Paid contracts for student nurses would ‘undermine training model’, Cabinet told

Offering student nurses contracts as paid healthcare assistants in hospitals would have more disadvantages than advantages, a report given by the Minister for Health Stephen Donnelly to Cabinet this morning has found.

The report said such a move, which has been called for by nursing representative organisations, would “undermine the graduate training model “for nurses and “may have a displacement effect on healthcare assistants”.

The key recommendation of the Collins report to be given to Cabinet is that student nurses and midwives should be allotted a “pandemic payment” of €100 per week for each week spent in healthcare settings during the pandemic.

The payment will cost an estimated €5.4 million this year, which is based on the assumption that it is, as recommended, backdated to September and that the pandemic will end in 2021.

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Student nurses were offered healthcare assistant roles for several months last year at the height of the first wave of the pandemic under an initiative introduced by the then Minister Simon Harris. The report to the Cabinet on Tuesday said this option should be retained for similar emergency situations.

However, it said it did not recommend that student nurse placements or internships be replaced by offering the individuals concerned healthcare assistant contracts.

The Irish Nurses and Midwives Organisation (INMO) said on Tuesday the Collins report - which was based on a review carried out in December -"no longer reflected reality in the health service" given the new Covid-19 wave.

The union called again for the re-introduction of the scheme which offered student nurses contracts as healthcare assistants.

Under the so-called Harris initiative last spring, over 1,300 student nurses took up roles as healthcare assistants at a cost to the State of about €41 million.

The report given to the Cabinet said students on placement in hospitals were considered to be in supernumerary positions and were not employees of the health service.

It said the primary object of the student nurse or midwife was to learn. It said that any change to their status as higher education students could undermine the intrinsic nature of the graduate training programme.

It said “any change to the supernumerary status could confer new responsibilities and accountability on both the health service and the students themselves and could not be met, given students’ level of practice competence”.

The report said that staffing in hospitals “should be dealt with within the overall strategies of the healthcare setting rather than by an ongoing reliance on the spontaneous and voluntary commitment of students”.

The report said eligible students should continue to have access to other allowances in addition to the proposed €100 pandemic payment, including contributions towards travel, accommodation and any SUSI grants. Mr Donnelly also told the Cabinet that the grant should be included in the Government’s longer term review of supports for student midwives and nurses, as should pay rates for those on rostered duties. In addition, third level institutions will be asked to assess the emotional and psychological needs of nurses that may arise from traumas experienced while on placement in clinical settings.

On Saturday the Minister suspended the clinical placements of more than 2,000 student nurses and midwives in hospitals for at least a fortnight to facilitate training personnel to return to frontline roles.

The INMO said about 40 of its student representatives who met on Monday to consider the suspension of the clinical placements expressed” frustration at being left up in the air, facing uncertainty over the coming months”.

It said the student representatives called on Mr Donnelly to return to the scheme that was put in place last March which included:

* Offers of healthcare assistant contracts for all students whose placement is suspended,

* Moving interns up to healthcare assistant pay in recognition of their increased workloads and risk,

* Clarity on what will happen to placements over the coming months.

INMO general secretary, Phil Ní Sheaghdha, said: “There is still time for the Minister to do the right thing. Offer the students contracts as healthcare assistants to boost staffing and move up interns’ pay to reflect their new workloads and risks.”

“Our student members tell us they feel left up in the air. Last minute decisions are being made about their placements, with no clear plan in place for the future. They are thanked for their work so far, but the thanks ring hollow when their reasonable demands for fair remuneration go unanswered. “

“Many students tell us that they want to make a direct contribution to the fight against Covid, and are seeking healthcare assistant contracts while their placements are suspended.”

“Our interns rightly feel abandoned. They continue to work for miserly wages, facing increased workloads, huge Covid risks, and weakened support.”