STUDENT nurses who are currently doing their placements are facing serious risks. Their lives are at risk as many are treating coronavirus patients and to make matters worse they are both unpaid and without life insurance.
Student nurse Lizzy, who is on placement at the moment has spoke up about what she is experiencing on the wards. She, like the rest of colleagues are demanding to be paid for the work they do.
‘It’s really scary,’ she says, ‘You don’t know what you’re going to face every day.’
‘There’s a lot of anxiety and stress for students working on unpaid placements right now. Covid is worse than it’s ever been, especially with the new strain. We should be paid, because without it we have no life insurance protection for death in service.’
Lizzy is one of a number of students who have spoken out and think they need better protection while on placement.
During the first wave of the pandemic in 2020 students could either opt out of hospital placements, or join the NHS under paid contracts.
This then meant they were covered by the The NHS and Social Care Coronavirus Life Assurance Scheme which was set up in recognition of the extra risk front line workers face during the crisis, with families offered a payment of £60,000 if an NHS or social care worker dies from coronavirus, contracted at work.
But for students, paid contracts ended in September when pressure on the health service initially eased.
Last week, the Nursing and Midwifery Council (NMC) announced they’ll be reintroducing pay for third year nursing students, and those in their first year will now be able to opt out of placements.
But NHS students are angry that the other years are still unpaid.
James, who’s a second year student nurse, says people like him have been at a ‘massive risk’.
‘If anything was to happen, we’d be left without the protections a qualified nurse would get,’ he says.
‘The universities are supporting us, but there are certain limitations to what they can provide, and we need the reassurance of knowing we are protected.’
The Department of Health and Social Care (DHSC) claimed it was ‘immensely grateful’ for the work of student nurses during the pandemic. However, that ‘gratitude’ is not reflected in how much they are paid which amounts to exactly zero.
The Tory government axed the NHS student’s bursary in 2016.
The number of people applying for nursing degrees dropped by 25% from 43,800 in 2016 – the last year students received the bursary, which covered tuition fees and helped with living costs in England.
Nursing leaders have called for the government to take ‘decisive action’ to cover nurses’ tuition fees on top of the £5,000 annual grant for living costs which students received from September 2020.
Now, with it neigh-on-impossible for student nurses to take on a second job, financially, they have been left up to the eyeballs in debt.
Even though student nurses in their third year will be given pay and protection, first years are faced with working for free, or opting out of placement.
Lizzy said the stress and anxiety is taking its toll, with this adding more pressure.
‘It’s so busy right now. We’re doing long shifts and it’s exhausting. At times it does feel quite overwhelming. Essentially we are putting our lives at risk with no backing or benefit.’
Nurses’ union the Royal College of Nurses (RCN) has responded to the news that final year nursing students have once more been invited to support the response to the Covid-19 pandemic through undertaking paid placements.
The RCN has outlined how it expects nursing students to be supported as emergency education standards are reinstated by the Nursing and Midwifery Council (NMC).
The RCN said: ‘As before, taking on a paid clinical placement is optional, not mandatory; each individual student can decide whether it is the right option for them.
‘The NMC has also introduced two additional emergency standards relating to first year nursing and midwifery students and supervision and assessment in practice.
‘The RCN is clear that employers and educators must take full responsibility for the supervision, support and wellbeing of any final year students whether they choose to opt-in or not. Students must not be disadvantaged, either financially or in terms of their education, irrespective of their individual decision.
‘To support our student members, we have set out eight guiding principles and a series of FAQs and the RCN Students Committee continues to represent the student voice in meetings and on social media.’
Mike Adams, RCN Director for England, said: ‘Any students being asked to provide support must be given the same rights and protection as all other frontline workers. This includes access to vaccinations and the right level of PPE.
‘The local decision to ask final year students to volunteer should only be done where all other options for increasing the workforce have been exhausted – and no student should feel pressured to do this.
‘It is vital that any disruption to students’ education and ultimately date of registration is kept to an absolute minimum.
‘If implemented, higher education institutions and practice placement providers should implement robust risk assessments, which consider the safety of the student and clinical demands of the proposed placement area.’
