Nursing students in Canada may finally be presented with an opportunity already afforded to numerous other faculties: paid final practicums.

For many years, medical and engineering students have had paid practicums and internships. So why have nursing students been forced to complete these lengthy practicums without fair pay in exchange for their work?

Many argue that these placements pay in experience. They provide students the opportunity to put theory into practice, gain hands-on skills, and learn to navigate the ins and outs of their potential work environments. There is no replacement for the practical knowledge that is gained through this type of learning.

However, this perspective does not account for the contribution of nursing students to the facilities and teams in which they work during their placements. These work placements are highly valuable to the students, but they are also valuable to the medical field.

Student nurses come from their universities with fresh knowledge and a clean slate, complete with optimism and void of any bad habits that need to be unlearned. Students also come out of school and into the workforce having just learned the most recent medical research, something that can be very beneficial to the hospitals they work in.

This is where the Canadian Nursing Students’ Association (CNSA) comes in. It is primarily a nursing student advocacy group, but it also helps to develop curriculum changes and future curriculums for nursing students across Canada. In the summer of 2017, it helped pass a resolution to have the Federation of Nurses’ Unions investigate a fair wage for final preceptorships.

The CNSA holds regular conferences for nursing students across the country and has also created a Legacy Fund to increase scholarships and awards to $150,000 over the next five years. The fund provides individual scholarships in a variety of categories, as well as travel and accommodation for conferences. This year’s CNSA national conference will be held in Nanaimo B.C. and will focus on interdisciplinary care.

Keri-Ann Berga, an associate professor in the nursing program at MacEwan University, says it is “inspiring to know that we have such skilled and knowledgeable future nurses who will be shaping our healthcare system.”

She also says that hearing about the experiences of nursing students involved with the changes being made by the CNSA has helped her “recognize how nurses are extremely well positioned to be leaders in the healthcare system locally, nationally, and globally.”

According to the CNSA website, the organization is devoted to furthering the legal, ethical, professional, and educational aspects of the nursing industry. The organization’s advocacy committee works to make changes within nursing all over Canada. This move to paid practicums falls under the goal of bettering the ethical aspects of student nursing programs. If people are working, they deserve to be compensated for that work.

Rachel Boyle, a recent graduate of MacEwan’s nursing program, says she understands where both nursing students and field placement sites are coming from.

“I mean, all nurses go through (an unpaid preceptorship), and I’m just not sure if there is money to pay students. I do know engineers get paid during their student placements, but maybe because it’s a different profession those (companies) have the money for it … You’re not an expert. This is where you get to learn and practice your skills.”

As a 2017 graduate, however, Boyle knows how difficult and stressful unpaid placements can be and recognizes that “any financial support is helpful as a student.”

According to a 2015-16 final report from Statistics Canada, undergraduate nursing students pay an average of $5,401 in annual tuition fees. This amount does not include textbooks or costs for other school materials.

In an article for the September/October 2017 issue of Canadian Nurse magazine, Colton Gray says, “School costs for the year amount to about $10,000, but these do not include transportation and parking expenses for school and placement, which are sometimes more than an hour away.”

A second-year nursing student at Georgian College and York University, Gray explains that, in her experience, nursing students are “expected to pay these costs, work almost full time with no pay, attend classes and do homework assignments and study, while having to work a real job to pay for school and all … other expenses.”

“I was told on my first day of orientation that I would most likely have to quit working if I was going to keep up with the demands,” she says.

In her article, Gray suggests two solutions to the paid placement dilemma.

Her first suggestion is: “Lower tuition costs, to reflect the time actually spent in the classroom, so that they are more feasible for the average student.”

Her second solution is that preceptorship sites “pay minimum wage during placements. This means that students would earn a little over $100 for each day.”

Gray says that either of these solutions would help students tremendously. She is also the founder of an online petition with change.org, campaigning for the fair payment of nursing students during their placements.

Advocating for changes in the way nursing practicums are run isn’t just helpful for current nursing students; it also encourages future nurses. A lack of compensation for work can be a hindrance to students who may want to pursue a career but be unable to afford the costs of training.

Exploiting nursing students may discourage some of them from pursuing careers in healthcare altogether. Paid practicums, however, are incentives for pursuing a nursing education.

By instituting paid practicums, the CNSA aims to level the playing field for nursing students.

Engineering students, for example, receive pay for their practicums, and a nursing degree takes the same number of years to complete. Medical students also receive pay for their practicums, and they are in a field that requires the same degree of competency and hard work as nursing.

The expectation that nursing students work for experience instead of pay while engineering and medical students receive compensation devalues the work nursing students do.

In order to function effectively, the healthcare system in Canada relies on nurses in much the same way it relies on doctors, and the CNSA argues that nurses ought to be compensated accordingly.

Today’s nursing students will one day have a critical role in our healthcare system. According to a report put out by the Government of Alberta, rates of opioid related deaths in 2016 were 12 times those of 2012.

Berga says, “As the healthcare system is constantly changing, I believe that nurses will increasingly be at the forefront of care of individuals, families, and communities.”

The reality is that Canada desperately needs more capable nurses, trained with as much hands-on experience as possible. At this point in time, we shouldn’t be asking ourselves if the system can afford to invest in paid final practicums for nursing students.

The question we should be asking ourselves is: Can Canada’s healthcare system afford not to invest in these nurses? 

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Graphic by Kia Valdez Bettcher.