Nursing Schools: Lots of Applications, But Lots of Dropouts

Nursing schools face a paradox: an “attractive” course with a record number of applications on the post-baccalaureate Parcoursup orientation platform, but the training that many students drop out during the course is further exacerbating the shortage of caregivers.

According to the Ministry of Higher Education, in 2021, 365 Nurse Training Institutes (Ifsi) received more than 689,000 application files on the orientation platform after completing their bachelor’s degree. Just four years ago, the institutes registered 180,000 applications.

A surge that can be partially attributed to the 2019 reform. Prior to this, applicants were required to compete for each school they applied to, with key registration fees and travel. As of 2019, graduates apply to a maximum of ten Ifsi through Parcoursup, free of charge or competitively.

A nurse in the intensive care unit at the AP-HP Antoine-Béclère hospital in Clamart, near Paris, December 23, 2021 (AFP/Archive – JEFROY VAN DER HASELT)

“This profession is highly valued and respected in public opinion, but there is a gap between training and reality on the ground,” Mathilde Padilla, president of the Federation of Nursing Students (Fnesi), told AFP. A nursing degree is an “attractive course” but has a hard time keeping students, she notes.

A “chasm”, which, according to a young woman, explains the defection during a course of study.

Those refusals then escalate into recruitment difficulties for hospitals, according to a Senate commission of inquiry released in March.

Thus, two months after the start of the 2021 academic year, almost 13% of students dropped out, according to 165 Ifsi data submitted to the Committee for Paramedical Educational Institutions (Cefiec).

So many future nurses have been lost to the sector, “with very significant recruitment needs,” recalls Amélie Roux, human resources manager for the French Hospital Federation (FHF).

– “Orientation errors” –

Nurse at AP-HP hospital in Kremlin-Bicetre, near Paris, May 2021 (AFP/Archive - BERTRAND GUAY)
Nurse at AP-HP hospital in Kremlin-Bicetre, near Paris, May 2021 (AFP/Archive – BERTRAND GUAY)

Advertising campaign, announcement of opening 10,000 apprenticeship contracts at the beginning of the next academic year: the government has just announced a number of measures to change the profiles of students in the paramedical field.

In a sector where schools and health facilities make little use of apprenticeship contracts, the government hopes to attract new audiences and limit financial dropouts.

For nursing student representatives and trainers contacted by AFP, training is “the remedy, but not the solution.” “Between internship and theoretical training,” paramedic training is already based on fieldwork, stresses FHF’s Amélie Roux.

It is the confrontation with the reality of the hospital or other medical institutions, discovered during the internship, that is the first reason for students to leave during training, says Matilde Padilla. The Cefiec survey points to “orientation errors” and “personal reasons” cited by students when they left.

Vaccine preparation by a nurse in Quimper (Finistère), April 30, 2021 (AFP/Archive - Fred TANNO)
Vaccine preparation by a nurse in Quimper (Finistère), April 30, 2021 (AFP/Archive – Fred TANNO)

“The competition at least gave the students time to mature the project and think about the nursing profession,” says Michelle Appelshauser, president of Cefiec.

The Senate report, released at the end of March, addresses “less current” school access through Parcoursup.

“A selection that no longer has interviews is not appropriate,” Rémy Salomon, president of the Paris Hospitals Medical Commission, said during a Senate hearing. The “excessive demand” for high school students who want to become nurses is “directing too many profiles to Ifsi that seem insufficiently motivated or prepared for the reality of learning,” the Senate report said.

The president of the nursing student federation says she is “strongly opposed” to a return to entrance exams. Instead, Mathilde Padilla calls for the unification of the recruitment criteria between the 365 Ifsi and especially for “orientation work” in high school to avoid disappointment after entering the school.

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