Hosting Student Nurse and Midwife Placements in Ireland: What Employers Should Know

Student nurses and midwives spend a large part of their programmes in real clinical settings, and the organisations that host them carry real responsibilities. If you manage a ward, a nursing home, a community service or a maternity unit, you may be asked to take students from a higher education institution (HEI). This guide explains, from the Nursing and Midwifery Board of Ireland (NMBI) pages we could open, what hosting involves for employers, where the official pages are silent, and how to prepare. It is a workforce and governance guide with no clinical content. Many hosts also run preceptorship for newly qualified staff, which is a different stage; see our guide to preceptorship for newly qualified nurses and midwives.

Who sets the rules for placements

NMBI approves nursing and midwifery education programmes, and its standards cover practice placements. On its practice placements page (part of its approvals material for nursing programmes; the page shows no date), NMBI describes placements as a shared responsibility between the education body and the associated healthcare provider. They select, develop and provide placements together, so that students get a broad range of experience that supports the curriculum and the competencies needed for registration.

The same page says a Memorandum of Understanding sets out the commitment of both parties to monitoring placement quality and describes how academic staff liaise with practice sites. It adds that placement choices must be reviewed and monitored on an ongoing basis, because health services change. For an employer, the practical point is that you are a partner in a documented arrangement, not just a place students are sent.

What NMBI says the host setting does

According to the NMBI page, clinical placement settings:

• work with the HEI to monitor and support the learning environment, as set out in the Memorandum of Understanding;
• work with the HEI on the audit of placements (the standard says all placements are audited) and, under an agreement between the HEI and the healthcare provider, safety concerns raised by students are followed up with the clinical site;
• where students are supervised by other multidisciplinary professionals, make sure a registered nurse monitors that learning, and that a registered nurse can take part in the final assessment of the placement.

The page also says education bodies must have a framework for students to raise safety concerns, plus a formal process, agreed with the healthcare provider, for following up with the clinical site. Hosts should therefore expect to receive and respond to concerns routed through the HEI.

The clinical learning environment guidance

NMBI's National Quality Clinical Learning Environment (NQCLE) Professional Guidance Document is titled 2020, and the document gives its publication date as April 2021. It replaces a 2015 publication and is aimed at registered nurses and midwives who teach and assess pre-registration students in clinical settings. According to the document, a quality clinical learning environment includes:

• a supportive, respectful culture based on trust and partnership;
• dedicated time for registered staff to lead and support students, and enough registered staff at all times to supervise them;
• a named preceptor for each placement, with clear learning outcomes and planned reflective time;
• a written, structured orientation for students;
• students treated as supernumerary, except during internship;
• respectful environments in which patients, students and staff are treated with dignity and respect;
• student participation in the placement audit.

It also assigns roles. The director of nursing or midwifery holds overall governance for the suitability of the environment and delegates preparation for audits. Other roles include the nurse/midwife practice development coordinator, the clinical placement coordinator, the allocations liaison officer and the clinical nurse or midwife manager, who selects preceptors. The preceptor is described as the primary teacher in the clinical area, and the document advises that preceptors will have attended the teaching and assessing course before taking up the role, and says preceptors must undertake a refresher course every two years.

Audit of the placement site

The NMBI practice placements page says all placements must be audited to confirm they are suitable learning environments, and that before a new site is used the HEI must endorse the completed audit and submit verification to NMBI. The NQCLE document says the audit tool is completed collaboratively by healthcare providers and HEIs, supports NMBI site inspections, and helps identify how many students a site can support. It also says HEIs and healthcare providers are required to produce an annual report that includes information on the quality of the practice placement.

One caution: the document is not consistent about audit frequency. It says existing sites are audited every 24 to 36 months in one place and that all sites are audited every five years in another. We therefore give no single interval; ask your HEI partner which applies to your site.

Practical suggestions for host employers

Our suggestion: the following is our own checklist, not an NMBI requirement.

• Name your lead. Decide who in your organisation owns student placements and who answers the HEI. Write the role into a short procedure.
• Check preceptor readiness. The NQCLE guidance advises the teaching and assessing course before taking up the preceptor role and says preceptors must undertake a refresher every two years. Keep a record of who has completed it and when it falls due.
• Plan the first week. A written orientation is part of the NQCLE description. Decide what students are shown on day one, and which of your local policies they must read.
• Agree what is expected of students before arrival. The pages we read do not say which employer mandatory training a student must complete or who provides it. Ask the HEI, and see our overview of mandatory training for healthcare staff in Ireland for the wider picture.
• Keep records. Track preceptor training, orientation, audit dates and concerns raised. Our guide to a training records matrix for healthcare employers shows one way to organise training evidence.
• Protect capacity. Agree with the HEI how many students your site can support, using the audit outcome, and plan staffing so supervision time is real.

What we could not confirm

This post does not cover Garda vetting of students, indemnity arrangements, uniform or occupational health requirements, placement allowances or the HEA's role. We did not find an official page we could open that sets out those points for host employers, so we leave them out rather than guess. We also did not open NMBI's separate midwifery approvals page, so the standards quoted here come from the nursing programmes page and the joint NQCLE guidance. Your HEI partner and your own HR and legal advisers are the right sources.

Learnsignal's offices are off Baggot Street in Dublin, and we offer in-person training from there. For current details, see our CPD pages.

Frequently asked questions

Who is responsible for the quality of a student placement?

NMBI describes it as shared between the education body and the associated healthcare provider, set out in a Memorandum of Understanding, with the director of nursing or midwifery holding governance for the suitability of the environment according to the NQCLE guidance.

Are students counted in the staffing numbers?

The NQCLE guidance describes students as supernumerary, except during internship. Check the detail with your HEI.

Does a new placement site need to be audited first?

According to NMBI's practice placements page, yes: before a new site is used, the HEI must endorse the completed audit and submit verification to NMBI.

Do preceptors need specific training?

The NQCLE document advises that preceptors will have attended the teaching and assessing course before taking up the role, and says they must undertake a refresher course every two years. Confirm the current expectation with your HEI.

Hosting students well is easier with clear ownership, current records and an early conversation with your education partner.