Opinion //

Let’s re-evaluate how we treat student nurses

It's high time we consider the ethics of placements for medical students.

The lady of the lamp, Florence Nightingale, is the gold standard who we as nursing students are made to look up to. But Nightingale worked by her own rules and ethics. This pandemic, more than anything, has shown that the Nightingale paradigm is really just there to make us feel like we have autonomy by being sacrificial and ‘nice’. Really, we aren’t holding any lamp – as a student nurse who has been expected to embrace the pandemic as a ‘learning opportunity,’ the lamp is broken.

The university’s treatment of nursing students and staff has been consistently appalling in peak and downfall, as it maintains its adamance for clinical placements to be completed this semester –  not just for final year students, which would be understandable, but for first years too. Whilst clinical labs have rightly decreased in number and frequency, the 1.5m distance implemented by the university is impossible, because while students try their best to stand on crosses sellotaped to the carpet, teachers are doing their best to teach, so they stand closer to demonstrate skills to students, putting themselves at risk. Clinical placements also can’t be justified, because while a ‘grocery shop’ has been described as riskier by university staff, placements for first year students, who may rely on public transport, have been allocated at locations up to 2 hours away from their homes.

The university’s justifications for these decisions have spanned from well-meaning to bizarre. A week after the census date and in the wake of the virus’ suspected peak, an email from the health faculty stated that “as future health professionals, we are bound by professional standards to prioritise patients and the health of our community”, and that the pandemic is a “career learning opportunity that we may not experience in our lifetime again.”

At a zoom meeting for students, the nursing faculty told students that if they did not get PPE (personal protective equipment) packs during placement, it would be okay, because they were proven to be ineffective against the virus. The desperation to get students on placement and feeling safe on placement is embarrassing.

But maybe I’m shooting the messenger.

The only believable justification the university has for making placements mandatory for all students at this time is the fact that the workforce will be severely impacted if we don’t all graduate in the timeliest manner possible. The problem with this is that health services have been understaffed with nurses for years, and the government has never done anything significant to tackle this problem. Pandemic or not, the threat posed by having less nurses than already present is huge. That’s the ‘learning opportunity’ that this pandemic has given me, which has not been about the pandemic itself, but about the more threatening problem of understaffing that the Australian government has done nothing significant to tackle. Nurses are fundamental to our society’s functioning all the time, but they aren’t valued.

Many nurses have quit because pay hasn’t increased for years and is usually worse for essential nurses, like those in the aged care sector, who are especially important due to our aging population. In 2020, for every 1 male nurse registered under the nursing and midwifery board in Australia, there are 7 female nurses. The  consistently low pay suggests a connection to  the historical association with nursing as ‘natural’ women’s work rather than a profession which people must earn their livelihood from.

Bursaries and specialised programmes to get more nursing students into universities are non-existent. Immigration policies for skilled workers from overseas to get into Australia still puts these nurses a minimum of around $5-10,000 dollars out of pocket, not including the potential costs of a solicitor to aid with applications and waiting times of at least one year for a response. Our government’s stinginess makes Australia seem like a self-sufficient utopia rather than a country whose healthcare system is unnecessarily understaffed. 

So, this month and in the months to come, student nurses at USyd will be travelling to mandatory work they don’t get paid for, when many students are not able to go to their actual workplace and earn a wage due to lockdown, having chronic conditions, or living with vulnerable people. They have been advised to wear clothes other than their nursing uniform offsite to avoid harassment, and they may potentially have to shower at their placement site after their ‘shifts.’ In a classic moral guilt trip, this is apparently their ‘duty,’ as future ‘health professionals.’ Maybe everything will be fine, and risks have been assessed meticulously, but the absolute lack of choice students have had, regardless of what valid reasons they have to not go on placement right now, has shown how much this country relies on students and registered nurses to keep the system chugging along purely on the mythic, bounding generosity bouncing out of their chests.

The problem is, I don’t want to be told I’m nice. I want rights.

Nothing significant has been done to make being a nurse beneficial rather than sacrificial, and it’s because of this that there’s a lack of nurses, and why student nurses are paying for government misdoings by compromising our own safety before we have even entered the workforce.

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