STUDENT NURSES MADE headlines last month after the government voted down a Dáil motion that would have seen them paid for placements during the pandemic.
The motion called for the reinstatement of a payment given to nurses and midwives on clinical placement during the Covid-19 pandemic, among other measures.
During the initial phase of the pandemic, many student nurses acted as healthcare assistants to assist the sector and were paid for the work they did. However, this arrangement is no longer in place.
First, second and third year trainee nurses – who are required to work a sufficient number of hours as part of degree courses to become qualified – are not normally paid for their work. Fourth year nurses are paid, but at a reduced rate.
Tánaiste Leo Varadkar told the Dáil after last month’s debate that a review of student nurses’ allowance was under way and will be available in September.
The Taoiseach also described the motion at the time as “simplistic” and designed for social media.
The issue was raised again during a debate in the Oireachtas last week, when Opposition TDs read the experiences of some nurses into the Dáil record.
Many student and full-time nurses had previously contacted Health Minister Stephen Donnelly’s office directly. Copies of these emails have been released under the Freedom of Information Act.
They sought to highlight the type of work student nurses do as part of their educational placements, with some describing the long hours they spend juggling part-time jobs and travelling to placements for no pay.
Some sought a reply from the minister or an acknowledgement that he had received their emails, but a response to a query by TheJournal.ie to the Department of Health did not clarify whether this happened.
A spokesperson said that the Chief Nurse’s Office had read the emails and was planning a number of engagements with student nurses and midwives to address some of the issues raised.
“We take any allegation of exploitation or unfairness very seriously, so an independent view was also sought on all the letters,” a statement read.
Here are some of those nurses’ stories and what they told the Minister for Health in their own words following the debate about students’ pay. Some pieces of correspondence have been edited for length.
Warning: Some readers may be upset by the graphic nature of these stories.
“My name is [redacted] and I am a general qualified nurse. I’ll never forget how difficult the four years were when I began my nursing career, working a 37-hour unpaid placement then travelling back home to my part-time job at the weekend to help ease the financial burden of my parents putting me through college.
“I want to ask you why you voted against student nurses and midwives receiving payment during their training?
“Although it was very difficult while I was training and often I wanted to throw in the towel, it’s nothing compared to what these young men and women are now facing every shift.
“I was 18 when I held the hand of my first patient while they passed away, a patient I will never forget. However, student nurses of this era are facing it on a daily basis.
“I’m on the front line and student nurses were redeployed to my unit and faced Covid head-on, but never once complained and were absolutely kind, caring and compassionate towards the patients in their care.
“Nurses in this country are historically treated unfairly by our government. It is demoralising that we are commended in the Dáil by politicians, but when a salary for student nurses is suggested, it is voted down and only a clap will suffice.
“I want to know why student nurses and midwives do not deserve a salary? We are the ones who are present at the start of a patient’s life, and will be there at the end to provide comfort and care.”
“The issue of exploitation of student nurses is not a new one but with the additional staff absences because of Covid-19, the problem has increased ten-fold. Now more than ever, student nurses are being used to bridge gaps in the poorly staffed hospitals.
“This is not education. Teaching opportunities are few and far between the staff nurses are simply overwhelmed.
“To fill these shortfalls in staff, we are often asked to do tasks associated with healthcare assistants as opposed to staff nurses.
“On placement, we are supposed to be continually learning and progressing our skills, but this is impossible when we are being used as an extra pair of hands.
“We are not learning, Minister Donnelly; we are working. Not only are we not getting paid for this work, we are paying upwards of €4,000 a year to work. It feels extremely invalidating to get home from an intense 12-hour shift and get told my work is not ‘real work’.
“To call what we do educational is completely untrue.
“Covid-19 adds an extra complication to the whole situation. Not only are we working, we are doing so in a very high-risk environment.
“It is unfathomable that we are expected to risk our health and that of our families and receive no compensation. Due to the risk of cross contamination, many of my classmates have been forced to quit their jobs, leaving them unemployed.
“All we are asking is that we are compensated for the hard work we are doing. On placement we are not being treated as students; we are being treated as employees and if that is the case, we want to be paid and respected as such.”
“I want to share with you an experience I had while on supernumerary clinical placement, where I was very much working.
