Nearly 10,000 people have signed a petition calling for student nurses to be paid while they train, as the country's strained health system continues face high demand.
To become a registered nurse in New Zealand, a person must complete 1100 hours of placements in hospitals and other clinical settings. But, according to petition organiser Arya Zale, the unpaid hours wouldn't help encourage people to enter and stay in the profession.
The Massey University nursing student said that on top of full-time placements, students had to find the time to complete their coursework and juggle other jobs to live.
She believed it was part of the reason some students were dropping out, in addition to other pressures like finding suitable placements during a pandemic, other Covid-19-related stresses, and burnout.
Zale, who was completing an accelerated two-year master's degree, said she was seeing it first-hand - only 68% of her original cohort remained one year into their studies.
The petition addressed to various ministers and the Nursing Council asked that students be paid minimum wage for their placement hours. It also proposed funding tuition fees to entice future students and give new nurses a bonus if they passed their state exams.
"It's not like the pockets are unending. We know that; we really do. But, we also know that lives are valuable. By not populating the nursing workforce, that's costing lives," Zale said.
The petition gained more than 5000 signatures in its first two days and nearly 10,000 in about two weeks. Zale said it was clear it had "struck a chord" and sent a message that the status quo wasn't good enough.
"We are the future of nursing, and we want to make it a desirable one. We're willing to be relentless."
Meanwhile, recent surges in Covid-19 cases mixed with winter illnesses were putting the health system under significant pressure.
'It would have been so nice'
A surgical nurse at Middlemore Hospital, who preferred to remain anonymous so she could speak openly about her experiences, said everyone she'd spoken to supported what the petition was asking for.
The recent Manukau Institute of Technology graduate said "it would have made a huge difference" for the people in her class.
"It would have been so nice because a lot of students are doing their full-time placement, studying, then juggling part-time or even full-time jobs on top of kids."
She said, for her, it meant heading to her placement in the morning and then heading to her job straight after. She often didn't return home until about 8 or 9 o'clock at night.
"That takes away the fun of going to placements because you're so tired and burnt out that you kind of feel like you're just going there to get work done," she said.
"It's just really hard to go through all that. So, I always used to say that even if I got paid $1 an hour [while doing the placement hours], I would have been happy."
The situations trainee nurses could find themselves in could also be tough at times, she said.
"Especially in a hospital setting, you never know what's going to come around the corner.
"So, I remember being a student on my first night shift and having a patient die and having to deal with the complexities around that and having to learn how to process that."
Nursing Council: 'Extensive consultation' needed for massive change
The Nursing Council, which set standards for training programmes in the country, said paying students while they were in their placements was a significant change.
Catherine Byrne, the council’s chief executive, said the council's standards specifically said clinical hours couldn't be in a paid position so that it was clear the trainee would be treated as a student, rather than an employee, to protect the quality of their learning experience.
"However, the council is well aware of changes in models of education to increase flexibility - which may be supported by the sector - and is engaged with the leaders in nursing who are currently exploring the possibilities and challenges of various paid learning models."
She said the current model was supported by the sector.
"A change of this magnitude would require extensive consultation with the sector and stakeholders."
Massey University student Shivam Chawla, a classmate of Arya Zale's, said the changes the petition asked for were ultimately about making the nursing profession sustainable to prioritise patient safety.
Chawla said he could understand some people's argument that students were learning on the job. But, he said people needed to consider why the likes of trainee psychologists, police, electricians, or final-year medical students were being paid while student nurses weren't.
"It speaks to the idea of 'is nursing work not valuable enough? Is there not demand for nursing work?'"
Chawla and Zale said while the environments they were working in were meant to be for learning, its hands-on nature, paired with critical staff shortages, meant student nurses were taking "real responsibility and adding real, day-to-day value" while being "expected to fully imitate the lifestyle of a regular nurse or employee".
They said they weren't asking to be paid at the same rate as qualified nurses while training.
"We are adding value, but we can't sustain ourselves because we have to go, after our placement, to an eight-hour job to pay our rent off as well," Chawla said.
As for how students might be paid, he said it was up to those with decision-making power to figure out the details.
"The results will speak for themselves if they do reach that threshold where they're incentivising nursing students and sustaining them appropriately - you will see more graduates emerging.
"And, at that point, we can say that the right balance has been set," Chawla said.
A survey of more than 2200 nursing students by the New Zealand Nurses Organisation between March and April 2021 found that about half of the respondents experienced increased financial pressure from Covid-19 lockdowns.
Students also reported Covid-19 made them miss out on some particular placements and made them unsure about whether they'd get enough hours for registration. When they were in training, one-third said they were asked or expected to work outside the scope of their placement.
More than two-thirds reported the pandemic hadn't made them reconsider their decision to finish their studies.