Nursing recruitment needs a boost

August 1, 2021

It might just be time for the great fees wipeout!

The idea that nurses are essentially taken for granted might be a truism within the profession itself, understood by few on the outside.

But in a nation facing an aging population, the challenges of an ongoing global pandemic and new generations less interested in nursing (look no further than an on-average aging workforce), and you soon realise there is another group taken for granted too.

What about new nurses?

Vince Paala
Vince Paala

People joining nursing are doing it for love – and it appears the prospect of a whopping student debt could stop some from ever beginning the journey.

Now some are calling for the government to remove what might be one of the biggest hurdles to recruitment.

They want a great fees wipe-out.

Vince Paala is on a mission to get changes to the cost of a nursing education.

Paala has worked for 14 years as a health-care assistant – 12 spent in critical care in Middlemore Hospital.

It took him years to finally make the decision to study to be a registered nurse – because of the cost.

Now aged 52 he is studying a Bachelor of Nursing at Manukau Institute of Technology. But, as he told Kai Tiaki Nursing New Zealand, he will be aged more than 55 when he finishes his course.

He was not able to get the first year fees-free, because of previous study, so will walk out into the workforce in his mid-50s with three years’-worth of student debt.

Paala launched a petition to Parliament calling for the government to consider fees-free study.

“I noticed the decline of interest in nursing… from the young people of today’s generation, despite the one year of free tertiary education and other scholarship grants.”

Apart from the pay and staffing issues in nursing, one of the major obstacles was the cost of a nursing degree, he said.

“As we know there are other deterrents, why there’s a lack of interest in nursing… but if this fees-free for nursing degree is available, it can stir or encourage more young people to get into a nursing career.”

As part of the fees-free degree, there could be a post-study period where the graduate must work in New Zealand, Paala suggests in his petition. It would help stabilise numbers in the profession.

There has been a fees-free set of programmes running in the deep south, at the Southern Institute of Technology, for several decades.

NZNO National Student Unit co-representative from Invercargill, Nic Brasch, said it was offered to New Zealand and Australian students through the entirety of their course.

“Zero fees was the entire basis for my return to study. I tried, and failed, to study at a tertiary level straight out of high school, which meant I wasn’t eligible for the fees-free initiative. I’ve always had potential, but not a lot of direction – so the prospect of undertaking student debt in a field I mightn’t enjoy definitely deterred me from further study.”

Brasch said she had never been to Invercargill before starting her Bachelor of Nursing.

‘I knew no one, and I knew I wouldn’t like the cold. Even so, it was the logical thing to do.’

“I knew no one, and I knew I wouldn’t like the cold. Even so, moving down here was the logical thing to do – I would emerge with the same accreditation, but $20,000 less debt than students who had studied elsewhere.”

She said she would be “delighted” to see free, or heavily subsidised, study for the future of nursing in Aotearoa.

“The baby boomers are getting old, and the median age for nurses in New Zealand continues to rise.

“More patients and fewer nurses mean we are facing catastrophic shortages… in the not-too-distant future if we don’t see some change soon.”

Access to education, better pay, and safe staffing would contribute to people joining the nursing profession – as well as the longevity of those who take on the challenge, Brasch said.

No Government policy plans

Health Minister Andrew Little told Kai Tiaki that making the entire degree fees-free was not Government policy at the moment.

“What attracts people into a profession isn’t whether they get their student fees paid for – it’s the job itself.

There is a range of things we need to do to encourage people into nursing, including remuneration, the working environment and job satisfaction, and we are working on those.”

He said enrolled nursing qualifications were already fees-free under the government’s new targeted training and apprenticeship fund.

There was also first year fees-free study available for degree students, he said.

In the midst of an industrial dispute with NZNO district health board (DHB) members, Little has previously said the Government would launch a recruitment campaign. He did not give specific details.

One person who faced a hefty cost, but took up the challenge anyway, was Christine Hay.

Now a registered nurse in women’s health with Capital & Coast DHB, she said she “absolutely” supported the idea of full fees-free study for nursing.

Trainee nursing staff by female patient's bed in hospital
Nursing faces huge pressure with an ageing population in Aotearoa.

Hay, 50, ended up with about $60,000 student debt. As a mature student with previous study under her belt, her entire living costs had to be loaded on her student loan as well.

I knew I was going to come into a lot of debt, particularly for someone my age, and thinking, ‘I’m going to be paying that off till I retire’.

“I only finished studying at the end of 2019. Having fees-free would be a huge difference. That was something I took a lot of consideration of. I knew I was going to come into a lot of debt, particularly for somebody my age, and thinking ‘I’m going to be paying that off till I retire’.”

She started studying nursing in the 90s, but family commitments meant she had to wait till her youngest child was 14 before she considered a return.

Hay said the likes of secondary teaching study was previously not only fees-free, “they actually got paid to study, at one stage”.

“So nursing definitely needs something like that to encourage people in.”

However, they also needed jobs ready to go for new graduates when they’ve finished study – allowing them to gain experience.

She started at her job with C&CDHB in July, after having to travel to the West Coast – from her Wellington home – for a year-long stint at her first job.

She enjoyed her rural work, which had its challenges, and a broad scope. “We had anything and everything coming through the doors”.

But with her family in Wellington, she jumped at the chance to return.

Hay said the most sensible thing to have done was study in other fields – but she always wanted to be a nurse.

She put a lot of consideration into how long her nursing career would be, versus the cost to become qualified.

“I ended up having to put the emphasis on what I wanted, rather than what was practical, purely because the cost.”

Hay said it appeared she would likely pay off her debt about five years before reaching her retirement age.

Any support can’t come soon enough for Vince Paala, who has shaken up his life and taken on a large debt to study. A labour of love, not financial security.

“I’m 52-and-a-half years old, doing my Bachelor of Nursing… so by the time I finish… I will be over 55 and still have to pay my student loan too.”