My Nurse Externship Experience

January 7, 2020

On December 27th, 2019 I officially retired the ceil blue scrubs after working my last day as a student nurse extern.

To give you some background:
  • I interviewed for this position in November of 2018. In my interview, I expressed an interest in working in a Critical Care setting. I was told that the program does not place newly admitted students (I began nursing school in August 2018) in Critical Care settings but they had the "perfect" setting for me.
  • After interviewing, I was offered a position in the CV IMCU (Cardiovascular Intermediate Care Unit) approximately 1-week later. On this unit I would primarily see heart failure patients, LVAD and HVAD patients, Post open-heart surgery patients, Pre-Op open heart surgery and Vascular surgery patients.
  • The hospital I worked in is a Level 2 trauma center.
  • The pay rate was non-negotiable.
  • The position was a PRN position - meaning I was required to work only 1 shift every 2 weeks.
  • Over the summer I was working anywhere from 3-5 days per week and did not receive any overtime pay.
  • I worked 12-hour shifts during the day for the duration of my externship with the exception of 2-night shifts in February 2019.
  • This externship is as long or as short as you'd like it to be - one semester, 1 year, 3 semesters, whatever!
  • The externship naturally merges into a new graduate residency meaning externs have carte blanche when it comes to picking new graduate residency positions. 
  • We had the opportunity to pick up shifts on other units as they were posted in the facebook group, however, these shifts would always go very fast!
  • There was also the option to request to work but there was no guarantee where you'd end up in the hospital - staffing would place you on any unit that was short-staffed.
  • I typically had anywhere from 6-8 patients per shift.
Getting into specifics of how I served in my role:
  • In my interview I was told that I would be directly shadowing a nurse, administering medications and practicing skills (starting IVs, inserting foleys, dressing changes).
  • Once I began on the unit I was trained for 3 days by 3 different Care partners (Patient Care Technicians).
  • My actual scope of practice was the same as other care partners on the unit: bed baths/assisting with showers, ambulating patients, assisting with feeding, linen changes, obtaining vitals signs, assisting with patient transport and checking blood glucose levels. 
My thoughts on the externship:
  • After 1 year I was supposed to move into an Extern 2 role (finally move into the CV ICU), however, when I mentioned this in my annual evaluation it was bypassed.
  • I was very firm and persistent about what I wanted. I had classmates tell me that they went into their interview as an open book and were placed on a GI or Renal floor when they really wanted placement in the Women's Services tower. 
  • After 1 year I did not receive a raise, however, other externs stated they did not either.
  • During my Fall 2019 semester, I filled out a questionnaire from school for practicum placement. The understanding was that students who have an externship will be placed at their respective hospitals and units. I was not placed in my unit or at my hospital. This was a major reason why I stayed in my externship for so long. Once I found out I did not receive any placement at my externship hospital I resigned.
  • I also resigned due to the fact that the program was not what I expected/what I was sold on. 
  • I had monthly and sometimes weekly check-ins with the extern coordinator to express my concerns and update her on my progress with school, which I really appreciated. I could tell that she genuinely cared about how I was doing and any concerns I had about the program.
  • Only a handful of times did I have the opportunity to work with other Nurse Externs.
  • I never got the opportunity to practice any skills, administer medications, practice patient education, or work a code. 
  • I left on good terms and gave a two-week notice/resignation.
  • This is my final semester in school and it would be almost impossible to juggle 2 jobs along with practicum. Another reason why I chose to resign from this job was for the simple fact that in my PRN patient care technician job I am required to do a MINIMUM of TWO hands-on patient care tasks (drawing labs, setting up a syringe pump, hanging maintenance fluids, assisting with a code, picking up formula from the formula room and feeding a child, bladder scanning and straight cathing a patient, assisting with a bath, etc.) I learn so much more at this job and the differentials for working weekends + nights is definitely noticed each pay period.

I'm grateful for this opportunity and I definitely think it will help when it comes time to interview for new graduate residencies! I do plan to apply at this hospital for a CV ICU residency. Given my background of working as a CNA for 2 years prior to starting nursing school, I felt as though this externship was just a continuation of working as a CNA. I feel as though this externship would be ideal for a student that recently started nursing school, that has no hospital experience or no experience working in a clinical setting.

If you've ever had an externship or you're applying soon let me know your experience in the comments! 

Talk to you soon!

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