The exploitation of student nurses
In a conversation with a friend a few weeks ago, he implied that student nurses are lucky because they don’t have to pay for their qualification, as opposed to other university students. Although he wasn’t coming from a Marxist perspective he was at least right in one aspect, all education should be free education. But there are massive differences between academic courses and apprenticeship-like courses, where you are essentially in training for a job. Not to mention that I am actually one of the lucky ones; if you were studying degree level nursing (as of 2013, you don’t have a choice as all nursing graduates have to go through the degree programme) then you would have to pay it all back. We (student nurses, whether diploma or degree) work 750 hours a year unpaid – where we are supposed to be supernumerary, and this is to aid our learning process. Obviously it is necessary for us to spend time in the hospitals if we want to be nurses, and the amount of time spent there is not the problem, it’s the way we are used whilst in clinical practice. Effectively as Health Care Assistants, but unpaid, so in a way you could say we (diploma students) are paying for our qualification with this. It is hard to justify a degree student nurse paying all tuition fees and everything else whilst also working 750 hours free labour a year just so she can qualify. Nursing is supposed to be one of the most important jobs according to the government, yet they expect us to pay for our qualification and work for free?
As a lot of student nurses were working as HCAs before coming into their training, you can imagine how now working as a HCA for free whilst gaining little extra knowledge feels. Amongst student nurses there is a lot of animosity towards our mentors who are registered nurses aiding and scoring us on the wards – either they ignore us, make us feel like an inconvenience or we can never find them. During student feedback sessions the question is often asked ‘why did they bother taking the mentor training?’(because they work in a teaching hospital and it is attached to a promotion) but the real question that should be being asked is how are they expected to deal with the exact same patient case-load as before but now teaching and letting a student try out new practice? It seems like the more you bother your mentor about signing off your competencies, the more she seems bothered by you and is reluctant to sign things off in bitterness because you’ve made her job harder. Whereas if you are helpful to her by picking up the slack of things she’s too busy to do and which you are already competent in, such as bed-making and washing patients, while she gets on with the things only she can do such as medications and blood transfusions, the ward runs a lot smoother and she’s more happy to sign off things for you- whilst you’ve not actually learnt the new skills. And I don’t have to stress how dangerous this is!
Although obviously the main reason for students being used as HCAs is due to under-staffing of nurses and HCAs on the wards, as are most of the problems you would encounter on a ward. Some hospital staff try to ignore this or pretend it’s not true, and seem oblivious to the fact that students get treated as HCAs. At one point one of my previous ward managers came over to me and two other student nurses and asked if we were working at the weekend. We all said no, he then gave a massive sigh and asked one of the staff nurses to ring for a bank HCA this weekend. Of course he is simply trying to deliver good patient care whilst keeping his job and stopping the ward from closing due to new financial pressures. This to me was a very obvious depiction of how hospitals and wards are run like businesses, and students work as unpaid labour in the hospitals. These conditions are only going to get worse with the new health care bill, which puts even more demands on staff and targets for wards which if not met incur financial penalities. Which then results in even less money for the ward/hospital, and more cutbacks in staffing, essential equipment and medications for patients.