NURSING enrolments need to be closely monitored from next year to ensure the number of undergraduates doesn't swamp the capacity of the health system to provide clinical places.
Jill White, chairwoman of accreditation body the Australian Nursing and Midwifery Council, said there was a strong possibility the government would have to cap nursing places, a direct contradiction to the student-demand driven system that will come into play next year.
The council will write to all institutions reminding them of their responsibilities to keep the ANMC informed of any "larger than normal" changes in student numbers, staffing patterns and infrastructure.
Nursing students are required to undertake 800 hours of clinical placement over three years.
"We need to keep clinical places, new graduate places and university intakes in some form of alignment," Professor White, dean of nursing at the University of Sydney, said.
She said nursing was likely to attract large enrolments in the uncapped system.
"We don't want to get out of kilter by opening the floodgates too early," she said.
She said the availability of clinical placements was patchy but not yet at a crisis point.
Chairman of the Council of Deans of Nursing and Midwifery, Patrick Crookes, echoed her concerns.
"I'd like to see a managed increase over several years," he said.
However, Leone English, dean of health at Holmesglen TAFE in Victoria, said nursing was expensive to run and institutions were likely to limit their student intake accordingly.
"This may make nursing courses less attractive," she said.
In 2009, the federal government allocated $157 million to boost the supply of clinical placements.
Professor Crookes said he was optimistic dedicated health workforce funding would deliver the necessary increase in placements, but warned that additional money needed to be made permanent, possibly by incorporating it into base funding.
According to the council of deans' submission to the base funding review, the average cost of an 800-hour placement is about $6672 per student, compared with present funding of $3300.
Professor White said universities need to look beyond hospitals as sources of placements to include community medical centres, general practitioners and aged care.
The tightness of work placements is frustrating students. At the University Technology, Sydney, where a doubling in international nursing enrolments this year to 300 has contributed to a dispute with nursing staff over workloads, students complain about being given late notice of placements and of having to travel long distances.
"It is a big issue," UTS student association president Neha Madok said.
UTS dean of nursing, midwifery and health John Daly said all students are guaranteed access to required placements. The need to provide a range of experiences meant that it was necessary to place students across the metropolitan area.