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No bursary, no problem? 
The challenges and changes that face us


Questions bounced around the lecture theatre full of student nurses in 2016, “What does this mean for us?”, “I wouldn’t have done the nursing course if I could get paid to be a nursing associate” and “who will be responsible for them when they do meds?”

A year on and the nursing associates are several months into their journey of being employed on a ward, with one day a week in university for their foundation degree.

Once qualified, they will likely have a PIN number and be able to administer all drugs except IV routes. Nursing associates will be paid an increasing wage throughout their training on a specific ward and become a band 4 practitioner once completed. 

Another change from September 2017 is that student nurses and midwives will now pay £9000 a year to train, as NHS bursaries are sadly a thing of the past. These cohorts will qualify with a £22,150 annual full time salary and approximately £30,000 of debt.

Many will not finish repaying the debt in full, with the last £7000 being wiped at the thirty year cut off. Others if part time may NEVER even meet the threshold for any repayments.

“It is vital to remember that fear is a natural response to the unknown.”

Many universities are doubling their yearly intake of fee paying students, with cohorts up to three hundred students, increasing the pressure on lecturers, placement administration and mentors themselves out in practice.

To manage this the NMC is making mentoring compulsory for all qualified nurses and midwives, which may cause concern for students who have already been through the daily/nightly dreads of working alongside a reluctant or cold mentor.

Nurses, regardless of whether their training was as an enrolled, diploma, project 2000 or undergraduate degree level nurse, will probably feel that their way was the right way.

We may all question why higher powers are interfering in the well-oiled machine that is the ward or community team, but it is vital to remember that fear is a natural response to the unknown, and nursing and midwifery is ever evolving alongside the scientific and holistic research that underpins it.

“This light we hold is challenged every day with increasingly poor staffing levels and the huge loss of experienced health professionals leaving the register.”

If we never changed anything, we would not know what worked and what did (and we may still be using egg whites and oxygen to treat pressure ulcers!). Without change, we would not know that with every 10% extra nurses that are qualified to degree level there is 7% reduction of patient death and we would not be able to welcome back the enrolled nurse, in the guise of the nursing associate.

I can understand how bursary-funded students may feel worried about the nursing associate role overlapping with theirs. Many have dedicated their lives to the course; leaving loved ones, pets, homes and decent salaries behind just to get their PIN.

With the increasing £££ racking up in my Student Loans Company invoice from previous study, I would have loved the idea of working and earning. (Perhaps I could have squeezed in a social life too on the side? What a luxury!).

“It is essential to remember that our spark will shine much brighter if we fully embrace change.”

With so many changes happening in the NHS, it can feel that what we know as ‘solid’ is suddenly slipping through our fingertips. Yet we must not forget that we are all united in our goal: to reduce suffering, to keep those we care for safe and to provide a glimmer of light in their days (and no doubt many, many nights..).

This light we hold is challenged every day with increasingly poor staffing levels, a growing population who are living longer with greater needs, and the huge loss of experienced health professionals leaving the register.

It is not a time to let new roles or ways of learning divide us.

You cannot truly learn to be a nurse, nursing associate or midwife, it is a vocation and part of your soul.

Therefore it is essential to remember that our spark will shine much brighter if we fully embrace change, and welcome new practitioners in whatever form. This way, they too have their chance to shine and become a part of the health teams that humbly and silently prop up society; 24 hours a day, 7 days a week.




Readers' comments (3)

  • Anthony Johnson

    Sorry but I totally disagree. We should fight for what's right not put the best spin possible on an awful situation. The taxpayer, including nurses, will pay for the student loan debt which is wiped off so it's bad no matter which way you look at it.

    Nursing Associates should be funded to become RNs and we should be paying all students for the time that they work.

    Most important of all, Nursing is a profession, not a vocation. The government will continually try to beat us over the head with Florence Nightingale if we let them. She, and nursing, have been framed as angels, the lady with the lamp, the ethereal nurse. It's that attitude, of calling us a vocation, that lets us be treated like dirt because we don't deserve the same rights as other professionals. Nursing needs to remember it's power as the largest voice within the healthcare arena.

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  • Hi Anthony,

    Thank you for engaging with the article. Just to explain, I purposely avoided commenting on the wider social and political issues regarding nursing, as I completely agree that it is a diabolical situation but I am limited to 600 words and the subject is huge. I completely agree we should be funded and we should be completely supported and respected. I also feel it's key that we attend rallies and make sure our voices are heard for these changes, as I do as often as I can.

    In terms of vocation, that is something I believe shines through when you work with nurses, or anyone who is truly passionate for helping others. In no way do I feel this should enable those to take advantage of our kindness, and I am personally close to very good people who have become burnt out by current affairs to do with nursing, so I am not unaware.

    However, the theme for the article was for a brief discussion from the perspectives of what students nurses may have seen or may now see, in terms of changes and challenges in practice and university. It was not based upon my own wider, political views. I wanted to briefly explain/discuss what is happening for first year students new to reading SNT, reassure student nurses of their role, whilst also welcoming the new faces of nursing associates as highly valuable members of the team.

    I wanted to press the importance of being united. As you said, we are more powerful as one voice.

    Thank you for reading :)

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  • I am currently studying to become a Nursing Associate.I was previously a healthcare assistant and welcome this opportunity with open arms, it is a huge step for me personally and professionally. I agree there are many challenges in healthcare, and think all options to ease pressure should be taken into consideration and people should have an open mind. There is much controversy about the role, and I have had many rude comments to my face, and mentors unwilling to take the time to help me learn as they disagree with the role.This does upset me, but at the end of the day I am working at providing patient care, same as us all. I do agree all nursing students should be paid for their work and feel lucky that I am. The NA role is not fully set in stone and has no scope of practice yet and so people should wait to find out what it encompasses before passing judgement and complaining. I do understand RN's may feel invalidated by it but they are being paid more for their work and ultimately have more responsibility, and the NA role is designed to relieve some of the pressure put on them. I am excited about my new role and am waiting to see how it will work out.

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