Healthcare is under pressure. That is why it is extremely important that the University of Applied Sciences Nursing programme (HBO-V) trains enough new, motivated people. And yet too many students drop out in the third year. Not because they find the study too difficult. They mainly strand on the internship. The Partner Up collective within HBO-V - an inclusive participation of students and teachers - is trying to map the severity and extent of internship discrimination among HBO-V students.

When speaking of 'discrimination', one quickly thinks of racism and sexism. Internship discrimination in healthcare is broader, says HBO-V lecturer Andries Hiskes. "There it is also mainly about abuse of power. I had not even been a lecturer at the course for three months when I already had a crying intern with me who had been told words an intimidating way during her internship that I will not repeat here. Then I realised: this is a serious problem that we also need to do something about as an education programme." Alumna and nurse Christy Foster agrees. "Internship discrimination is a big, but also a latent problem. During one of my internships, I was scorned by the team I was in because I dared to question a colleague's action. I never reported it, but as a result, my internship was a very unpleasant period."


Andries Hiskes believes that as a school and as an education programme, you have a responsibility in this. He was therefore immediately interested when he heard a pitch about the Partner Up project! In it, students and teachers work in partnerships on a case relevant to them. For example, improving the curriculum. Why, Andries thought, couldn't that also be placement discrimination that HBO-V students were suffering from? He looked for co-researchers among lecturers, students, and alumni and so the Partner Up project Internship Discrimination was born.

Standing firmer

Andries: "Apparently the pressure on healthcare is so huge that the stress is taken out on the young trainees. But they don't ask for that pressure. They like the work in care, but not always the working conditions or the way they are treated. In our partnership, students, teachers and alumni think about the profession, how they can take a position in it and how they can be firmer in their own actions."
Christy: "Our consultations are highly democratic. Every voice counts equally within this Partner Up! project. As a partnership, we want to get as close to the trainees as possible. We want to pick up their stories. They can tell those in brave spaces."


If internship discrimination is such a big problem, these stories stack up, you might say. But this is where the partnership encounters a barrier. Andries: "We ask students to come to us outside their internship and study hours to tell us how they experience that internship. That's usually in the evening. Then they no longer have the energy, or they still have a small job to support themselves. The agenda of the modern student is very full. The alternative is to integrate our partnership into classes. But that can be difficult for teachers."

Change as a necessity

Andries, a teacher himself: "It is not unwillingness. There is also a pressure on them to teach a curriculum. They really need the time they are given to do this. But if nothing changes in the work culture, nurses will continue to drop out early in their careers. More and more fellow teachers see that this has to change. And so, we are getting wider and wider support among teachers."

Breaking through

Christy: "At first, I didn't recognise my unpleasant internship experience as a problem I was allowed to burden others with. I felt I had to solve it myself and almost fell into a burnout. I can imagine students thinking: what does it add if I report it? And if they already wanted to: where can they go? There are no guidelines, not for teachers and not for internship coordinators. So, every teacher has to constantly think of the best action to take. This has also caused many students to leave it at that. They are busy. Teachers are busy. Everyone is doing their best. Then if it doesn't work out with the internship, you choose another education programme. We want to break that."


Andries: "We let the collective continue to grow. We collect stories anonymously so we can share what is going on in the field. We call on students to tell their stories. The brave spaces are there for them, independent of teachers. This is about bringing about a sustainable cultural change within the nursing profession. Those who mature in this system adopt the behaviours of their superiors. Breaking that system is a very important goal of this Partner Up! project."
Christy: "With every new hurdle we face, I get more and more passionate. Then I think: this is exactly why it has been a problem for years. A problem we have to tackle together."

Call to Report

Are you an HBO-V student and have you (had) unpleasant experiences at your internship? Would you like to talk about them in a safe environment? Then sign up at Brave space.