportunities for universities and elementary, junior high, and high schools to exchange information and discuss things so that those points can become a line as much as possible.

Also, and I think this will be a keyword for today, perhaps we are 'relatively light on our feet' (laughs). So, I really felt that we might be able to move even more.

The university I am at is small, but because it is an art university, each course has a quite distinct character. However, there is not much interaction between those courses, and in courses with fewer people, assistants and associate staff tend to become isolated.

There were times when they didn't know who to consult and came to the health room, and since I didn't really know either, at first I just listened to them. But through various triggers, we started holding 'Information Exchange Meetings,' and as they gradually became more established, some teachers started saying, 'I'd like to go to that meeting.'

We also have a 'Connect Salon' where the president himself invites a coffee shop to the president's office, and everyone drinks coffee and chats. We can talk about students who are struggling, or just have casual conversations.

I thought that in that way, I would like to be able to build an organizational structure, one step at a time, starting with what we can do.

May 22, 2026
At Otani University Main Campus

Interviewer Profiles

Mikako Suzuki
Otani University, Student Support Division, Student Support Section (Health Room)
Team Leader and Coordinator
Born in Okayama Prefecture. Inspired by the work of emergency nurses she saw on TV, she entered the nursing department at university, but gave it up after fainting at the sight of blood during training. After graduation, she worked as a public health nurse for the government, then as a school nurse at a public elementary school, where she keenly felt the difficulty of dealing with children with developmental disabilities and their parents, as well as children requiring special support. In 2018, she joined the Otani University Student Support Section (Health Room) as a public health nurse, in charge of supporting students with disabilities. While exploring ways to respond to people with disabilities and diverse developmental characteristics, she studied in the Graduate School's School Education and Disability Education course while working. Following the launch of the Disability Student Support Team in October 2022, she has been working as a team leader and coordinator (current position).

Misaki Shibuya
Yokohama University of Art and Design, Student Support Division, Wellness Group (Health Room/Student Counseling Room)
Head of Student Support Division Wellness Group
Born in Kanagawa Prefecture. Aspiring to become a school nurse after meeting one who supported her through her worries during junior high school. After graduating from university, she focused on mental health support for students as a public junior high school nurse. In 2021, she joined Yokohama University of Art and Design as a public health nurse, and while involved in supporting students with disabilities by utilizing her previous support experience, she deepened her interest in reasonable accommodation and building on-campus support systems. The following year, she obtained a certified public psychologist qualification and became more deeply involved in supporting students with disabilities. Since 2025, she has been concurrently serving in the Student Counseling Room, providing support while clarifying the roles of the health room and the student counseling room. She is currently working on creating spaces for faculty and staff collaboration and building an information-sharing system for students who need support. She values connecting people with people and people with support through dialogue.

Text by Megumi Kitani (DIIN Center)
Photo by Katsutoshi Omae (DIIN Center)

"Hitokokyu" (A Breath) is an interview magazine born from a project called "Higher Education Accessibility Platform (HEAP)", which began at Kyoto University to consider the rights and support for students with disabilities. Over approximately four years starting in 2019, we published a total of 15 issues (back issues are available here). After a three-year hiatus, we have relaunched in 2026 as "Hitokokyu weaver" (for details, see "Introduction."). We will be serializing records of dialogues spun in support settings here on note.