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Explainer: What is the current situation with unpaid student nurse placements?

The government last week voted against a motion to pay student nurses on placement.

Image: Shutterstock

STUDENT NURSES HAVE been in the headlines recently after the government voted against a motion to pay them for clinical placement during the pandemic. 

The motion was rejected by the three parties in government, which was described as “cold-hearted” and a ‘betrayal that won’t be forgotten’ by People Before Profit TD Richard Boyd Barrett.

The Irish Nurses and Midwives Organisation (INMO) is currently in talks with the government in relation to student nurses’ pay.

Speaking in the Dáil yesterday afternoon, the Taoiseach Micheál Martin said there should be “no exploitation of any student nurse in any hospital setting”. 

Let’s take a look back at the details of student nurse payments and what exactly student nurses do while on clinical placement during their degree.

Are student nurses ever paid?

During their time in college, student nurses are required to work unpaid to get the necessary number of ‘working hours’ needed to become fully qualified.

From fourth year onwards, these nurses receive some payment but a large chunk of their clinical placements are unpaid during the rest of their degree. 

Clinical placement takes place in healthcare or related settings such as hospitals.

The placements usually last for 12 weeks in the first three years and take place at different times of the year depending on the college and setting.

The INMO said in March that students nurses and midwives completing unpaid work placements during the pandemic should be paid and protected as employees. 

On 26 March, it was confirmed by then-Health Minister Simon Harris that student nurses and midwives completing placements during the pandemic would be paid. 

Harris said all student nurses and midwives would be offered contracts as a healthcare assistants (HCAs) and be paid accordingly. 

This scheme is no longer in operation. It ceased in August, leading to the Opposition motion that was rejected by Fine Gael, Fianna Fáil and the Green Party.

Here’s what happened with various groups over the past nine months: 

First, second and third year 

The placements during these years in college are usually unpaid. However, this changed during the pandemic. 

After union negotiations, students in these years on clinical placements were offered temporary contracts and paid on a HCA salary between April and August.

Anyone who completed a placement during this time on these contracts was paid on the scale which starts at €13.82 per hour. 

These temporary HCA contracts for first, second and third year students were extended until 31 August. This measure ended at that point and has not since been reinstated so people on placement since then have been unpaid. 

Fourth year 

In the fourth and final year of their degree, nursing students undertake a 36-week roster of continuous placement and are paid as health service employees.

This internship has traditionally been paid but the payment was reduced during the recession.

Again, the pandemic changed the situation with this payment. The government said fourth-year students on their continuous placement should also be paid on the HCA scale.

This was originally due to be for a three-month period from April to July but was later extended to the end of the students’ internship. 

As of 1 October this year, the salary for a student nurse on 36 weeks placement stood at €15,056, according to the INMO. This works out at almost €11 per hour. 

Allowances

First to third year students doing nursing or midwifery are entitled to an accommodation allowance of up to €50.79 per week for the duration of their placement.

This is only paid in the instance where it’s necessary for the student to live away from their normal place of residence during the placement.

A review of the student nurses’ allowance is under way and a report will be available in September 2021, Tánaiste Leo Varadkar has said.

What happened last week? 

Last week, the government voted against a motion to pay student nurses.

The Solidarity-People Before Profit (PBP) motion put forward by TD Mick Barry was defeated by 77 votes to 72.

Fianna Fáil, Fine Gael and the Green Party all voted against the motion, while opposition parties and groups supported it.

The motion called for the immediate reinstatement of the payment at HCA rate for student nurses and midwives who either were or are on placement during the Covid-19 pandemic, among other measures.

These include: 

  • Setting up a bursary or payment system to cover costs of travel and accommodation for the length of placements. 
  • Abolish college education fees of €3,000+ per year for students “training to work on the frontline of the health service”
  • Ensure parity of pay for nurses and midwives with all other paramedical graduates

A similar motion was defeated in a vote earlier this year.

The Taoiseach yesterday described this motion as “simplistic” and designed to be put on social media. 

“I understand what you were at last week, in terms of putting up a motion, put up the dashboard, go on social media and say ‘they don’t want to pay we want to pay’, that’s overly simplistic and you know it,” he said to Sinn Féin leader Mary Lou McDonald in the Dáil.

The government put down a counter motion outlining the current provisions in place regarding the €50.79 weekly accommodation allowance for some on placement among other measures.

Green Party TD Marc Ó Cathasaigh said on Twitter: “Everyone wants to do their best by student nurses, myself included, but this motion wasn’t the way to do it.”

What is the job of a student nurse? 

Student nurses complete their placements in a variety of different clinical settings. 

A second-year student nurse, Chloe Slevin, wrote a piece for TheJournal.ie last weekend saying: 

We are not just students, we are fully integrated into our placements and despite being a student, every patient I have ever met has called me “nurse”. I am sure you can imagine how strange that was to hear at 18, and it is still weird to me now. To my patients, I am more than just a student.

Last month, Richard Boyd Barrett spoke in the Dáil about student nurses who had reached out to him.

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“One second year nurse worked six weeks on placement. She worked four days a week in the Rotunda Hospital from 7.30am to 4pm,” he said. 

“She also had a job in retail at the weekend where she was being paid absolutely nothing. She worked two weeks in a gynaecology ward from 7.30am to 8.30pm and was not paid a penny.”

It is understood that student nurses in their fourth year 36-week placement are often included in staff rosters. This occasionally happens in other years of placement too. 

The INMO said earlier this year: “The purpose of a placement is to train the student, not provide extra resources to the health service.”

The union added that if the health service cannot provide proper training during the Covid-19 crisis, “then they need to change the status of students on placement”. 

The Taoiseach made reference to the status of students too, saying that nursing education has been designed so the nursing students receive a degree. 

He argued that it would be a backward step for it to return to an apprenticeship scenario where nurses would be in effect working in hospitals. 

“At the heart of this, it seems to me now is, do we want to protect the learning experience of nurses on the degree programme or not,” he said

I introduced it myself as Minister for Health and it was important in terms of giving a higher degree of respect in terms of the nursing profession within the overall hierarchy health itself.

“One nurse educator, the head of a particular college, said to me that this is critical from our perspective. Everything we fought for over the past 20 years is now at risk if we go back to thinking it is okay for nurse students to do every type of job in the hospital when they are meant to be learning,” he added.

What has the INMO said recently? 

The INMO is in talks with the government on the issue of student nurses not being paid while on placement.

In a statement this week, the union said: “The INMO and our student members are engaged in intensive discussion with government on the issues for student nurses and midwives. We will issue a further statement in the coming days once the next steps have been agreed with our members.” 

- With reporting by Rónán Duffy

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