More nursing students share concerning training experiences

More nursing students have come forward with concerning stories about their degrees and clinical placements.

Some described driving long distances to unpaid hospital placements, and having to cover the cost of their petrol, parking, uniforms, and food.

Health Minister Andrew Little told Checkpoint last week he would consider payment for third-year nursing students. 

But some nursing lecturers said the number of students graduating their degrees and entering the stretched workforce would not improve without greater financial support throughout their entire degrees.

Second-year AUT student Olivia* knew she wanted to be a nurse since early in high school.

After a challenging couple of years studying, she was still determined to pursue the profession - but was definitely not staying in New Zealand post-study.

"Some of the nurses and healthcare assistants are the hardest working people you see, and they're continually not prioritised. I've had enough of it."

AUT's nursing degree was fulltime, and the university said it was challenging to have so many students fitting study around other work.

But throughout her degree, Olivia had worked three jobs just to support herself and pay for the petrol, parking, and uniforms she needed for her clinical placements.

With a student loan of $30,000 - and one year to go - she said cutting down her hours was not an option.

"When I'm not on placement, I'm basically putting myself down for as many hours as I can at all of these jobs to try to earn enough money to save and pay my student loan, pay for my rent, and support myself throughout my placement."

Olivia said when students raised concerns about their workload, the response from AUT had not done anything to reassure them.

"It's a constant battle. Nobody listens to what you have to say, and if they do, it's normally met with pretty belittling arguments such as, 'You expected that when you signed up for nursing', or 'This is what nursing is - harden up'."

AUT responds

In a statement, AUT said it provided support for its students, but said the students who had shared their stories with Checkpoint in recent weeks had not taken up opportunities to engage with staff, such as monthly meetings with programme leaders.

Dean of health and environmental sciences Fiona Brooks said the nursing school was arranging a meeting with students to work through their concerns.

"There are multiple sources of support - we will discuss with the students when we meet and try to understand why they did not access them in their specific cases."

Nursing staff members would report back to Brooks after this meeting.

Asked whether AUT would investigate ways to improve its communication with nursing students, Brooks said the university was always looking to improve and would discuss this in the meeting.

Figures supplied by AUT showed that of the 1085 students enrolled from 2017-2019, just 612 had gone on to complete the degree by the end of 2021.

Brooks said the number of new nursing students each year did not correlate directly with the number of nursing graduates three years later.

"Some students start in Semester 2 and complete a fulltime course in the fourth year, and some students study part time or take a break in learning.

"Also, the number of students enrolled varies year to year."

According to the Organisation for Economic Co-operation and Development [OECD], just 39 percent of fulltime students entering a bachelor's programme graduated within the theoretical duration of the programme, of three years.

The average completion rate after three additional years increased to 67 percent.

Brooks said that by 2021, 68 percent of nursing students from AUT's 2016 cohort had graduated.

She said about 86 percent of nursing students completed the academic elements of their course, but said that other life circumstances and financial factors could impact their graduation.

"AUT colleagues are part of a national nursing pipeline group addressing the challenges facing the sector, and we know the issues of retention in programmes are a sector wide issue in New Zealand and internationally."

The Nursing Pipeline had released reports showing that of the students enrolled in a bachelor nursing programme between 2010-2017, about 29 percent had not yet completed the course.

Across different education providers, assumed attrition rates ranged from 18-47 percent, with the majority (57 percent) leaving in their first year of study.

Tutors speak out

Registered nurse Susan* worked as a clinical tutor for a year.

She only lasted that long because she could not bear the pressure students were put under, she said.

"There were some students who were bullied in placements, and in fact I had to withdraw students from that placement because they were being shouted at."

Susan said nursing schools did not understand the immense workload they were giving students during placements, and still expected them to prepare for exams and complete assignments - with zero tolerance for late work. 

The system had to change, with more alignment needed between the academic side of study and clinical work, she said.

But most importantly, students needed payment for their work on placements, Susan said.

"I understand that workloads are very heavy in public hospitals, but that is no excuse for exploiting people."

Pipi Barton, a senior nurse lecturer at Northland Polytechnic and PhD student at AUT, has been researching strategies to grow the Māori nursing workforce.

She had interviewed students across New Zealand and said economic hardship was their number one issue.

Barton said the high rate of attrition among nursing students was linked to the financial struggles they faced throughout their degrees.

"Seriously, we need to be looking at investing right from the word go.
"As soon as a student decides that they want to join the nursing programme, they need to be paid."

Minister of Health Andrew Little told Checkpoint nursing students should get some form of support during their final third-year placements.

However, he could not yet commit to details on how much and by when.

*Some names in this report have been changed.