‘Silenced and disrespected’: Nursing students say they’re stressed by long-term care staffing plan

Students moved from pediatrics to geriatrics with no guarantee missed curriculum will be made up

Carolyn Ray · CBC News 

It was touted as a historic solution to help the dire health-care shortage.

But some nursing students at Dalhousie University say a plan to have them work in long-term care homes for two weeks has backfired. Instead of motivating students, it has sparked concern and stress.

They say they’re being pressured into “volunteering,” and they’re worried their education will suffer as a result.

CBC News has spoken to four students in the program, but has agreed not to use their names. The students fear repercussions at school or in job placements for speaking out.

Just over a week ago, the provincial government announced nursing students were being drafted to help an urgent staffing situation in long-term care homes. The Nova Scotia Nurses’ Union also applauded the plan.

But the students say the reality of the request has been chaotic. While some students in the class are fine with the changes, others are stressed.

“Unfortunately, our education is being sacrificed,” said one student CBC is referring to as Jessica. “How do we know that they’re not going to continue to prioritize our education second?”

The students were given 10-days notice that their semester on pediatric and perinatal care was being put on hold so they could work in long-term care for two weeks.

The placements could be anywhere in the province, although the students could indicate a preferred location. They were told the government would help with transportation and costs of accommodations.

Unknowns

As of Friday evening, some still did not know where they would be working on Monday. They were warned they may have to go back to class instead.

“Students who need child care and other accommodation were not addressed fairly. And students also have other jobs they cannot rework within a week’s notice – this has caused an immense amount of stress on the student body,” said Angela, another student.

All four students want to make it clear that their class is eager to be part of the solution — that’s why they applied to work in nursing. But they say they have no guarantee that this is an isolated request.

“Health care is in a really bad spot,” said Jessica. “We want to make sure that we’re well equipped to enter the workforce as registered nurses. We want to be able to enter the workforce safely and confidently.”

The nursing students say the class is divided and some are fine with the new plan. Those speaking out want a guarantee that they will receive the training they need in multiple fields, not just long-term care. (Carolyn Ray/CBC)

After the students started asking questions, they say Dalhousie gave them options. They could volunteer to start their rotation in long-term care on Monday, or wait until their scheduled clinical placement in March. Those who waited would not receive the $1,000 honorarium from the province.

The students say they were shocked to learn that no matter which option they choose, they could not do their planned clinical rotations in pediatric or perinatal settings. Everyone would be sent to long-term care, even though they had already completed that placement in previous semesters.

It turns out their pediatric and perinatal placements had been cancelled by Nova Scotia Health and the IWK weeks earlier in January over COVID concerns.

Dr. Ruth Martin-Misener, the director of Dalhousie’s school of nursing, said the school hadn’t informed the students yet because they were hoping COVID numbers would ease and the placements would go ahead as planned in March.

Instead, she said, the students would be tested on new skills in long-term care facilities.

‘We’re doing our best’

“We understand that it has created uncertainties and anxieties for many students,” said Martin Misener. “We’re doing our best to try to allay those as best we can.

“We’ll be tracking their competencies, which will be different than the competencies they were expected to achieve in long-term care earlier in their program.”

Martin-Misener said the government first approached the school with the request for help on Jan. 21. Dalhousie is not receiving any money to compensate for the disruption to the semester.

“It’s certainly our understanding of how acute the current crisis really is. I’m really proud to tell you that our students have really stepped up to answer that call,” she said.

Martin-Misener said Dalhousie will do its best to make up for the missed clinical opportunity. But she couldn’t guarantee that the students won’t end up back in long-term care for future clinical placements.

“It’s just so unknown what the pandemic is going to evolve,” she said. “We’re hoping that that won’t happen. But I’d be lying if I said no, that won’t happen because I don’t know. I don’t know what’s coming down the pipe in the future.”

Alumni file complaint

Angela said they feel “silenced and disrespected” after the celebratory announcements were sent to the media to announce the plan. The students say their biggest concern is that this will set a precedent to place them in long-term care for future placements.

The students are being backed by Dalhousie’s student union. A petition is also circulating, raising concerns about the process.

“I want to be very clear, nursing students are not frustrated that there is a need for them in long-term care facilities,” said Madeleine Stinson, the president of Dalhousie’s student union.

“If the faculty had simply asked students to help with this call to action, an overwhelming majority of them would have gone without questions asked… They were simply told what they were going to do.”

CBC News has also received a copy of a letter from some alumni of the nursing school that says cancelling the students planned training is “unconscionable.”

The letter says the department of health has created a “bandage to their long-term staffing crisis on the backs of tuition paying university students.”

The Nova Scotia Nurses’ Union, which initially applauded the plan, declined to comment on this story.

The province did not make anyone available to speak on the issue. Instead it sent a statement that reiterated the first announcement.

“The timing is due to both the urgency of the situation in long-term care facilities, and the reduction of acute care clinical placements that would have taken place during this term,” the department wrote.

It went on to quote Barbara Adams, the minister of seniors and long-term care from the original announcement: “I am personally grateful they are taking on this challenge. They represent what it truly means to be a compassionate Nova Scotian.”

Applying to help

One student, Catherine, said she feels pressured by the emotional language that is being used when describing the need for them to accept the placements.

“It’s left me feeling powerless, I feel out of control of my own education. I feel robbed.”

The students say they have suggested many solutions that have been rejected. Among them, they asked to have the option to complete their original clinical work in a simulated setting.

They say they also called on the school to be flexible on exam and assignment deadlines to allow them to accept shifts in long-term care while studying.

Jessica said the frustrating part of this is that many of the students already applied to work in long-term care after finishing their previous work placement.

“Many of my classmates are very willing to go help,” she said. “A lot have applied for CCA positions and many haven’t been called back to get jobs. It speaks to the willingness – it’s there.”