Unqualified students are being left to pick up the slack on NHS wards amid a dangerous staffing crisis. Nursing and midwifery students say their training has been inadequate, and one says she has to go to food banks to make ends meet.
Nina* is a third year midwifery student. Most of her placements have been at the Royal Infirmary in Edinburgh.
She said that at one point last year on a postnatal ward, “there was myself and two midwives for a ward of 30 mums and 30 babies. Normally a midwife would have about 6 patients.
“We’re always short staffed. I think I’ve worked on a ward that’s been fully staffed once in the 2 and a half years that I’ve been training.
“I do feel sorry for the people that we look after, because I just feel like their care is suffering.
“You’re sitting in a room with somebody, and you’re thinking in your head, oh my God, please don’t bleed, because there’s nobody out there to help me.”
Her studies have been severely affected by the COVID pandemic, as she said that “our first year was essentially all online”. Although she felt more prepared than others because she had worked in healthcare before, she thought this had contributed to the incredibly high drop out rate on her course. According to Nina, her cohort had started off at around 100 people and had dropped into the sixties.
She explained, “you’re expecting us to walk into the workforce, having not given us the foundation skills that we need.”
In 2021, a study found that 29 out of 30 new midwives either leave the profession or never start to begin with.
Eva*, a trainee nurse in Edinburgh in her last year of study, faced similar difficulties starting her degree during the pandemic.
“We had a first year with reduced placements that were ‘online’ instead.’ Our course was meant to be full time in person- we rarely go in once a month for skills training even now.”
Eva added that as a European student, she isn’t entitled to a maintenance loan. This means that “as well as placement and uni, I have to work part time and visit food banks to make ends meet.”
Her tuition fees are paid by the NHS, but she’s in the last year group where that is the case, because of Brexit.
Facing a future in an underfunded and overloaded health service, Eva said that, “I am doing everything I can to gain additional qualifications this year, so I have options outside of NHS nursing.”
Anne* is studying mental health nursing and works on an acute psychiatric ward, also at the Royal Infirmary in Edinburgh. She explained that “as a student nurse it’s very difficult to feel like we’re going to be prepared, because of staff shortages.”
She is also worried about her patients. Many patients on her ward need a nurse to escort them outside. They should be able to go for a walk every day, but because of a lack of staff, “some of them haven’t been out for a couple of weeks now.”
As Anne explained, “it’s not doing their mental health any good to be locked up all the time.” The wards are not only understaffed but also very full. According to Anne, at one point in December “there were no mental health beds in Scotland left for acute patients.”
Anne often works with patients who are at high risk of hurting themselves and others. She’s been at work when “there were three staff on the ward for 16 patients”.
She described how “a patient attacked another patient and we had to wait because you cannot restrain someone without five people there.” In that situation, the staff had to pull an emergency alarm and wait two minutes for back up, which is a long time when a violent altercation is taking place. Anne says that “it’s a regular thing” for staff and patients to be in unsafe situations.
In December, the chairman of the Scottish doctors’ union said that “there is no way that the NHS in Scotland can survive.” In the week before Christmas, nearly 2000 people across Scotland had to wait 12 hours or more in A and E, and there are so many unfilled jobs that the country is currently missing “enough doctors to staff an entire large hospital”, according to the BMA.
Unions for NHS staff in Scotland announced plans for a strike late last year, but last week they agreed to put this on hold while they negotiate a pay deal with Scotland’s health secretary Humza Yousaf. Meanwhile, nurses in England and Wales are going on strike on February 6 and 7. For students preparing for a career in the NHS, the future looks dark and uncertain.
*Names have been changed.
“File:Main Entrance, Edinburgh Royal Infirmary – geograph.org.uk – 432996.jpg” by Lisa Jarvis is licensed under CC BY-SA 2.0.