“In first year, in my first ever clinical placement, I recognised that a patient of mine was not looking well and carried out a set of vital signs, indicating that she was indeed suffering from a heart attack. I called on my preceptor, who contacted the emergency resuscitation team and participated in CPR, as this heart attack lead to cardiac arrest.
“I held this patient’s daughter in my arms as she cried for her mother to be okay. I was later informed by one of the many doctors who ran to help this patient that if I had not acted so promptly, this scenario would have had an unfortunate outcome.
“I, a student nurse, helped to prevent a death on my first ever clinical placement.
“In second year, I participated in two weeks of maternity placement. I watched lives enter the world and families grow. However, I unfortunately saw huge disappointments too.
“While my preceptor attempted to listen to a foetal heartbeat, she noticed there was no movement or heartbeat. I delivered the most heartbreaking news to the parents of this foetus, that their baby was not alive any longer.
“I had to tell somebody that their baby was dead, which greatly impacted my mental health and made me feel very ill.
“In third year, I voiced an opinion on a paediatric ward that I thought that a child was being abused. The child presented with burns that looked as though they had been dipped into boiling hot water. I thought this was suspicious, and sought help and advice.
“This was a scary thing for me to do: to potentially accuse someone of abusing their own child. I voiced this opinion to a staff nurse, who helped me in discussing this topic with the parents of this child, the child themselves and a multi-disciplinary team.
“Unfortunately, it turns out that my opinion and gut feeling was right; this child was sadly a victim of domestic abuse and was later referred to a social worker.
“I, a student nurse, prevented a child from being abused further and potentially saved their life.
“This year, at the beginning of the pandemic, I was on a renal ward. This ward was incredibly short-staffed. One day I arrived to placement, and completed one of the most challenging days of my life.
“I was left in charge of an ‘observations room’, where patients on the ward who need to be monitored closely stay. I was responsible for everything to do with these four patients, including medications which I am not allowed to administer, so had to repeatedly seek help when carrying out this task.
“I was responsible for Patient A, a man who had his left leg amputated, who was on dialysis (which I had no training in), who was a type-2 diabetic, and who loved sweet and sugary foods. He was being monitored due to the risk of injury and of hyperglycaemia.
“Patient B was a man who had COPD, a chronic lung disease which left him gasping for air, clutching his chest and looking at me willing me to help him because he was so breathless that he could not speak.
“Patient C was a man with an intellectual disability, who loved to wander the ward, who did not have a healthcare assistant to stay by his side, and who became physical with me, punching me when I asked him to sit down, leaving a bruise and scratches on my arm.
“Patient D was a lady who had a fall down her stairs as a result of alcohol consumption.
“This lady was involved in domestic abuse and was living in extremely poor conditions. Her Glasgow coma scale score [used to communicate a patient's level of consciousness] was 7/15 indicating serious cognitive impairment.
“She also became violent when her cognition returned slightly and she repeatedly attempted to climb out of bed, even though she could not walk because she had suffered brain damage.
“Can you please explain to me how this day alone does not qualify as work?
“I have participated in situations where I have prevented death, brought life into the world, pronounced a person’s death, taken on my own patient load, and performed invasive procedures.
“I’m pleading with you to consider me and the thousands of other student nurses and midwives who are working on wards, delivering heartbreaking news, and completing the tasks that qualified nurses are doing.”
“At the beginning of the pandemic, many student nurses from around the country stepped up to help reinforce our health system from the threat of Covid-19. We left our part-time jobs and headed for the frontline to work as healthcare assistants while everyone was trying to keep themselves and their families safe at home.
“We answered the call when Ireland needed us most. Now that we are back to college, we are no longer superheroes: we are simply ‘just students’.
“As student nurses, we are responsible for our own patients. We measure vital signs. We give them medicine. We carry a huge responsibility on our shoulders.
“We carried none of these responsibilities when we worked as healthcare assistants during the summer, but now we are expected to carry extra responsibilities for no pay.
“We wash our patients, we help them eat, help them dress, measure their vital signs, give medicines, change dressings, help them go to the toilet, pray with them, admit and discharge them, and write notes.
“We are rostered for 13-hour shifts and if we are lucky enough to get a lunch break, we take it opposite a staff nurse so that there is someone to care for the sometimes 13+ patients under our care.
