Clinical placements

Self-rostering on placements: should students be able to choose their shifts?

Planning ahead, reducing stress and anxiety – the arguments in favour are difficult to ignore

Planning ahead, reducing stress and anxiety the arguments for self-rostering are gaining support and are difficult to ignore

When WeStudentNurses held its first Student Nurse Mental Health Day in May 2019, one of the common themes that emerged was the stress and anxiety caused by not having an advanced rota for our clinical placements.

Not knowing in advance what shifts you will be working makes it difficult to plan ahead. In a follow-up survey with 616 student respondents, 89% said that not having an advanced rota had a negative effect on their mental health.

Rota uncertainty has a negative effect on mental health

As well as causing issues with childcare or other caring responsibilities, it can

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Planning ahead, reducing stress and anxiety – the arguments for self-rostering are gaining support and are difficult to ignore

Illustration showing a student in uniform holding a clock and a work rota
Picture: iStock

When WeStudentNurses held its first Student Nurse Mental Health Day in May 2019, one of the common themes that emerged was the stress and anxiety caused by not having an advanced rota for our clinical placements.

Not knowing in advance what shifts you will be working makes it difficult to plan ahead. In a follow-up survey with 616 student respondents, 89% said that not having an advanced rota had a negative effect on their mental health.

Rota uncertainty has a negative effect on mental health

As well as causing issues with childcare or other caring responsibilities, it can mean missing out on social events, which may lead to social isolation, while not being able to plan for paid work can cause financial worries.

One of the possible solutions to this problem is self-rostering, where students choose which shifts they work. The issue of whether students should be allowed to self-roster has gained momentum in recent months, and in October @WeStudentNurse held a TweetChat on this subject.

Self-rostering gives students more control over their work-life balance

Many views were expressed, both for and against self-rostering, along with some poignant narratives about how a lack of an advanced placement rota has affected students’ lives.

As part of the chat, we ran a poll asking if students should be able to self-roster, with all stakeholders invited to vote. Over a 12-hour period, we had 445 votes, with 79% of those who voted saying that self-rostering systems should be implemented.

Allowing students to self-roster would give us more control over our work-life balance. As well as helping us feel more empowered and less affected by burnout, it would enable us to develop our communication, leadership and conflict management skills.

But it is not only nursing students who will reap the rewards – NHS trusts and patients will gain from this too.

Introducing e-rostering makes financial sense

In February 2016, Lord Carter of Coles’ review of productivity and efficiency in NHS hospitals revealed ‘significant unwarranted variation’ between trusts, including sickness absence rates, which ranged between 3.1% and 5%.

One of the recommendations in the report was better implementation of technology, such as e-rostering systems, which it said could reduce sickness absence rates and potentially save trusts millions of pounds every year.

These savings could be further enhanced by a self-rostering system for nursing students; if the need to create a student roster was eliminated, it would improve efficiency by saving the time of already over-stretched nursing staff.

Self-rostering systems for registered nurses have been trialled at numerous NHS trusts over the years.

Mutual respect in the workforce creates a happier workplace

In 2003, Luton and Dunstable University Hospital NHS Trust carried out a six-month trial of self-rostering in three wards of different specialties. The results were positive, with 82% of those who participated reporting a better work-life balance compared with just 38% before the trial.

More recently, electronic self-rostering was implemented across 32 inpatient areas at The Royal Free London NHS Foundation Trust from September 2018 to May 2019, following a successful pilot in the intensive care unit.

Mutual respect, fairness and trust create a healthy workforce culture and show staff that they matter. If implemented well, self-rostering has the potential to reduce favouritism and conflict over staff rotas, allowing each team member to feel valued.

Staff who feel valued are more likely to remain with their employer, reducing attrition rates and absenteeism, and nursing students who feel valued are more likely to seek employment at that trust, creating a talent pipeline.

Ultimately, the workforce will be happier and productivity will increase, which can only be a positive thing for the patients we care for.

Guidelines would ensure that self-rostering for students creates a safe learning environment

Although it would be difficult to apply a one-size-fits-all approach, it is evident there is a need for a self-rostering framework for nursing students that sets out guiding principles and parameters.

This could include requiring students to complete 20% of their placement on night shifts or placing restrictions on the number of students on a shift. This would ensure a good skill-mix and create effective and safe learning environments for nursing students.

‘Allowing students to self-roster would give us more control over our work-life balance, helping us to feel more empowered and less burned out’

A robust technology infrastructure also needs to be in place to manage this effectively. Most NHS trusts have electronic scheduling systems and students could be added as unpaid employees so that their hours can be recorded.

More flexible working could help reduce student attrition rates

With nursing student attrition rates high, now is the time to develop new ways of flexible working that can have a positive impact on students, staff and the patients we care for. It’s about creating the right culture and trying new approaches, something healthcare staff have had to do a lot during the COVID-19 pandemic.

If self-rostering for nursing students is to be successful, we need support from the whole nursing team. If you are a manager, why not try a six-month trial in your clinical area? We need to build a body of evidence to evaluate the change to see if it works, and it could make a real difference to the well-being of your students.

We are often called upon to demonstrate the 6Cs in nursing. During our TweetChat there were calls to draw upon a seventh C: compromise.


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