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Placement system ‘too weak’ to support hoped for rise in student places


Suggestions that thousands more nurses would be trained under plans to scrap bursaries are misplaced due a lack of placements and mentors to support students, it has been claimed.

Nurse educators and former students said the current system of placements was “fragile” and would be unable to meet increasing numbers of trainees.

“One thing that is well researched and well understood is that the placement system is fragile”

Kate Brown

In its spending review at the end of last year, the government announced proposals to end free university education for student nurses in England and instead introduce a loans-based system from 2017.

Chancellor George Osborne claimed the move would allow universities to provide up to 10,000 extra course places for nurses, midwives and allied health professionals by 2020, because they would no longer be restricted by how much government funding was available.

But during a debate on the plans – hosted this week by London South Bank University – a series of concerns were raised about placements, with one former student claiming the current system “doesn’t work”.

Robert Waterson, a newly-qualified staff nurse at Guy’s and St Thomas’ NHS Foundation Trust in London, said: “You have some placements where you’ve got a huge array of students from different universities fighting for time with a mentor or nurses. So something needs to be done.”

“At the moment we haven’t got enough staff, and within that we haven’t got enough mentors. When you can’t retain staff how are you going to train them to become mentors?” he added.

Mr Waterson suggested government decisions to cap nurse pay rises to 1% were partly to blame for retention problems.

Nurse educator Kate Brown, also at the debate, described the required increase in placements to support the expansion in training places as “mythical”.

“One thing that is well researched and well understood – certainly every university in London knows – the placement system for nursing is fragile.

Elisabeth Jelfs

Elisabeth Jelfs

Elisabeth Jelfs

“Even [with] this great proposed expansion, given the current number of hours [for minimum practice hours] specified by the Nursing and Midwifery Council there isn’t this mythical huge potential for expanding number of placements. So it’s dishonest,” she said.

Elisabeth Jelfs, director of the Council of Deans of Health, which represents faculties of nursing and midwifery across the UK, agreed there was a “huge” amount of work to be done around placement capacity.

However, she said these problems were not being experienced across all regions of the country, suggesting nurse trainee numbers would be able to increase – but not in all areas.

Following a protest in December, student nurses are planning to gather in London for a second time on Saturday to demonstrate against the government’s plans to end free university nurse training in England.

In addition, a debate is scheduled to take place on the issue in the Commons on Monday, after a petition on the parliament website reached the necessary threshold to trigger its discussion by MPs.


Readers' comments (10)

  • I can't believe it!!!!! This was so obvious from the start. Although your report says that not all hospitals have this problem it's a real issue for the majority. Nurses are working overtime to cover the lack of staff, the last thing that they want to take on is mentorship and all that involves on top of every day survival. The responsibility that the mentor has for the awarding of the student's qualification is also something to remember and increasing the student numbers is just not feasible.

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  • Way back when, I used to enjoy having a student or recently qualified to mentor. Then it became nothing but a chore to add to my ever-increasing workload. The paperwork required was repetitive and lengthy. I don't know about other universities, but we couldn't just write that the nurse had achieved the goal required with a short paragraph, we had to write along the lines of 'Susan was confident and kind when she approached her patient. Susan remembered to close the bed curtains and at the same time maintained eye contact with the patient. Susan gave a thorough explanation of the procedure and allowed time for any questions and gave positive reinforcement etc etc etc etc' and on and on and on. This method apparently made it more 'personal'. To me it looked like the ramblings of a 5 year old's first composition.
    It could take over 2 hours to fill a journal in and I'm afraid that we just didn't have the staff to do it properly although we tried our very best.
    There is a noticeable lack of clinical educators who come to the ward to work with the student and if a senior nurse on the ward is given that responsibility it takes away an experienced nurse from the bedside.

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  • As a Return to Nursing Practice student, I have first hand experience of the fragility of the placement system. My university with a cohort of less than 20 students has had exceptional difficulty placing us for our practice hours. Indeed some students have still not had a placement allocated with less than a week to go before their placements were due to start. Quite how the government think we can train more nurses and midwives whilst the numbers of mentors and the availability of placements is so restricted beggars belief. It's just another indication of how little the government actually understands what's going on in the real world. When will they actually listen to people who know?

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  • Never a problem in the past. What has changed?

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  • I have just completed placement hours on a return to nurse practice programme. Despite all of the pressures of workload and having enough mentors I have nothing but praise for the area where I was placed. I learned a lot from the placement my mentor was supportive and staff very welcoming and appreciative of my involvement on the department.

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  • As experienced nurse with over 30 years experience working in the community. It is so obvious that the system just cant cope with more students but more importantly neither can patients and their families!

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  • Cameron doesn want to train nurses it is cheaper to recruit from those already trained abroad and replace trained nurses with health care assistants, soon health care assistants wont get any training and it will be volunteers working 24/7 , hunt and Cameron despise the nhs

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  • along side this there are those of us pre-planning our retirement after 40 yrs service to mankind. I have really enjoyed my career as a nurse but it is a tough dilema. there is so much skill and talent and dedication. We need to nuture and pass on all we can to our keen students. The end of the bursary may omit a pool of talent which will be a shame .we will just have to wait and see.

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  • Universities need to employ clinical tutors for the workplace, to expect workplace staff to undertake this role when the University is being paid to educate is WRONG. Remove the burden from the NHS or pay them for the service they provide. Providing students with a good clinical experience usually comes out of the nurse's own time to mentor and complete paperwork. This can be a significant workload in areas that take significant amounts of students.

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  • I am a first year student currently on my first placement it's been a tough and emotional rollercoster. I feel having someone in practice specifically to train students would be great for us and the next generation bcz ima at the end of my placement and only worked with my mentor a few times which is devastating.
    Sometimes I feel like ima being ignored but it's that they are extremely busy and have to balance yur needs and those requiring care is challenging I guess.

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