Meanwhile, the RCN is seriously concerned about staff wellbeing and patient safety as intensive care units (ICU) across the UK experience extremely high levels of activity and operate considerably beyond their usual capacity.
It is recognised that there are not enough critical care nurses and ICUs are having to respond by reducing the critical care nurse to patient ratio from 1:1 to meet demand.
NHS England and NHS Improvement with Health Education England issued guidance in December on workforce models for hospitals during Covid-19, which stated the staffing standards for intensive care units can be temporarily suspended. It said:
- Nurse to patient ratios could be maintained at a minimum of one trained critical care nurse for two level 3 patients, compared with the normal 1:1 ratio, supported by one other registered nurse.
- And, one trained critical care nurse for four level 2 patients, compared to the normal 1:2 ratio, supported by one registered health care professional.
The RCN said: ‘We understand from our members that nurse to patient ratios in ICU are being diluted more than this, and that ward areas are also significantly short staffed.
‘We’re firm that dilution of ICU nurse to patient ratios should only happen in exceptional circumstances where there is a need to expand capacity, despite escalation to regional and national critical care networks; and when all local and regional mutual aid options, including inter-regional assistance, have been exhausted.
‘The UK Critical Care Nursing Alliance (UKCCNA), of which the RCN is a member, also requests that departments of health in the four nations provide further guidance on how increased workforce requirements are managed.’
RCN Chief Executive & General Secretary Dame Donna Kinnair said: ‘The safe ratio in intensive care units is one nurse to each patient. With every change to this ratio, the pressure on nursing staff increases and it becomes harder to provide care to patients.
‘This is not safe practice, but it has become unavoidable in many hospitals. It is exacerbated by the severe shortage of nursing staff, which is not only affecting ICU but many wards packed with seriously ill patients where nurse to patient ratios are very high.
‘We must see an urgent response from the government that addresses the chronic underfunding of nursing over many years.
‘Nursing staff are already doing everything they can, but this is not sustainable. Many nurses and other health care staff are off sick which is making an intolerable situation even worse. Conditions are very difficult, and it is taking a toll on their physical and mental health.’
The RCN insists reducing the ratio of specially trained intensive care nurses to patients must be a temporary measure and only used when it is absolutely necessary. Outside of pandemic conditions, national recommendations for critical care nurse-patient staffing ratios for level 2 (1:2) and level 3 (1:1) patients should continue to be the standard. Staff must also be supported to raise and escalate patient safety and psychological concerns.
- Hundreds of soldiers are to be sent into major London hospitals to help shore up understaffed intensive care units as the numbers of coronavirus patients in the capital has risen again.
200 medical combat technicians will be sent into intensive care units at the city’s main trusts including the Royal London Hospital in Whitechapel, east London, and the Royal Free Hospital in Hampstead, north London.
Another 150 military staff will be put into non-clinical roles to help free-up nurses and doctors to keep caring for patients. The move follows a request for aid from the NHS.
The city’s hospitals are in a staffing crisis with the latest data from Thursday showing almost 15,000 staff across London are off sick from work, with 60 per cent of the absences linked to Covid-19.
This includes more than 6,100 nurses and 789 doctors. Nursing bodies have also issued a warning over hospitals stretching nurse to patient ratios to unsafe levels in intensive care wards.
BMA member, Anna Athow said: ‘Clearly, the situation is so desperate today. Rising emergency cases and more and more staff off sick has led to hospitals reaching crisis point.
‘It is more respiratory trained nurses and doctors that are really needed. It is not very clear what soldiers can do to help, apart from portering jobs.
‘This situation is being replicated all over the country. The peak is not yet reached. Patients lives will continue to be lost in greater numbers because they will not have the expert care, they deserve. Soldiers are no substitute for healthcare workers.
‘The responsibility for this disaster situation is this Tory government which has pursued a reckless policy of rejecting all scientific advice, and going along with the privateers at the top of the NHS bureaucracy and in his cabinet, who only care about short term profiteering and not suppressing the virus.’