The Truth About the Conscription of Student Nurses: Let Them Eat Cake (Again! But This Time With Clapping!)

On 19th March, the Nursing and Midwifery Council (NMC) called for student nurses in the final stage of their course to “volunteer” to assist in the fight against the COVID-19 pandemic. At Nursing In Practice, 2 student nurses were asked what they thought about this plan. The first respondent, Josh Brand, expounds basically the same reasoning as the government- this is a national crisis, the nurses being called to work are already basically qualified, and most importantly, “the fact that students will have the right to decline the offer”. Sharntay Saunders, the other nursing student asked her thoughts mainly focused on how nursing students, although they already do have lots of practice experience, are not usually registered for the basic reason that they are not ready- the course is 3 years of intense theoretical and academic work mixed with at least a few thousand of hours unpaid experience as supernumerary nurses.

As much as I sympathise with Ms Saunders, the legislation is already on its way through and it is expected that thousands of final year students will begin working this month. The main focus of this article will be to highlight the atrocious wordplay bordering on an outright lie of claiming that early registration is on a voluntary basis.

Indeed, on the face of it, students have the option to not opt-in, and another option they have, basically the same as the yet to happen, early registration, is finish their final six months of their course as a placement. Yes, the student nurses could indeed choose to not do either of those things… But this choice doesn’t simply reflect their willingness to help out as, often left out of these debates is what this choice is actually to do.

Universities are locking down and any teaching that can still be done is online. In reality, just as the regular NHS experiences major disruption as thousands of workers are forced to go into isolation, many nurses are unable to meet their obligations to do their placements forcing them to defer. Just as registered nurses, healthcare assistants, doctors, cleaners, porters, and other essential NHS workers are told to stay at home, student nurses must take similar precautions.

Forgotten and without voices are the thousands of student nurses who don’t really have a choice because they have underlying health conditions, elderly relatives or young children at home, or perhaps simply don’t feel confident or safe to take up this challenge, which they are being constantly told is “optional”. What this means for them, even UNISON, the public sector union admits, is that “the completion of your degree might be delayed”. With a whimper, the union, well aware that nurses don’t really go on strike, adds on to their statement: “You should not be financially disadvantaged.”

UNISON knows not to make empty promises about supporting their nurses but this statement also hides the fact that the cohort of final year students being asked for support, are some of the most financially disadvantaged students across all courses. Many student nurses already work alongside their placements as healthcare assistants in order to survive. In previous years, student nurses received bursaries to relieve the massive student debt one gains in any UK university course. Nursing students in the following cohort are also to be receiving some form of financial aid to encourage applications and retention, including the possibility of being paid for the thousands of hours worked on placement.

For this cohort however, while the NHS was already approaching crisis levels due to under-staffing, meaning placement students that are supposed to be supernumerary are under increased pressure to perform as registered staff anyway, the government only offers an entire pay-band below the usual starting nurse wages, to enter the workforce at perhaps its most difficult time to work. As other workers are being guaranteed 80% of their wages will be paid by the government if social distancing protocols lead to them being furloughed, NHS workers continue to work longer and harder, and will even continue to pay taxes.

I spoke to a few student nurses about their actual situations and how this crisis is affecting them (names have been changed to protect the identities of sources). While of course, these experiences may not reflect the majority, if we truly value our NHS then every individual should count.

One student, Claire is a single mother with 2 young children, one of whom is immuno-compromised and therefore very high risk of complications if infected with COVID-19. This would already be enough to severely limit her ability to assist during this crisis but this woman is also caring for her elderly mother, another person at such a high risk that the family needs to self-isolate. As a single mother, Claire is entitled to some assistance with the costs of childcare, but she has still had to ask for assistance from other relatives throughout her studies, and although now she doesn’t pay to stay home caring for her family, not being able to go on placement means her income is devastated and she must defer. Considering pursuing her course has already been a financial struggle, deferring another year may mean the end of her university career and hopes of becoming a registered nurse, but this is her only real option- no choice.

Another student, Debs, is ineligible for financial assistance relating to course fees and daily living due to nursing being her second degree. Throughout her studies she has worked part-time in 2 other jobs, 1 being a healthcare assistant for the NHS. Multiple placements Debs has been on have required her to travel, sometimes totalling over 2 hours daily commute time, to work 12 hour unpaid shifts. I think Debs has sacrificed enough and, as much as she is willing to help out, asking to help and only offering to pay now shows how unbalanced the governments changes in policy have been if they aim to retain thousands more nurses in future.

Finally, Jane is a final year nursing student that suffers with mental health issues. Although Jane feels able to work a placement for the remainder of her degree, and appreciates the fact that for once it will be paid, the unfairness of the situation will not be forgotten. Further, although confident in her ability to perform the job as required, Jane is anxious about her safety as the media continues to report government failures to procure proper PPE and enforce social distancing guidelines. One can only imagine that there will be hundreds, if not thousands, of student nurses at risk of being totally overwhelmed with nerves to the point of breakdown in this situation.

A couple of years ago, I wrote about how then Prime Minister, Theresa May, told an NHS nurse around the time of the NHS’s 70th anniversary, there was no money for increased wages because “there is no magic money tree”. Shortly after, the magic tree materialised in the form of a billion pound deal that kept her and the Conservative Party in power. This time it made its miraculous appearance in the form of unlimited funding for workers furloughed due to the social distancing guidelines the government established last month.

NHS workers were shown appreciation in the form of free cakes and lots of people wearing little badges, but working conditions and real wages continued to decline. Now, yet again, NHS workers are shown appreciation by public applause. It really is a nice gesture and appreciated by all the NHS workers I’ve spoken to about it, but they are also keenly aware that a gesture is all it is.

Maybe this article can only be a gesture, a bit of effort to show that forgotten cohort of students, shafted by the removal of the bursary, drafted by the demands of the pandemic, that they are not completely unnoticed and unspoken for. Again though, it’s not that the applause isn’t appreciated, most people understand that others are underpaid and struggling too, this is all on the government except for one thing you can really do to make a difference: Stay At Home!

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