Providers have been urged to ensure nursing students from black, Asian and minority ethnic (BAME) backgrounds are supported to raise concerns on their return to clinical placements amid Covid-19, under new guidance.
It recognised that coronavirus had disproportionately affected people from BAME communities and highlighted that “systemic issues and experiences of discrimination” made it “more difficult for BAME students to raise concerns”.
“Systemic issues and experiences of discrimination can make it more difficult for BAME students to raise concerns”
The comments come in new guidance published by the Council of Deans of Health on returning nursing students to clinical placements, risk assessments and life assurance arrangements.
The guidance – called Returning to clinical placements – dealing with the risk of Covid-19 – said the impact of the virus on BAME groups meant risk assessments of students from these backgrounds “warrants sensitive and robust engagement”.
It stressed that universities and placement providers should support mentors and tutors to have “sensitive and comprehensive” conversations with BAME students.
“Systemic issues and experiences of discrimination can make it more difficult for BAME students to raise concerns,” said the document, published on 4 August.
“HEIs [health education institutions] and placement provider organisations should ensure that personal tutors and mentors are supported to have sensitive and comprehensive conversations with BAME students, recognising the longstanding context of the poorer experience of BAME staff in all parts of the NHS.”
As part of these conversations, existing underlying health conditions that may increase their risk when undertaking frontline roles must be identified.
But “most importantly”, the guidance stated that conversations should also, “on an ongoing basis, consider the feelings of BAME students, particularly regarding both their physical safety, their psychological safety, and their mental health”.
During the pandemic, the emergence of the disproportionate effect of Covid-19 on people from BAME groups has placed a stark lens on the inequalities faced by nurses from these backgrounds.
Recent reviews uncovered that institutional racism and bullying at work meant that nurses from BAME backgrounds were “afraid to speak up” about issues that put them at a higher risk of Covid-19.
At the peak of the pandemic, concerns were also raised to Nursing Times that BAME nurses and healthcare assistants felt they were being picked to work on coronavirus wards more so than their white colleagues.
Overall, the guidance stressed the importance of risk assessments for all student nurses, acknowledging that some “will be at greater risk of experiencing severe Covid-19 symptoms”.
Those who had been identified as ‘clinically extremely vulnerable’ or who have been shielding “may be best advised to defer their studies”, noted the document.
Among the guidance, the council also flagged the concerns of some universities who were worried about securing appropriate personal protective equipment (PPE) for student nurses.
“Some HEIs are concerned about their ability to secure PPE for students, particularly where supplies were donated to the NHS during the peak of the pandemic,” the document said.
The council went on to assure that it had “raised this matter with HEE [Health Education England] and asked that arrangements are out in place for university healthcare faculties to access enough PPE”.
In response, a spokesperson for HEE stressed that “the safety of students is of paramount importance”.
“Whilst HEE is not responsible for sourcing PPE, we will ask HEI’s and providers to give assurance that students have access to it as set out in the current Public Health England guidance,” they added.
In addition, the guidance went on to discuss life assurance arrangements and noted that “heightened risk and discussion of death in service during the pandemic has created some unease” for students returning to placements.
“The council has asked governments in England and Scotland to review life assurance arrangements for students on placement with a view to securing a comprehensive scheme to cover death from any cause related to healthcare placements,” noted the guidance.
A Department of Health and Social Care spokesperson said: “The death of any healthcare worker is a tragedy and the scheme provides added financial security for the families of frontline NHS and social care workers in England who die in the course of their work because of coronavirus during this unprecedented pandemic.
“The scheme also allows the health and social care secretary to consider individuals who are not automatically eligible, such as students on unpaid placements.
“Universities have a duty of care for their students and we would expect they have suitable liability insurance, whilst placement providers have liability insurance through the NHS Litigation Authority.”
Meanwhile, a Scottish Government spokesperson said: “In order to provide students and their families peace of mind at this time, the Scottish Government has confirmed that it will provide a temporary Covid-19 related death in service scheme to students of Higher Education Institutes on clinical placements in health and social care settings.
“This provides a single lump sum payment of £60,000 to the next of kin of any student of a higher education institute, should the worst happen.”