Preparing nurses for practice
Shortages of clinical placements for nursing students exist across a wide range of specialty areas and are limiting the ability of nursing students to gain vital clinical skills and experience. Particular shortages exist in clinical placement opportunities in rural and remote areas, in midwifery, sexual health, mental health, psychiatric nursing, high dependency, paediatric, community health, drug and alcohol, and maternal and infant care.
The recent comparatively small increases in university places for nursing students has increased the pressure on clinical placements, but it has not been sufficient to meet the demand for nursing courses by prospective students. Nor has there been an increase in appropriately trained clinical teachers. Clinical staff are under pressure to meet higher workloads at the same time as being asked to mentor and support students.
There is also only limited funding available to support student accommodation during clinical placements, adversely affecting those undertaking placements in rural and remote areas.
While some funding has been allocated to create additional university places, it falls far short of meeting demand.
There is an increasing number of nurses who believe that undergraduate curricula should have a greater emphasis on clinical preparation and there should be improved partnerships between the tertiary education and the health delivery sectors.
Quite simply governments and employers aren’t doing enough to get more nurses into the health system. Those that do start in, or return to, the system often feel ill prepared.
Supporting nurses
There is an urgent need to continue to expand the enrolment of nursing students by increasing the numbers of undergraduate and post graduate nursing places in universities for registered nurses and in the technical and further education sector for enrolled nurses.
Urgent action is required to address national nursing workforce shortages.
In addition the federal government should offer HECS and PELS relief (such as a temporary fee removal, a discount, or a HECS holiday) until such time that shortages are addressed. A similar scheme for the VET sector for nursing qualifications for ENs and AINs will assist in addressing workforce shortages by boosting a section of the workforce who provide vital support to registered nurses.
Consideration also needs to go toward addressing the issue of those wishing to undertake nursing as a second degree where there is currently no HECS scheme available.
The recent federal government announcement that teaching graduates who take up primary school positions in maths and science will now be eligible for a 50 per cent refund on their HECS-HELP repayment for up to five years shows such options are available to boost the number of graduates entering nursing.
This decision is timely, particularly given the QNU’s estimation that Queensland must have at least an additional 2,300 nurses commencing an undergraduate nursing degree each year just to keep pace with demand.
Additional funding for clinical placements is also vital, as there are currently too few clinical places available to accommodate the existing number of students and care must be taken to ensure that any increases in the number of students do not place an additional burden on an already stretched health system.
Increasing funding (fees or subsidies) for nursing clinical education through the provision of additional clinical placements for nursing students and for the supply of clinical teachers is essential.
Sustainable retention, refresher and re-entry practices must also be the focus of the government to get nurses back into the health system.
It is essential that nursing qualifications appropriately articulate and therefore support the maintenance of a meaningful career structure that encompasses AINs, ENs and RNs.
Urgent action is required now to develop a nursing workforce plan and the educational preparation of nurses is a critical component of such a plan. | 
