Nursing students have only recently begun their gradual integration into the third-level sector after years of training in nursing hospitals and on the job. There are about 3,000 nursing students in the State, spread over 17 general nursing hospitals. Under the new nursing diploma programme, which replaced the more traditional, hospital-based nurse training, the nursing schools operate their programmes in association with a number of third-level colleges, including UCD, DCU, UCC and the RTCs in Waterford, Dundalk, Sligo and Letterkenny.

At the end of their course of study, which involves 58 weeks in college and 86 weeks in a clinical setting over three calendar years, the nurses are awarded a diploma in nursing from the associated third-level college, which entitles them to apply for membership of An Bord Altranais, the statutory nursing body.

The new programme was introduced on a pilot basis in 1994, in line with the recommendations in the report The Future of Nurse Education and Training in Ireland. According to a spokeswoman for An Bord Altranais, the move towards a college-based programme was in line with both global trends and a belief that nurses should have a greater body of knowledge on which to draw. "The way it differs is that, under the old system, the students were part of the workforce for three years," she says. "They would get a certificate in the end and they were registered with us." Under the new system, "the theory time has been increased and the students were made supernumerary and paid a grant".

The process of integrating nurses into the third-level system is still ongoing and may yet take some time: the practical training and placement work involved in nursing, combined with their longer academic year, means student nurses can find themselves at one remove from the rest of the student body. Difficulties like those being experienced by nursing students in UCG at present (see panel) can reinforce the impression of nursing training as a territory perched awkwardly between the education and health sectors.

"I don't think the nursing sector is fully integrated at third level but it is moving towards integration," says Malcolm Byrne, education officer of the Union of Students in Ireland. "Essentially, we'd like to see greater recognition given to the role of student nurses. There's a challenge not just to colleges but to students' unions to involve student nurses more." It is also a challenge for the Nursing Commission, formed earlier this year to examine the profession following the nurses' pay dispute. Among the issues raised by USI with the commission are the fact that nurses still have to sit two final examinations, one diploma examination and another separate registration examination; the difficulties in the current clinical assessment method, which nursing students claim is often personality rather than capabilitiy-based; and the need for a more clearly defined role for diploma student nurses, who are often used as staff when shortages occur in hospitals.

"Another thing that affects student nurses is that many have a longer academic year than ordinary students," Byrne says. "That means they need more money to get them through the year, but also that they have a shorter summer, which gives them less time to earn money to get them through the year."

Student nurses are also often expected to pay for travel to clinical placements and to cover their living expenses. In its submission on nursing education in Ireland to the Nursing Commission, USI proposed an increase in the £2,500 maintenance grant currently given to student nurses, arguing that the existing grant left student nurses below the poverty standard and failed to take into account the additional expenses incurred by the students. USI also says student nurses should have greater input into the content of their courses. Thus the union calls for student representation on An Bord Altranais, in order to ensure that the voice of student nurses is heard and that student nurses have a national forum to turn to in the event of difficulties at local level.

"Most of the nurses elected to An Bord Altranais come from a trade union base: the Irish Nurses Organisation, SIPTU nursing or the Psychiatric Nurses' Association," says Byrne. "But the needs of student nurses can be quite different to those who are professionally qualified. "In some cases, you may even have a conflict of interest: for example, a local INO shop steward may also be a lecturer in nursing."

A spokeswoman for the Department of Health said the Minister was still considering his 12 nominees to An Bord Altranais.