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Student increase causes training bottleneck

A lack of clinical placements delays graduation for up to 150 UWS students, reports Annabel McGilvray.

An acute shortage of practical nurse-training positions means that up to 150 students at the University of Western Sydney will be unable to complete their nursing degree as scheduled this year.

In what nursing educators and administrators say is a growing problem affecting campuses around Australia, UWS has been unable to organise for the students to do their required clinical training within their three-year degree. Instead it has been compelled to arrange for them to complete the off-campus practical training early next year.

The potential ramifications for those students when it comes to applying for jobs are significant as registration cannot occur until full completion of the bachelor degree, which includes 800 hours practicum.

"In a short space of time we've had a huge growth in student numbers and that's put a burden on the hospitals for those places and that's why we've got this problem," said Christine Taylor, UWS director of clinical education.

UWS is not alone in feeling the pressure of rapidly increasing student numbers when it comes to arranging practical placements and assessments. In 2010 alone there were 16,628 new students enrolled in bachelor of nursing degrees at universities and colleges around the country. This was a 9.2 per cent increase on 2009 and many expect a similar increase for 2011. However, the number of nurse-training places at hospitals and other health service providers has not grown and in important areas such as mental health the number has declined.

With the lifting of government caps on student numbers in 2012, there is concern at the top of the profession about how further potential student number increases will affect the ability of Australia's 38 nursing education providers to continue providing the required practical experience within the three-year degree.

In June this year, this concern saw the new national nursing accreditation body, the Australian Nursing and Midwifery Accreditation Council (ANMAC) send a letter to all accredited nursing and midwifery providers, asking them to provide details of any planned "significant changes in student numbers" together with details of clinical placements and infrastructure and staffing alterations.

"With the removal of the cap there is a real risk that the number of undergraduates could swamp the capacity of the health system to provide clinical places and thus put at risk the students being able to meet all the requirements of the accredited program," wrote ANMAC chief executive, Amanda Adrian.

This week, Adrian told Nursing Review that in response to her letter ANMAC has received substantial number of notifications from campuses about proposed changes but the council is still assessing the implications.

Regarding UWS, Adrian said ANMAC had not yet received any complaints from students about the arrangements, but would investigate closely to ensure accreditation standards were being met if a complaint was made.

"If we get a complaint or notification from students that the accreditation standards are not being met then we will follow that up."

Increasing student numbers and increased competition for clinical placements is also causing problems for the Faculty of Nursing, Midwifery and Health at the University Technology Sydney. In a recent public exchange, at least one nursing student expressed frustration with the allocation of clinical placements requiring significant commuting time and travel at unsuitable hours.

The university has since taken steps to increase placements through NSW Health and to improve communication with students via a student think-tank comprising student representatives and staff which is designed to anticipate such problems in the future.

"But it's a huge problem for the sector," says UTS dean, Professor John Daly.

In an effort to better address the problem, the new federal body, Health Workforce Australia, is in the process of crunching the national figures for the demand and supply of clinical placements - not only in nursing, but also medicine and allied health.

At the same time, multidisciplinary bodies with the working title, Integrated Regional Training Networks, are being created to better co-ordinate such placements between disciplines and organisations to ensure all opportunities are being exploited.

In the area of nursing in particular, there is agreement that there is room for further placements in the areas of aged care, primary and community health, and even home care - although each of these has its own difficulties regarding supervision and cost, which currently fall to the university sector.

The chairman of the Council of Deans of Nursing and Midwifery, Professor Patrick Crookes, from the University of Wollongong, says that ultimately the new awareness of the nexus between student numbers and clinical training across government, university and faculty administrations means that deregulation of student numbers is unlikely to see a dramatic increase in nursing numbers in 2012.

"Without exception universities would be prepared to take more nursing students if they weren't going to make a [financial] loss on it when it came to clinical placements, and if there was a guarantee that those placements would be available in a timely fashion.

"But I don't believe that on the back of government taking off the caps, there will automatically be complete and utter overwhelming numbers of students because I think too many people have got their act together so that they know what numbers they can manage."


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