From the beginning of a course, students' attention is brought to the point that their learning is paramount during any placement (Open University, 2021). Supernumerary status is essential to the placement learning experience for any healthcare student. Similarly, many institutions appreciate the benefits of supernumerary status, even going as far as to offer it to newly qualified practitioners for some time. The Nursing and Midwifery Council (NMC) states that:
‘Programme providers must ensure that students are supernumerary during all practice learning. Supernumerary means that the student will not, as part of their programme of preparation, be contracted by any person or body to provide nursing care.’
Allowing the student to accrue placement hours means they gain invaluable experience, and can reach the essential number of hours required to register within the UK.
The pandemic context
It goes without saying that the healthcare systems across the UK have been bruised and battered for a year, with many seeing no end in sight. Sickness absence rates remained as high as 12% during 2020 in parts of England (NHS Digital, 2020). During the first peak, students from England and Scotland were given the choice to ‘opt-in’ to a paid placement. In doing so, students forfeited their supernumerary status in return for monthly payments.
Fast forward nearly 6 months from the scheme finishing and the peak of COVID-19 passed the 60 000 daily case mark for the whole UK (BBC News, 2021) in January, with a peak of 2649 daily cases in Scotland (Public Health Scotland, 2021)—and over 2000 inpatients in Scotland with confirmed COVID-19 (Public Health Scotland, 2021). During the opt-in scheme, which ran from April to September 2020, the peak number of daily confirmed cases was 430 in Scotland (although it is worth remembering that at that point not all suspected cases could be confirmed with tests). The sheer scale of infection and the knock-on effects of this have caused chaos in teaching and learning.
Thoughts from students
Within Scotland, there is particular unrest. The NMC has repeated these changes in 2021, meaning emergency measures have been put in place for students, with the NHS in England taking up offers to allow students to optin, once again allowing payment to students (NMC, 2021). However, this will mean they forfeit their supernumerary status. Similarly, students within Lanarkshire have complained of being moved between areas within NHS Lanarkshire, as substitutes for healthcare support workers. In response, students wrote an open letter to individuals including management within the university and individuals from local and national government, including Chief Nursing Officer, Fiona McQueen. The CNO has written an open letter stating there are no plans for another opt-in scheme (McQueen, 2021). From this letter, many are content that there will be no formal interruptions to current proceedings with gaining placement hours. This was last seen when students were withdrawing from their learning environments for a month until placements could be confirmed.
However, no firm plans were put in place for students experiencing troubles with being moved from ward to ward to facilitate the needs of management. The CNO has echoed the past messages regarding contacting lecturers for advice and support. Despite this, there are no strategic guidelines available to help protect students' learning.
Conclusion
There is no doubt that the NHS requires help as never before, with staff sickness increasing four-fold in the past year and COVID-19 cases reaching over 60 000 during January 2021. Despite this, thousands of students across the UK go to their placement areas and provide the best safe and effective care possible with the available tools.
Even with all this effort that student nurses give, only recently have they been included within the ‘Death during service’ plan—which seeks to compensate families if an individual dies while at work (RCN, 2021). Furthermore, every day students attend their practice learning environment only to be told they will need to assist another ward or department.
More must be done by both placement providers and Government to ensure students are provided with the tools to allow themselves to learn during placement, without the burden of redeployment.