Through the latter half of 2023, ANMF (Vic Branch) has been involved in consultation with the Department of Health regarding clinical placement requirements for undergraduate nursing and midwifery students and diploma of nursing students. The Branch’s position is that the current clinical placement processes require urgent reform.
Through student forums and regular contact with our student members we have a deep understanding regarding the challenges they face in meeting the minimum clinical experience requirements to complete their nursing and/or midwifery course.
The problems with clinical placement
With nursing and midwifery students required to complete between 400 and 800 hours of unpaid clinical placement (or more than 1500 for those students doing a combined nursing and midwifery degree), the Branch understands that the most common barriers and challenges reported by student members to ANMF regarding clinical placement include:
- financial and social impacts of mandatory unpaid clinical placement
- unreasonable placement scheduling and lack of notice of clinical rosters
- lack of affordable student accommodation
- lack of travel support to enable rural, regional and metropolitan placements
- lack of practical support and organisation from education providers (university and TAFE)
- lack of strategic support from clinical placement providers and preceptors
- repeated and unnecessary police checks during the course
- lack of provision and co-ordination of PPE testing adding to financial burden.
ANMF’s recommendations to address the problems
The Branch’s submission to the Department of Health’s review of clinical placement made several recommendations to address the above problems. Key recommendations include the following:
Paid clinical placement
In addition to offsetting loss of income from their usual paid work while on placement, students require support for other costs associated with undertaking clinical placement – including travel, accommodation, parking, childcare, and mandatory uniform and clinical tools.
Payment to students working on clinical placement will help alleviate financial stress and reduce the struggle of sacrificing paid work for unpaid placement. Paid clinical placements will make it more feasible for students to complete their diploma/degrees and join the workforce.
Among the payment options we have suggested are:
- Government provides funding to education providers who will distribute a clinical placement payment for each placement a student completes.
- Students completing a placement can apply through Services Australia for a temporary payment dependant on weeks of placement allocated.
Streamline out-of-pocket costs
Enforcing Department of Health advice and combining security checks will reduce the costs and time associated with mandatory documentation, including:
- annual police check: $25 to $42
- NDIS worker screening check: $128.20
- Working with children check: $128.20
- annual mask fit test: approximately $89 to $150
- valid HLTAID011 certification to provide first aid & CPR: between $100 and $215
- immunisation/vaccination, which is often not covered by Medicare
The matter of combining security checks is currently being worked on for registered staff as a 2022 Andrews Government election commitment. The Branch calls for it to be extended to students.
In addition, mandatory mask fit tests must be provided free for students on their clinical placement, as per ANMF (Vic Branch) recommendations and current Department of Health advice.
Minimum notice period of clinical placement location and roster
Implementing a minimum six weeks’ notice of roster and placement location will drastically improve students’ ability to plan and prepare for clinical placement. This is vital to avoid the significant hardship many students currently face when notified of lengthy, and distant, placements with unreasonable notice – sometimes within just one to three business days.
The six-week minimum notice period should be embedded into policy for education providers and clinical placement providers.
Flexible placement options, and a commitment to student accommodation
Allowing students to have a say in the location, and time, of their clinical placement whenever possible will alleviate the hardships associated with being expected to travel across the state, often at short notice, to attend lengthy placements.
Commitment and action are also required from the state government and health services for more student accommodation to be made available in order to address the current limitations that, when combined with limited advance notice of placement dates, often make it difficult for students to find somewhere to stay while on placement.
Preceptor training and recognition of work
To instil the value of the work it takes to supervise and mentor students, appropriate remuneration should be provided to suitable nurses and midwives who take on the preceptoring role. Appropriate training should also be offered to ensure staff have the skills to deliver safe, inclusive and best-practice mentorship.
Clinical support teams and educator ratios
Separate, dedicated clinical support teams for students and graduates are required within healthcare facilities to provide assistance, guidance and feedback to both groups. These separate teams should be tailored to the different needs of graduates and students to ensure every individual has the correct support.
To ensure adequate coverage and support clinical placements, ratios for students and grads could be implemented across tertiary hospital funding models.
Another workshop on the matter of clinical placement requirements for undergraduate nursing and midwifery students is scheduled for November with the Department of Health. The Branch will continue to contribute, advocating for more support and change for students of nursing and midwifery – our future workforce.
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