Access provided by
London Metropolitan University
Many nursing students need to work while studying to cover costs, but it can be tough to keep up with coursework and avoid burnout
Nursing students working while they are studying is less a question of want and more of need, says RCN professional lead for nursing students Rachel Wood. ‘It’s a financial necessity to find some kind of income,’ she says. ‘Unless a student is fortunate to have private means then the funding they can access is insufficient for them to live.
Nursing Standard. 39, 1, 33-34. doi: 10.7748/ns.39.1.33.s17
Published: 03 January 2024
‘In England, they’re entitled to a cost of living loan, but it’s not enough to pay rent and meet their daily living costs,’ she adds.
While students in Scotland and Wales have a bursary, which usually covers course fees, they still don’t have enough money to cover their living expenses, says Ms Wood.
An RCN Scotland survey published in June 2023 found that students are facing serious financial hardship, with many struggling to make ends meet. In the survey of more than 1,000 students in the country, 99% said their finances cause them some level of concern, with 90% saying they are working 11 or more hours a week on top of studies and clinical placements to supplement their income.
‘So many of us are struggling, given the financial difficulties we all face,’ says University of the Highlands and Islands third-year nursing student Lou Hyett-Collins, one of the Scotland representatives on the RCN students committee. ‘Behind every statistic are hundreds of individual nursing students trying to persevere with so many odds stacked against them.’
Chloe Jackson, a third-year nursing student at Robert Gordon University in Aberdeen and also a member of the RCN students committee, adds: ‘Nursing is not like other degrees. There are many nursing students who must work to supplement their income. Working long hours on top of completing clinical placements and studying can lead to burnout before students even start their nursing career.’
The RCN’s Ms Wood says putting students under the kind of pressure they are facing ‘might be a short-term fix, but will have long-term implications. There’s real concern about nursing students who complete their programmes but don’t end up registering to practise,’ she says. ‘We lose people who have great potential.’
» Prioritise your own needs, advises RCN professional lead for nursing students Rachel Wood. ‘You must put your own health and well-being first. Recognise your limitations and if you’re struggling, ask for help.’ This includes seeking support from your university or seeking advice from the RCN
» Find work that is flexible and fits around your studies, says newly registered nurse Lenka Huntley. ‘It’s impossible to do it the other way around’
» Put your studies first, advises Ms Huntley. ‘At the end of the day, being a registered nurse is where you want to be. Don’t lose sight of the bigger picture’
» Learn how to say no If you are working for an agency, don’t feel guilty about turning work down, says final-year nursing student Sam Moffat. ‘I used to get phone calls at 5.30am and you just have to say a firm no’
» Plan shifts carefully Don’t book them too far in advance, advises Mr Moffat. ‘Things change,’ he says. ‘And you also don’t know how you’re going to feel. In a lot of places, you can often book a shift the day before’
Other students often get long summer breaks, which means they can take a job and build a nest egg to draw on, says Ms Wood. ‘But nursing students don’t have those long breaks, so there’s no opportunity for them to do that. It means they are having to work during term times.’
Placements add to the pressures. ‘On placements, they may be doing shifts, or it could involve lengthy journeys – up to an hour and a half in some situations – so they’re struggling to fit everything in,’ says Ms Wood.
Ms Jackson adds: ‘Many nursing students are older and have existing financial commitments, children or other dependants, and many are responsible for providing more than half or all of their household’s income while studying. We need more financial support to prevent so many falling into hardship and experiencing burnout.’
While students can take on a healthcare support role, it should not go beyond their competence or skill base, says the RCN in its advice for nursing students.
‘It should be clearly understood by all staff that you are working as a healthcare assistant and not in a nursing student capacity,’ it says.
Before agreeing to the work, students should discuss the arrangements with their clinical supervisor, ensure they will be paid the rate for the job, ensure the nursing bank or agency specifies the basis of their attendance, and have the same access to all local agreements and terms and conditions as other employees, advises the RCN.
‘Nursing education continually enforces the importance of accountability,’ says Ms Wood. ‘When a student is working as a healthcare support worker, it’s a challenge for them to remember the role in which they’re working and the expectations of that role.’
In an emergency or when there are staff shortages, this can be doubly difficult. ‘It can be hard for them not to use the skills and competences they may have already gained,’ she adds.
Placements may also be affected. ‘If someone has built skills and competences in a paid healthcare role, they should not be using them inappropriately when they’re a student on placement,’ says Ms Wood.
‘It’s important to value those transferable skills, but equally students are not there to be an extra pair of hands, and their supernumerary status needs to be protected.’
While placements should be designed to give students what they need to achieve their goals, a wide range of work experience can enhance knowledge, says Ms Wood. ‘It could be a good thing, complementing the programme,’ she says.
For newly registered nurse Lenka Huntley, who graduated in 2022 from Brighton University, the primary aim was to gain experience. ‘Although the extra cash is good, it also gives you many transferable skills,’ says Ms Huntley, who worked as a healthcare support worker on the bank for her local trust alongside a paid role with her university as a student ambassador.
Ms Wood says concerns about working while studying relate to achieving a good work-life balance and the detrimental effect having to work could have on a student’s health and well-being, as well as their ability to learn.
Almost three quarters (74%) of students who responded to the RCN Scotland survey said financial worries were having a high or very high impact on their mental health, with 58% saying this was having a high or very high impact on their academic performance.
Try your local trust for bank work as a healthcare support worker, advises Ms Huntley, whose book How to Thrive as a Mature Student Nurse, published last year, includes a chapter on working while studying.
‘If you’re on placement with them, they’ll usually take you on in a support worker role,’ she says. Other options include your local care home.
It is also worth looking at any opportunities with your university. ‘They usually advertise for student ambassadors around September,’ says Ms Huntley. She was able to choose when she worked in a role that also included blogging about her experiences as a student.
Now in his final year at Dundee University, Sam Moffat has worked most of the way through his adult nursing degree.
‘I do have the advantage of having a Scottish bursary and that covers a good chunk of what I need,’ he says. ‘But to be able to live a life, rather than just pay the bills, I work too.’
Initially, he continued working at a care home where he had been employed before he became a nursing student. He then worked as a community carer with an agency where he could choose his hours.
‘That’s important for students,’ he says. ‘When you’re doing theory, you want to work more, but you have to bear in mind you have essays to do as well. It can be tricky to get the balance right and you need to work out what’s best for you.’
Working can give you a more holistic view
Although he loved the community role, he found working conditions so poor he left. ‘We’re only paid for the time we’re booked into someone’s house, so I could end up doing a six-hour shift, but only being paid for three and a half hours,’ says Mr Moffat. Being a nursing student also made him appreciate that the care he was able to give fell short of what he wanted to deliver.
Despite the difficulties, he believes working can give students insights they may not otherwise gain. ‘It can really open your eyes to other areas of healthcare and you understand the relationship between different providers, giving you a more holistic view,’ says Mr Moffat.
‘I loved going into people’s homes and being able to work a bit more independently. In a hospital, people are often reduced to beds – such as ‘bed number one needs this’ – but in someone’s home, you’re going into their environment and it’s about them being able to live their lives.’
Finances, placements and well-being: support for nursing students rcni.com/student-finances-support
