Student nurses: ‘I will never be able to explain the feeling of having to leave a dying man alone’
Students give their views on pay and conditions during the Covid-19 pandemic
‘Every time I enter a room I have to wear full PPE and if I come out of that room even for a minute I have to take that PPE off and put on new ones.’ File photograph: Paolo Salmoirago/EPA
The issue of pay and allowances for student nurses and midwives has been the subject of discussion in recent weeks.
Minister for Health Stephen Donnelly has started a short-term review, expected to be completed by the end of December, of the allowances paid to student nurses in first to third year, and any increase in allowance will be paid from January.
First-, second- and third-year nurses are not paid and are eligible only for a weekly €50 accommodation allowance.
A longer-term review is under way into payment of fourth-year students who work in their final year and are paid for 36 weeks between €21,000 and €22,000.
The Irish Times sought the views of student nurses on the subject. These are a selection of edited responses.
Fermoy, Co Cork
I’m a first-year nurse and am just finishing my first placement. I have really enjoyed my experience so far but it has been really tough. So far I have washed and fed patients, emotionally supported them and have been on the ward as two patients have died. I’ve received sexist and hurtful abuse from patients. I’ve worked 12-hour shifts back to back and been so tired I’ve been physically sick. Every time I enter a room I have to wear full PPE and if I come out of that room even for a minute I have to take that PPE off and put on new ones. I am putting my life at risk to care for patients. I am being exposed to patients who likely have Covid-19. I have taken out cannulas and catheters, changed bandages and often at times done the work of a healthcare assistant. I have had so much support from staff nurses and do not condemn them at all. Leo Varadkar’s comments about student nurses just being “another body” on the wards was really hurtful. I’ve done so much already and I’m only a first year. If the Government can get hefty pay rises on top of their already decent wages, why is it so ridiculous for student nurses to ask for the bare minimum? Almost every other college placement/apprenticeship in the country is paid, so why are student nurses so “unworthy” to the Government? We don’t want the Government’s pathetic claps of appreciation. We want them to take some responsibility. We want some compensation for caring for the people of this country. We want some basic respect.
Ardee, Co Louth
Since I commenced my nursing studies in 2017 “sure we have the students” is a sentence I have commonly heard. Staff members who are sick or off on leave are very seldom replaced when a student nurse is on placement. I have had my own case loads, attended to all kinds of personal care, assisted with caring for someone at the end of their life and the deceased after their passing. Dealt with and supported families when needed. Completed full admissions. And that’s before I even touch on the alternative accommodations which I have had to avail of when going on placements as some are too far from home to commute to and from. I have worked 72-hour weeks in healthcare settings between my part-time work and placements. Generally more part-time work when on placement so I can afford to get to and from.
We are only slaves. Every job nobody else wants is put in your schedule. Mopping all the floors, cleaning toilets, windows, handles, day in day out. Disinfecting rooms, drawers, lockers, all surfaces.
Student nurses have to go where they are sent that could be Wexford, Enniscorthy, Kilkenny, Tipperary. They may have to move from one to another all of which costs.
I’m in psychiatric nursing and some experiences I have had while on supernumerary clinical placement, I very much was working. I was once on a placement living away from home. The shifts were close to 13 hours long. We had an elderly man who was dying. He had no family. I sat with him and held his hand. It was so busy and we were short staffed so I was called away to do another job. (This is work, not education). I couldn’t stop crying. The team were brilliant and comforted me. But I had to explain that I wasn’t crying because he was dying. Dying is sad of course but dealing with it is part of my job. My job is to make sure that the person is as comfortable and pain free as possible. I was crying because he was dying alone due to us being short staffed. I will never be able to explain the feeling of having to leave a dying man alone. It goes against everything in me as a nurse and a human. I got the job that I was called away to do done and made it back to the man at 7.14pm. I held his hand before timing his death at 7.17pm. I finished my shift at 8pm and went back to my accommodation. I got up the next morning and worked another 12-plus hours unpaid.
We see how short staffed these areas are, how stressed the nurses are. It isn’t their fault that they are short staffed and we are having to take on extra responsibility. This issue has been going on a long time, Covid-19 only highlighted it. I’m not only disheartened but also have lost faith in this Government now that they have both backtracked on supporting us and within the same week give other Government members a pay rise even though they are already on a substantial wage. Claps do not pay the bills and to be honest we don’t need or want the recognition. The best recognition is when a patient or patient’s family member says “thanks nurse”. However, to continue to get to these placements and afford food, we can’t survive off of nothing. I am just one of thousands, which is why we need the Government to keep their promise in supporting us. For me personally, I have support from only one parent. I worked multiple jobs while studying full time and attending placements for the first three years of my course. Outside of college/placement I work as a support worker in the areas of mental health, intellectual disabilities and childcare. I earn €14/€15 an hour. From January – September I will work as an intern nurse where my workload and responsibility will double. Yet I will be taking a pay cut, earning less than €11 an hour with every one of my placements in a different county to where I live, all while still in the middle of a pandemic. Are student nurses and midwives not worth the investment? Are me and my fellow intern nurses and midwives not worth the same €14 an hour that a healthcare assistant gets, the same pay that the government granted back in the first lockdown? I went into nursing not only because I care and want to make a difference but because I wanted to give back to the Irish services and to my country. But what do I do when this same country doesn’t support or value me? It’s very difficult for me to accept the harsh reality that I would be better off going abroad when qualified.
