Job training is built on a simple exchange: work for experience. In theory, it is a fair trade. The trainee gains fundamental skills while the employer benefits from their labour. But at what point does the pendulum swing too far, where the employer benefits disproportionately at the expense of the trainees? Two recently qualified nurses, Emily and Jane, believe that within nursing training, it has.
“By the end, I was acting as nurse in charge on some shifts, responsible for the care of nearly 30 patients. It was overwhelming to be in this position as a student… real people’s lives were at stake, and I didn’t feel qualified.”
In the early stages of any career, many feel their skills are insufficient. But for Emily, these decisions could have had serious consequences while she was on her placements during her three-year degree.
Financial issues were also a concern, as many nurses were unable to work part-time due to the long placement hours, leaving them reliant on NHS bursaries.
“£6.50 per hour… that was what I worked out I got paid after I divided my bursary money by my 2,300 placement hours.”
In other industries, she would have been paid £11.44 per hour after turning 21. It is also unlikely she would have faced this level of responsibility elsewhere.
Accounts of beds in corridors, negligible pay rises, and skeleton teams have led to the treatment of qualified nurses receiving exposure in recent years, but it appears there is a group within the NHS facing a similarly dire situation without receiving proper compensation.
The Royal College of Nursing has estimated that 32,000 students could drop out of their courses by 2029. This comes as no surprise if they are being placed in these positions on a regular basis.
Placing trainee nurses in positions of responsibility during shifts has led to the NHS facing criticism from nursing unions in the past for using student nurses as “free labour.”
Emily echoed this sentiment, saying the course had left her feeling used at times: “It wasn’t just the financial situation that frustrated me, it was the tasks that I was asked to do. At times, it felt like I wasn’t actively learning, I was only there to work.”
“The people in charge never seemed to get the balance right. I was either repeatedly doing mundane tasks where I wasn’t learning anything or was thrown into situations that I wasn’t qualified to handle.”
The RCN said in December that NHS reforms are under threat due to the lack of new nurses. There was an increase of just 130 applicants starting nursing courses in 2023. This is a far cry from the additional 200,000 nurses that the NHS aims to train over the next 11 years.
A second nurse called Jane, thought that the lack of applicants could be a product of the extra commitments of a nursing degree, including obligatory summer placements. She said it was difficult having only six weeks off in the summer while her friends studying other degrees were all enjoying four months off.
“I didn’t go on a holiday with my friends for three years. They were all having a great time while I was stuck on placement.”
In December, the Department of Health and Social Care reiterated calls to reduce placement hours from 2,300 to 1,800 for student nurses. This appears to be a step in the right direction for making the course a more attractive prospect for potential applicants.
The RCN has also appealed to the government to introduce a loan forgiveness model and to provide funding for living costs to students who commit to working in the NHS after graduation. They said this was vital for encouraging recruitment into the profession.
Despite the difficulties of their jobs, both nurses agreed that they do not regret going into the profession. Emily said: “It’s an incredibly rewarding career, and there’s no replacement for helping people out in this way… but we need more help.”
Unless hours are cut, pay is increased, and proper training is received, it appears the NHS’ recruitment problem will worsen. The NHS must ensure students are given the means to succeed, not just survive