Why students are leaving healthcare before qualifying

Newly qualified Midwife, Georgina, left the profession after graduating with a First Class degree: how can we prevent this?

Georgina Harrow

The recruitment and retention of student nurses and midwives is everybody’s business; everybody is a patient at some point in their lives. Patients deserve access to high quality care from a well-qualified workforce. Equally, healthcare staff and students deserve to work in well-supported environments, with staffing levels that promote safe high-quality care. All students want is to be able to undertake their training and future job that they love, safely and professionally. This is not possible with the current staff to patient ratios in the majority of areas. 

Something has to change. We are losing quality students to burnout before they have even started their careers.

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There can be many reasons why students seek employment elsewhere once they have qualified, whether this is within the healthcare profession or not. Students are willing to relocate due to having a greater number of employment opportunities open to them than what may have been available to past generations. Another important factor influencing student choice is the quality of preceptorship and the level of support on offer. Preceptorship is a period of transition from student to registered nurse/midwife, which often involves more clinical supervision.

With being a newly qualified midwife myself, I come from an understanding of the pressures that the NHS and its staff are currently in. For the entirety of my life, I wanted to be a midwife. I grew up wanting to make a difference to peoples lives at such a vulnerable and life changing moment. I worked my butt off for years to get the grades to be accepted into University, but devastatingly, by the end of my three years of training I knew I didn’t want to be a midwife anymore; despite achieving a First Class Honours and being awarded by the University for my efforts as a student.

So how do we ensure we keep our students and ensure they stay and work for the NHS?

Firstly, to burden student midwives and nurses with large amounts of debt that they will struggle to pay back even with a modest NHS salary is just wrong. We should be doing everything to make the NHS as attractive as possible, but the current system and the removal of the bursary is making students think about leaving before their careers have even begun.

Secondly, there needs to be more opportunities and support available for students as they are eager to learn and thrive on challenge and opportunity. They look for ways to move up or take on new roles within the workplace, and value mentorship as a way to learn more and feel connected to a unified purpose – this is key to attracting and keeping students in the NHS. Lastly, but of critical importance, we should be offering more opportunities for students to train in a degree apprenticeship as it offers financial security and provides a flexible, work-based approach, combining University study and workplace learning.

Recruitment and retention is not an abstract challenge: it is an immediate and urgent problem and it really is everyone’s problem. But, if we can create a supportive, encouraging, safe environment from the beginning, perhaps we have a chance of helping to train our future nurses and midwives to be the very best that they can be, whilst also maintaining their own values and, crucially, their own wellbeing.

In summary the key things which need change to drive are: 

  • Backing NHS degree apprenticeships on a large scale, it is no longer good enough for a handful to be put through each year, the apprenticeship route should take precedence over international recruitment pipelines.
  • Implement mandatory mentorship programmes for all students on placement and into preceptorship
  • Values based recruitment should be implemented into the Universities to ensure that the right students are being selected – perhaps behavioral assessments should be used. The fact is that I was a dedicated student who entered university with a lifelong belief that I would become a midwife and I didn’t wind up entering the NHS. How can we expect individuals who selected courses through clearing to have what it takes to endure the process without proper support and mentorship?
  • Implement resilience and wellbeing training into midwifery and nursing courses

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Georgina Harrow

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