“Tell me that our placements are ‘purely educational’. We shouldn’t need to depend on the Pandemic Unemployment Payment that was offered to us to keep us quiet.
“If we are being treated like this as students how does anyone expect us to stay in this country once we graduate? Will we be treated like this as staff nurses too?
“We have earned respect, now please treat us with respect.”
“I want to share with you some experiences I had while on supernumerary clinical placement where I very much was working.
“I have completed numerous rounds of vital observation takings, in which I have discovered my patients are vitally unwell and required an escalation of care.
“I have assisted countless patients with their toileting and hygiene needs, including catheter care and stoma care.
“I have held my patients’ hands when they receive bad news and cannot have their family members and loved ones visit due to this horrific virus.
“In all of my time spent as a supernumerary student, every single patient has called me ‘nurse’. Not once did they refer to me as their ‘student nurse’. To them we are more than that.
“We are the people they see when they wake and the people they see before they go to sleep, day in and day out.
“I have come home from placement on numerous occasions crying, wondering if I did enough for them or if I had forgotten to do something, even if it was a simple as a fresh jug of water or fixing their pillow.
“I have worked seven days straight between clinical placement and my part-time job in order to be able to afford this ‘privilege’ of a protected clinical learning experience. This has left me physically and mentally exhausted.
“I receive €20 for travel allowance for my clinical placement, which doesn’t even cover the price of the train ticket I need to get each week to go to work back home and get me back to the county in which I undertake my placement.
“It is not the money we are fighting for; it is the chance to breathe and not to worry where the funds for our next lunch or bus fare will come from.”
“For the past three years of my degree, I have worked relentlessly. I have come home absolutely shattered, day after day.
“I begin a typical shift by waking up at 6am, and leave my accommodation at 6.35 to walk to my placement, as I can’t afford driving lessons, or a car, or insurance.
“I get my own caseload and I can receive anywhere between two and nine service users daily. If I’m lucky, I might get to go on lunch break but I never get to go on time.
“I carry out basic care, from changing a wound dressing to taking the time to shower an elderly man with dementia so that he can see his family in his best physical appearance.
“During the admission process, I must sit with the service user and their family, who often leave the minute I walk into the room. I must then comfort the service user, because their family leaving breaks their heart.
“Among other things, I must complete property check and confiscate any dangerous objects, and show them to where they will be staying during their time with us.
“I also ensure the patient has eaten, because they often arrive after the hospital canteen is closed so I have to prepare food for them.
“One elderly service user with dementia suffers from ‘sundowning’, so as days progress, he goes from being a sweet man telling me about how to fix a gate (when he thinks he’s 25 again and tries to touch my behind and other private areas) to an extremely angry individual who bangs on the nursing station glass and threatens to kill every one of us.
“I break up fights, I have stopped service users from burning themselves, and I have confiscated dinner knives and forks from service users.
“I have been threatened with extreme violence. I have been strangled and shoved against a wall, completely defenceless while waiting for staff to answer my personal alarm.
“I have been cornered by a man who is 6 foot 4 inches tall, three times my build and 40 years older than me, who told me I’m ‘a fine looking woman’ and was able to recite the registration of the car belonging to my boyfriend, who collected me from work two weeks previously.
“I have had my hair pulled, I’ve had faeces thrown at me.
“But every single day I get up and go back to work to help every single individual I can, regardless of their attempts to harm me the previous day.
“I would thoroughly enjoy having to see a member of our government work a day in my shoes or those of any other student or staff, and do that without pay.
“In March, you called upon us to help with the Covid-19 pandemic. I was one of the individuals who stood up and worked tirelessly through it.
“You paid us a wage, and when I received that wage, it was the first time in three years that I had money in my bank account and wasn’t living off pasta and cheese because I could afford food.
“I saw my parents in early January and commenced placement in February before Covid-19 hit. It was month before I got to see my family and friends again.
“While we do our jobs and the country does its job at following guidelines, I ask you why you are not doing you job as Minister for Health? You are not standing up for the healthcare profession.
“I hope you never have to receive medical or psychiatric care, because much of your care will be carried out by students who the government say don’t do ‘real work’.
“If caring for people and helping people as a nurse isn’t real work, then sitting and vaguely listening the Dáil is not work either.
“Sincerely, an exhausted student.”
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