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Paid placements for nursing students: your questions answered

The placement options for every year, plus what to do if you’re struggling due to COVID-19

The clinical placement options for every stage of your degree, plus what to do if you’re struggling due to the impact of COVID-19

  • How the Nursing and Midwifery Council’s re-introduction of paid placements for students will be implemented and who is eligible
  • The arrangements for COVID-19 testing and vaccination for students on placement and those who return to university
  • What to do if you are struggling with the pressures of coursework due to changed circumstances, and how to support fellow students
Four students holding cards with large question marks: many nursing students are wondering what the changes to paid placements will mean for them
Picture: iStock

Nursing students were among those allowed to return to university for the spring term in January 2021, but the majority of teaching continues to be online.

Meanwhile, intense pressure on health and care services due to the second wave of the COVID-19 pandemic is having an impact on clinical placements. Here we look at what this might mean for students and their progress through degree courses.

NMC reintroduces paid placements – for some

The Nursing and Midwifery Council (NMC) recently re-introduced the option of paid placements for final-year students. But this option is not on offer in all parts of the UK.

All other undergraduate nursing and midwifery students and postgraduate diploma or master’s students will continue to have supernumerary status when on clinical placement.

Increased availability of COVID-19 testing and the roll-out of the vaccination programme are helping mitigate risks to nursing students and others.

Could nursing students be asked to join the temporary register?

In the first wave of the pandemic, the NMC prepared to open a specific part of the temporary register to students, but this did not happen.

Although pressures on services are greater this time around, the NMC told Nursing Standard: ‘For now, there are no plans to open the temporary register for students.’

Can I do a paid placement?

This depends on where you are studying and what year you are in.

During the first wave of the pandemic, second and third-year students were given the option of doing extended paid placements.

The NMC has again opened up the option of paid placements – at the request of the UK government – but for third-year students only.

Devolved governments in Scotland, Wales and Northern Ireland have so far decided not to take up the option of paid placements, but say they are keeping the situation under review.

In England it is up to individual universities and placement providers to decide whether or not paid placements will be available – depending on the situation locally.

Under the NMC’s emergency standards, final-year students can choose to do an extended clinical placement for up to 100% of their course while the emergency standards are in place.

However, the focus is on enabling students to continue with their studies as normal where possible.

Katerina Kolyva, Council of Deans of Health executive director
Katerina Kolyva: ‘It is important for students to complete on time so they can join the workforce’

The situation is different this time round as students are at a different point in the academic year and many have already experienced significant disruption to their studies, explains Council of Deans of Health (CoDH) executive director Katerina Kolyva.

In areas where health and care services are under severe strain it may be more difficult to provide standard clinical placements.

'This is where the paid placement option comes in,' says Dr Kolyva. 'It will be up to the university and their placement provider to agree what the need is and where students will be most useful and then discuss the options with students.'

Students will be contacted by their university about the decision on paid placements.

Health Education England (HEE) has published new guidance on support for nursing students, including what to expect from paid placements.

Students will not be supernumerary but time spent on paid placements can count towards practice hours.

‘All students will receive appropriate support and supervision,’ states the guidance. ‘You will also be ensured protected learning to support your studies.’

Will normal clinical placements go ahead?

The hope is that many first years will be able to do practice placements as normal and this should be ‘actively supported and encouraged’, says the NMC.

But this may not be possible in some areas, so the NMC has re-introduced emergency standards that allow universities to focus on academic and online learning for this year group.

Normal placements will go ahead for second years, according to the HEE guidance, in recognition of the disruption to courses to date.

The NMC has stressed the need for students on normal placements to have supernumerary status.

Supernumerary placements for third-year students are expected to go ahead as normal in places where there is less strain on local services.

In areas where paid placements are introduced, the options open to those who can’t – or don’t want to – do paid placements are likely to vary.

Students will be supported by their university to consider the options, says the HEE guidance.

Meanwhile, the regulator has given universities extra flexibility on supervision and assessment, which means the same person can act as practice supervisor and assessor.

Should I get a COVID-19 test before, during or after placements?

In England, testing is being offered to all students who return to university.

A student getting a COVID-19 test
Picture: iStock

This will usually be in the form of two lateral flow tests three days apart. Testing is voluntary but students who do not get tested must self-isolate for ten days.

‘If students are on a placement and not attending university facilities, they should follow and participate in any testing regime in place at their placement,’ says Department for Education guidance.

‘It is not necessary to travel to university to be tested before travelling to a placement, unless this is advised by the placement provider.’

It is unlikely universities will require students to get tested again when they return from placement, according to the CoDH.

Similar testing regimes apply in Scotland, Wales and Northern Ireland.

When will nursing students get the COVID-19 vaccine?

Nursing students on clinical placements in all four UK nations are in the same priority group for vaccination as front-line health and care workers.

‘If students feel they are not being prioritised alongside healthcare staff in their practice placement they should talk to their supervisor and university,’ says Dr Kolyva.

Students not on placement will be prioritised for vaccination in the same way as the rest of the population, depending on age and other personal circumstances, such as if they are classed as clinically vulnerable.

What should I do if I have concerns about my own – or another student’s – mental health?

Jane Brindley, Canterbury Christ Church University senior lecturer in the school of nursing, midwifery and social work
Jane Brindley: ‘Students shouldn’t worry that mental health issues will affect their place on a course‘

Canterbury Christ Church University senior lecturer in the school of nursing, midwifery and social work Jane Brindley says the first step is to seek help and to do this as soon as possible.

Speak to your personal tutor, who can direct you to further support on offer through your university’s health and well-being service. Students can also self-refer to these services.

‘One reason students don’t come forward is they think if they say something is wrong – particularly with their mental health – then it’s going to put their place on the course in jeopardy,’ says Ms Brindley.

‘That is not the case. An important aspect of being a nurse is being self-aware, so it is actually a strength to know when you’re not coping.

‘If you go and see your personal tutor it is really unlikely you are going to say something they have not come across before, whether that is anxiety, self-harm, suicidal ideas or obsessive compulsive disorder exacerbated by COVID-19.’

Nursing students worried about a fellow student’s mental health should not attempt to solve the problem themselves, cautions Ms Brindley.

‘Reach out to them and keep in contact as a friend, but encourage them to seek help and signpost them to support,’ she says.

What should I do if I am struggling with my academic work?

Alert your personal tutor as soon as possible ‘rather than waiting to the point when something is due in’, advises Ms Brindley.

All universities have systems in place to support students struggling with academic work at any point in their course and most have built in extra flexibility – such as extensions to deadlines – in recognition of the difficulties posed by the pandemic.

For example, students at Canterbury Christ Church may be offered a ‘temporary learning agreement’, which could include revised submission dates.

A nursing student speaking to their tutor via online chat. Your personal tutor can signpost you to support if you’re struggling
Your personal tutor can signpost you to support if you’re struggling, or advise on how to ask for an extension Picture: iStock

‘The key is to talk to your personal tutor, who can signpost you to other support within the university,’ says Ms Brindley.

‘Students may need to evidence their circumstances and universities will have clear criteria on what is acceptable. Your tutor can guide you through this.’

Often students feel they are the only one falling behind, she says.

‘The reality is others are struggling, but people don’t talk about it. No university offers someone a place on a nursing course because they think they’ll be a good student, they offer them a place because they see them as a qualified nurse in three years’ time.’

She advises nursing students to make the most of university-run study skills programmes that can help them learn effective techniques for planning and completing academic work.

NS Student: study skills, tips and advice
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