Dropping like flies: The reality of unpaid placements

Bex Howells, second from the right, and other advocates fighting for paid placements for students in Aotearoa. Source: Supplied. 

Imagine being a student, juggling a full course load, a part-time job, and unpaid internships crucial for your degree. You're constantly exhausted, financially stretched, and worried about making ends meet. Well, health and social work students don’t need to imagine – because this is the reality in Aotearoa. 

By the third year of study, 25% of nursing students drop out – a figure that rises to 33% for Māori students and 37% for Pasifika students. The average dropout rate among midwifery students in 2023 was a staggering 42%. Additionally, the Social Workers Registration Board found that 45% of social work students did not complete their qualifications. 

"At the end of the day, we have seen that this system is failing miserably in so many different facets,” said former social work student Bex Howells. “And we are essentially hemorrhaging our training and graduate workforce. So, we have to do something different.” 

Howells contributed to this drop out statistic because of unpaid work placements. 

“I just thought, ‘This is ridiculous. I'm not risking my own basic needs to train in a short-staffed profession that will never pay me well enough to recoup the depth and training’. 

While attempting to juggle study and paying off a mortgage, she drew her studies to a close after the course coordinator announced unpaid placements.

Instead of accepting the status quo, she channeled her frustration into action. Howells was “really pissed off about this issue” and wanted to make a change. 

“I'm a raging feminist. And as I started to see that this issue affects nursing, teaching midwifery, social work, mental health – all of these female-dominated professions – and I just thought, ‘this is crazy’.” 

Howells pointed out that the chronic staff shortages in these professions is not by chance. “And it really isn’t any coincidence that they require trainees to collectively do millions of hours of unpaid labour every year to prove they deserve to earn an income at the end of it.” 

Howells is writing her master’s thesis on student experiences of unpaid placements, how they impact workforce development – and how we can change this system to make it better. But the thing that’s consuming most of her time is Paid Placements Aotearoa: a campaign advocating for paid training. 

Bex Howells, left, advocating for paid placements with the support of VUWSA. Source: Supplied. 

The platform allows students to share their stories anonymously if they choose, and let off some steam when the frustrations build up. 

“So many students come to me and say [they’re] so relieved someone's doing something about this. [The situation] really sucks.” 

Howells acknowledged the support of the Victoria University of Wellington Students’ Association (VUWSA) in organising events and encouraging student involvement. Managing the campaign has been a “wild ride”, with significant media interest, radio interviews, and TEDx talks. 

“I think the downside of the demographic that I'm advocating for is that they are slammed. They're already doing so much unpaid labour, between placements, ongoing study, and then having to do paid work on top, that they're just not the people that I should be asking for help,” she explained. 

Despite the challenges, Howells continues to lead the campaign, often with limited help. Even Hutt South MP Chris Bishop supports her cause. But Howells said that political viewpoints are irrelevant to this issue, as it affects everyone. 

"Wherever you sit on the political spectrum, everybody knows that workforce shortages are an issue. Whether you care about students or whether you care about accessing services, you're affected by this issue.” 

The data from Te Whatu Ora and the New Zealand Nurses Organisation underscores the severity of the problem. Over a quarter of nursing shifts fell short of safe staffing targets in the year 2023. 

“Students are exhausted, they are burned out, and they're over it. They're having to make choices between, ‘do I eat, or do I put a roof over my head?’ ‘Do I feed my kids, or do I put fuel in the car to get to my unpaid placements?’” 

Ara Nursing student Melissa Dunn echoed this sentiment. “Something needs to be done because it’s pretty ridiculous. We’re paying to work and learn.”  

After completing a 40-hour unpaid work week at her nursing placement, Dunn works at a shoe shop on Sundays. After only finding time on the Sunday to earn some sort of living, her holiday breaks are consumed by full-time work over three jobs in order to fund her living. 

“I was only getting my StudyLink each week, which was eaten up by rent, power, and food. There wasn’t much extra left over.” 

Placement was tough for Dunn, which might be a mutual feeling amongst her cohort. After months of study, they had six weeks of placement, with two major exams and a huge portfolio in the final week – which couldn't be done during placement hours. 

This consumed all of Dunn’s evenings and weekends, leaving no time for additional work except for five hours on Sunday. Not to mention the crowded schedule leaving little to no room for a social life. 

When the news rolled around that in Australia, those studying to be teachers, nurses, midwives, or social workers will get paid $320 a week on placement, Dunn was excited. 

“It was pretty awesome to hear – they’re definitely a step ahead of us and basically securing a workforce. My cohort isn’t just school leavers; many are young adults in their mid-twenties with families or living independently. Paid placements would significantly impact their lives,” said Dunn. 

Howells was mutually ecstatic with Australia’s progression and the leverage it would bring to Aotearoa. Until she read the fine print. 

“It isn't fair, and it’s not equitable, it only covers four professions. If you're training in mental health or any other healthcare profession that isn't covered, you still don't get paid. And it's means-tested, … I imagine they'll set the thresholds pretty low.” 

The Australian equivalent to Paid Placements Aotearoa’s advocacy is Students Against Placement Poverty. Their stance was that it still wasn’t good enough, especially in relation to the means testing. 

“It is an absolute disgrace that people training in these largely feminised industries must, for some reason, essentially prove that they are poor enough to receive a payment that will keep them in poverty.” 

Bex Howells. Source: Supplied. 

Howells acknowledged that the reasons why students drop out of these courses cannot be entirely pinned on unpaid placements, but said, “If you ask any student, they will tell you that the financial hardship compounds any other issues that they're having.” 

Ten years ago, Scotland introduced paid training, and over those years, they’ve increased their nursing workforce by 94.7% and midwifery by 201%. 

“How much more evidence do we need that paid training works?” Howells said. 

Her approach? A steady stream of people coming into the workforce that will then alleviate those workforce shortages. 

“And in terms of the argument that there’s no money, my position is, ‘cool’. Well, no funding, no workforce – that's what it all comes down to.” 

The solution seems simple, but the execution is difficult when the students who fight for this cause have no time to do so. In the end, it's clear that the status quo is untenable. Paid placements are not just a solution – they are a necessity. 

And as Howells and many others advocate for this change, the message remains clear: 

“Training is compulsory, there is no other way to enter these professions. So, if it's important enough that training is mandatory, it's valuable enough to be paid.”