I am a third-year general nursing student who has had to work for the past eight weeks in a Level 5 lockdown in the emergency department, the ICU and as a public health nurse. As my mother is immunocompromised, I haven’t been able to see her for months and this has been extremely challenging and an isolating experience for me. As student nurses we are supposed to learn from another staff nurse known as a preceptor who acts as a mentor and is there to teach the student nurse, although this simply does not happen as the staffs on hospital wards are so understaffed that student nurses must step up to the task and fill these huge gaps doing real work alone. As a student nurse, I have to pay €300 a week for accommodation out of my own pocket on top of my €3,000 a year fees and work on wards with Covid-19 patients and rarely get any type of supervision. I have never been able to take an evening break and have been asked to stay on later than 8.45pm when my shift was supposed to end in order to take patients’ vital signs and assist patients with complex needs. I have worked until my feet have blistered and bled and have had scars on my face from wearing PPE. I wouldn’t get home until 10pm where I would have to work on college work and assignments and then get up at 5am and do it all over again. I would often cry from the level of exhaustion and stress that I was constantly put under. Although I am passionate about nursing and helping others, like many of my colleagues I will be emigrating to a country that will respect me and pay me a living wage for the work that I will carry out as soon as I get the opportunity. The question nursing students now ask each other is ‘Where are you travelling to?’ Not if ‘You are going to travel?’. I have held patients hands in their final moments and comforted their families, I have been punched, spat on and verbally abused. I understand that other courses also don’t get paid for their practice placement although I truly believe it’s rare to have the level of exploitation seen among other courses where you are in such extremely close contact with Covid-19 patients and risking your life.
I have to ask do they really think it is acceptable to have young students working 35 hours completely unpaid during the worst pandemic of our time risking their lives and that of their families and being completely burnt out and disillusioned before they even begin their careers? Student nurses will never forget the actions of this Government and the exploitation that has occurred and continues to occur on a daily basis in the Covid-19 pandemic.
I was placed in a different county for two weeks back in September, with only one-week notice. I had originally hoped to stay there due to the distance and the time it would take to get there but the accommodation allowance for the week wouldn’t have covered accommodation for even one night. So I commuted over two hours a day and not only has the travel allowance not cover the full cost of my train ticket but I am still waiting to see it three months later. The staff there were excellent, the issue is not with the staff, not with any individual but with the system. Why should I be paying to work for free? Placement is an excellent opportunity to learn but it is hard to do so when you’re being used as surplus staff. On the ward your constantly moving, someone always needs assistance, 12 hour days on your feet constantly on the go, trying to help where you can and make life a little easier for somebody else. When you try to sit for a few minutes on the ward to read a case file or write some notes the bell goes and you’re up again or somebody’s asking for your help. When the nurse is on lunch or in another room doing writing or setting up medication it’s us that are there with the patients, fulfilling their needs and reporting everything back. Patients want our support, our reassurance, they want us to be there for them when they need it and we are, we would go above and beyond for them. We need our government to be there for us.
As someone who has completed an apprenticeship as a plumber and is now a third-year student nurse there are a few things about the recent discussion that have annoyed me. The first is the view that by paying nurses during work placement it will set them back and make them apprentices again. What people need to remember is that apprentices are paid while working and during their block placements. No one is making the argument that nurses should be paid while in college or university. Regardless of pay, nurses will still be required to complete a Level 8 degree in four years so that point is moot. The second point is that of people who think student nurses are not supposed be working while on placement and that they should just be shadowing a nurse. The whole point of placement is hands-on working practice. Student nurses work the same hours as regular staff and carry out most of the same duties. If people think that students shouldn’t be paid then fair enough but don’t cheapen what they do or how hard they work by saying there isn’t a requirement on them to work as part of the team while there. How else are we to learn if we are not exposed to carrying out our duties in realistic conditions? We are expected to be able to make informed decisions be it first thing in the morning or 12 hours into a shift when we’re tired.
Lesley Anne McLoughlin
I am a mature psychiatric nursing student in my fourth year, starting as an intern in January. I have three children and I worked as a healthcare assistant for seven years before deciding to pursue my nursing degree. I will have a considerable wage cut when I finally qualify next year. This is my main concern. I have been working through the pandemic. I tried to change my placement hours last year and when I asked it couldn’t happen because the ward was so short and I was making up the numbers on the ward. I believe 100 per cent that third year students and fourth year students should definitely be paid. I also believe that when we qualify that our responsibilities outweigh that of a healthcare assistant especially when you qualify with previous healthcare experience. Our starting wage should be reconsidered.
In September 2017, I started my path on the journey to becoming a nurse. I started a nursing degree as a lone parent of three with full fees to pay due to being a non-EEA national and not being eligible for Susi or other financial supports. I have now made it to fourth year of my nursing degree. I have paid nearly €8,000 in college fees every year since 2017. I have worked so many jobs to get me to where I am now, these jobs were all in healthcare through recruitment agencies to pay for my fees and to financially support my family and I throughout my studies. Unfortunately, earlier this year while working in a hospital I contracted Covid-19 which resulted in many weeks without work or any State support.
I have worked so hard to get this far. I love nursing, I am a caring and empathetic person and finishing my degree would be life changing for my family and I. I believe the pay and allowances for student nurses has to change.