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NHS Trust . ‘ Students have been amazing throughout this pandemic . They really have . They ’ ve been a central part of the NHS response .’
In March last year , HEE invited students in the final six months of their pre-registration programme to take up paid placements to support the Covid-19 effort . Likewise , second-year students or those in the first six months of their final year were told they could spend up to 80 % of their hours in a paid clinical placement . First-year students who opted out had clinical placements reduced or paused . This set-up was withdrawn in September 2020 . But in the wake of the Covid-19 surge earlier this year , final-year students were again mobilised to join the response . The latest HEE figures show more than 28,000 student nurses and midwives had been drafted in as of July 2020 .
These heightened expectations of students have had consequences , admits Mr Radford . ‘ We ’ ve had quite significant disruption to their training . For some students , that has been a positive experience , but for others not so .’
HEE conducted a survey of 9,799 nursing and midwifery students in May 2020 , which Mr Radford says revealed anxieties around finances , progression on their course and completing hours , and what they experienced during the pandemic ‘ which for some was quite traumatic ’. For example , 59 % of respondents overall expressed concern about catching up with academic studies , while 37 % of student nurses ( out of 8,397 ) said they were considering leaving for reasons including stress and a lack of support from their university . ‘ The demands and pressure on NHS and social care staff have been enormous , [ and ] students , they ’ ve been in those clinical environments themselves .’
But HEE is working with the Department for Education , universities , students and student leader bodies to tackle issues such as mental health and disrupted training . ‘ For example , we had a number of students last year who weren ’ t able to go into placement because they were shielding and so were delayed in qualifying ,’ says Mr Radford . ‘ We ’ ve been working with institutions to make sure they can get their hours up so they get their academic assessments done .’ Likewise , universities are helping students access mental health support and ‘ address any underlying challenges their experiences during the past 18 months ’ will cause them . The NHS has also set up regional mental health and wellbeing hubs that students can access while on placement .
We ’ ve had quite significant disruption to training . For some students , that has been positive , but for others not so
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Mr Radford is concerned Covid-19 may worsen attrition rates . Research from the Health Foundation in 2019 put the average nursing student attrition rate in the UK at 24 %, citing reasons such as finances , academic issues , workload and lack of support . ‘ At the moment , we aren ’ t seeing any evidence to suggest that ’ s the case ,’ he says . ‘ But I ’ m mindful this will evolve over the next year or 18 months . So we ’ ve got to make sure we ’ ve got a very firm handle on it .’
Opportunity for innovation Mr Radford believes this is an opportune time for change . ‘ There has been a lot of flexibility and change in nursing teams up and down the country . Some aspects of that are absolutely just for the pandemic , yet there are other areas where we ’ ve seen real innovation . I think it ’ s a really important inflection point . Now is the time to think , okay , we ’ ll start looking and examine what changes we should take forward .’
The rise in long Covid cases calls for the development of specialist nursing roles , he says ( see news , p5 ). Recent data from the Office for National Statistics suggest more than a million people in the UK are living with long Covid symptoms . Mr Radford reveals that he and England ’ s chief nursing officer Ruth May are working with NHS England on new approaches to long Covid , and nurses will be ‘ front and centre ’ of this .
He also says HEE has been looking at the sizable feedback received from student groups , about what worked well and what didn ’ t in the pandemic . ‘ For example , we ’ ve done work around support for simulation training during an undergraduate nursing programme – and have a had a lot of feedback from university students that developing and enhancing blended simulation learning is a real opportunity .
‘ We ’ ve got high-fidelity simulation suites [ where students can use lifelike mannikins in realistic patient environments ] up and down the country , which are being used more and more in terms of training and education . But we ’ ve also got online environments , where people are able to go and see wards and other types of facility online , which helps orientation .’
There have been changes to allow for more simulated training during the pandemic . In February this year , the NMC announced that up to 300 of the 2,400 clinical practice hours student nurses need to complete during their degree could be done in a simulated environment . In March , the Department of Health and Social Care backed this move with an immediate boost of £ 15m towards the expansion of simulated learning .
Other changes , unrelated to the pandemic , are also on the horizon , Mr Radford says . In January , HEE started testing its first ever blended-learning degree programme in seven UK universities ‘ where clinical hours are completed locally but most teaching is through a university that may be miles away ’. The programme is aimed at people with caring commitments or other barriers to study , whom a traditional nursing course may not suit . ‘ I think we ’ ll see more innovation in undergraduate curriculum design and delivery ,’ he adds .
What ’ s more , the NMC has also been seeking views on shaking up undergraduate education , which could impact on everything from required hours to the length of programme , as the UK no longer needs to apply EU law on nursing and midwifery education programmes . ‘ A lot of students have asked quite rightly why so many hours need to be completed . Does it create pressure ? Or does it mean they just complete hours for the sake of it – and actually we can have a better learning experience with reduced learning hours ?’
But whatever the future holds for education and vaccines , and whatever mountain looms next , Mr Radford takes a moment to look back at the peaks already conquered : ‘ I know how hard nurses have worked under extremely difficult circumstances . Without nursing , we could not have run our health and social care system . Our staff have gone way beyond in terms of hours and their personal commitment . In some cases , sadly , staff have died as a result of exposure to Covid-19 . My thanks to each and every one of them .’ nursinginpractice . com Summer 2021