Nursing students forced to pay to work at placements

Graphic by Augustine Ng.

Fourth-year nursing students in their final semester are paying for their clinical placements, and some students are not happy about it.

Students at the Daphne Cockwell School of Nursing are paying a full semester’s tuition to complete 350 hours of clinical training between January and April. Throughout this, they are only enrolled in one class at Ryerson. This means they are either at clinical three times a week for 12 hours or four times a week for eight hours in order to complete the required hours on time.

After these long shifts at the hospital, many nursing students cannot manage a part-time job in order to pay for school costs. Even for those who can, clinical shifts are not always set and can change every week, making it difficult to secure part-time job availability. “After three and a half years as a bank teller, I was told at my work that I must resign as they cannot accommodate my inflexible schedule,” said fourth-year nursing student Boyan Avonlea. This means that he will not be able to work until the National Council Licensure Examination (NCLEX), a nationwide examination for nurses to obtain their license,  is over in June.

“That’s a long period of unemployment for a single, mature student who does not have parents or a partner for support but must live off OSAP -, which is not a lot -, or from credit cards and lines of credit,” he said.

According to the director of the nursing school, Nancy Walton, the cost of the last semester’s tuition isn’t just to cover the placement.

“When we look at nursing costs we look at the program as a whole, rather than saying certain year levels cost more or less than others,” she said. “And, the university incurs costs not just in relation to classroom teaching, but all of the work that goes into running the nursing program as a whole.”

Walton added that the nursing central placement office is always working hand-in-hand with health care and community partners to find placement opportunities for students that meet curriculum requirements and which allow them to develop their skills.

“They also visit all placements and spend a great deal of time exploring new placements on a constant basis,” she said. “We also have costs related to lab and simulation experiences, which we are always trying to improve.”

But Walton, a graduate of Ryerson’s undergraduate nursing program, said she understands where the concerns of students are coming from.

“I think one of the changes we’ve seen is the increased complexity of students’ lives,” she said. “Fifteen years ago, student had lots of demands on them then. Most worked, were financial providers or caregivers for their families, so they had a lot of responsibilities outside of school but I think from my own perspective that students now have even more, multiple demands on them.”

In the first semester of their fourth -year, students must complete a mere total of 176 hours at clinical while attending three classes at Ryerson, in comparison to the 350 hours requirement in the second semester. According to one student, her tuition in her first semester totalled $3508.93. Her second semester’s tuition was not much different at $3576.42.

These figures don’t cover the out-of-pocket fees that many nursing students have to pay, ranging from transportation to the cost of scrubs (which are about $80 each). To do clinical work, students must complete paperwork every year, including a vulnerable sector screening which costs $35, as well as Health Care Provider CPR which is $40 each year.

For students like Shahar Amir, even parking at her placement adds up. The cost of parking at Mackenzie Health, the hospital she’s placed at, is $15 every shift. She said she’s very thankful she wasn’t in this situation throughout all four years of the program.

“Since I do 12- hour shifts, that’s four hundred dollars that I spend solely on parking,” she said. “I’ve gotten so used to paying for hospitals fees that I keep telling myself this is just another part of the program, another thing I have to do to graduate. But really I think it’s completely unfair, especially since we’re not getting paid.”

Whether or not it’s fair, completing 350 hours of clinical and paying the costs that come with placement are necessary to graduate the nursing program. Walton encourages students in their final semester to keep pushing through until the end.

“Students need to remember that they’re almost there,” she said. “They’ve already come so far and this is their last push before they can say they’ve made it.”