Annie Hoey (Labour) | Oireachtas source

I thank the Minister. Even now that their placements have been suspended, many student nurses and midwives are back in hospitals working as healthcare assistants. When offered the opportunity to stay at home or find work elsewhere, many have gone back into hospitals, which is incredibly admirable. A student described it to me as:

Terrifying, stressful, feel unsupported, feel as if I am a staff nurse and not an intern - 8 of my patients tested positive for covid, all staff nurses present were identified as close contacts and told to isolate - I was not. I had to continue to work for the 2 weeks of the ward outbreak. In A&E placement as supernumerary student 7 staff nurses were out sick due to Covid, myself and 4 other students had to take their place ignoring our supernumerary status especially in a specialised area.

It is not just during Covid that student nurses have played their role. They have been an essential part of the healthcare system for years. It should not have taken us reaching this point in a global health crisis to recognise their contribution, but to refuse to do so now would be shameful.

All work should be paid. I cannot believe that in 2021 as a Labour Party Senator, trade union activist and citizen, that still needs to be said, but here we are. No part of our public service system should be built on the back of unpaid labour and I will brook no argument from the Government that what student nurses and midwives do is not work. Nor, by the way, would their colleagues, their patients or the INMO, so let us put that idea to bed. If it walks like a duck and talks like a duck, then it is a student nurse doing actual, life-saving work for free. For the Government to say otherwise is simply gaslighting a whole cohort of student nurses and midwives.

This Government is fond of praising our student nurses but in the same breath it uses to acknowledge the work they are doing, it refuses to commit to paying them. One of the many straw man arguments I hear is that nurses are taking part in a university degree, not an apprenticeship, and that we do not want to devalue their qualifications. This argument is nonsense and tosh. There is nothing at all undermining about paying students for work they complete as part of their training. What is undermining is to say to student nurses that they will remain unpaid while they work in hospitals, to somehow protect them and their qualifications. That does not protect them at the end of the month when they have rent to pay; it does not protect them from Covid-19; it does not protect their well-being; and it does not protect the Irish healthcare system from a reputation of undervaluing its nurses, which starts from the beginning of their careers as students. Another student nurse said to me:

My biggest issue throughout most of this year is feeling like I'm more like a HCA rather then a student nurse, the nurses are walking angels but they are tied up in the endless work. Are teaching and learning has been pushed to the side because of covid and not getting the supports needed from the government.

I also want to speak about the nature of education and what requiring students to work for no pay does to the system. I have said this in the House previously and I will say it again. We have an obligation to ask who is not here, who is not in the room and who is not partaking in these educational opportunities. When it comes to nursing and midwifery, who is not able to undertake this course of study? Many people, due to their socio-economic background, their family obligations and their needs outside of education, must work throughout college. I know first-hand what that is like, having worked more hours for many years in college than I spent in lecture halls. When a service requirement is placed on students, as is done with nursing, it reduces the number of hours available to a student to earn a wage elsewhere in paid employment. This is a factor in people’s decision-making when applying to college and so we have put people in a position where they are asking themselves whether they can actually afford to become a nurse. That is not how we should approach this vocation and this educational opportunity. We have a nursing shortage in Ireland. When talking about this issue, we need to remember that we are not discussing an abstract idea. We are talking about real people on the front-line of the health service, year in, year out.

In the run-up to today's debate, I asked student nurses and midwives to share their experiences of working across wards in Ireland. I received a large number of responses and I am happy to share them with anyone who is interested. The first states:

As a 19-year-old, I have witnessed more people die in the past 12 months than I can count. I have sat beside them holding their hands, head to toe in PPE, in the exact moment they passed away. I think this is something that is extremely overlooked. 18 and 19 year olds have to look someone in the eyes at the exact moment they die. It is something that has kept me awake for many months. Supervision and support has crumbled despite staff's best efforts due to high absence rates. Learning is taking a backseat to get the basic care needs fulfilled. Academic aspects of the training have become much more difficult with inequality and access to online learning plus the pressure of isolation, parenting, etc., during the pandemic.

Another student who is in second year got in touch with me:

At the moment us second years are moving placement settings every two weeks. This is obviously dangerous during Covid but it is still happening. In January they refused to test us for Covid before we moved placement even if we had been caring for Covid patients. Students begged for tests as they did not want to spread the disease into other hospitals. It has been hell on earth so far. I always feel like I was put into the deep end of the pool. Sometimes you feel as if you have no support at all. While all of this was happening the Government are telling us that we do not do real work, that we are being educated. I have been doing real work on wards since first year but even more so this year when the wards and hospitals were being propped up by students.

When I asked a student what her experience had been over the past 12 months, she said to me:

It has been significantly worse than previous years. I feel like there is a lot more expected of me. As a supernumerary student, over the past 12 months I have always been counted as a member of staff on the ward. I have been delegated a minimum of six patients a day, and it has gone up to 12, to care for with little or no supervision or support. Not only am I under severe financial strain but I am also emotionally drained and stressed from the experiences on placement. It really upsets me how much we are taken for granted and not provided with basic supports.

Another student has said:

I had to move out of home to avoid the risk of my family contracting Covid so I am now paying rent on an apartment. I have to get taxis more often as a result of the reduced public transport service schedule and the irregular work hours that I have to work.

Another student said to me:

It feels like I am never off duty. There has been a drastic increase in responsibility due to the pandemic and the staffing issue as a result of this pandemic.

Another student said:

Full of uncertainty. I am uncertain that I chose the right career path. We can't have student nurses feeling that they chose the wrong career path because of how we are treating them. I am considering moving abroad when I finish my degree due to poor pay and working conditions. I constantly feel underappreciated and sometimes I feel like I am a burden when I am on placement. Nurses on the ward do not have enough time to give me to help me achieve my learning goals. I feel like I am just another number to help out when staff are under pressure.

One final story states:

It is hard to break it down for other people to understand the stress and heartache we have experienced. The main experience of me was being the only person in the room with the Covid-positive patient when he passed from the virus. I was the only one holding his hand and talking to him as he slipped away, not his family, not as friends, just me as a student nurse. This has had a huge effect on me as I had built a bond with him over the week and to see him go so downhill so quickly was hard to process. Afterwards I helped prepare his body and that was how he will be buried. I had to help transfer them over to the morgue as we were short-staffed from all sides. When I returned from the morgue I was expected to go on with my day as if nothing had happened.

Those are just some of the stories from student nurses and midwives on the front line and these are student nurses all the way from first year up to supernumerary year. It is not fair to say that the workload is just falling on fourth year students. It is falling on first second and third year students as well.

The campaign to see student nurses paid for their work did not start with me. The Irish Nurses and Midwives Organisation has been fighting for years for their members' work to be recognised. I thank them, especially Phil Ní Sheaghdha, for their tireless work on behalf of their members. The Union Students in Ireland, my alma materand my stomping ground to politics, has also been working tirelessly on this issue for years and it is how I got involved in this campaign. I also thank all the student nurses who have taken their time to talk to me about this Bill, and for sharing their very honest, real and painful insights with me.

It was implied this week in the media that the Government plans to allow this Bill to pass and then die out on Committee Stage. I want to put the Government, the Minster for Health, and the Minister for Further and Higher Education, Research, Innovation and Science on notice that the Labour Party, the unions which represent these students, the student nurses who are affected by this and, I can assure the House, I will not be letting this issue die. I thank the House.