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Seize the opportunity an externship offers

Mang, Lauren SN

doi: 10.1097/01.NURSE.0000392977.69031.3b

Nurse externships

Lauren Mang is a senior nursing student at Holy Family University in Philadelphia, Pa. She expects to receive her BSN in May 2011.

NURSE EXTERNSHIPS can open the door to real-life situational learning. Nurse externships are educational programs that take place over the summer so nursing students can gain experience.1 All the lectures and assignments in nursing school can't compare with the application of theory that externships offer. I learned from my professors and peers that externships are excellent for bridging the gap between classroom theory and clinical practice.

In this article, I'll tell you about how I got an externship, what the experience was like, and the benefits I gained. (See 8 tips for success.)

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Meeting my goals

I spent 8 weeks as a nurse extern at the side of a nurse preceptor on the trauma unit of Cooper University Hospital in Camden, N.J. Since 2001, 439 externs have gone through the nurse externship program at Cooper University Hospital, which hires about half of them after graduation, according to one of the hospital's clinical educators.

Not only did I get a lesson in experiential learning from the hospital's talented staff, but I met my personal goal of increasing my knowledge base to enhance classroom learning during my senior year. I anticipated that with this additional experience, I could achieve higher exam scores throughout my senior year and improve my performance on the NCLEX exam. Research shows a statistically significant difference in the NCLEX-RN pass rates of first-time candidates who've participated in nursing student extern programs and those who didn't.2

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Finding a match, snaring a position

Externships are fairly easy to find because many hospitals across the United States offer them.3 I researched the hospitals near my home by looking up their web pages to determine which ones offered externship programs. I'd already learned that I didn't need a sponsor to apply for an externship and that I could apply for any nurse extern position that was offered.

To make the most of my time, I knew I wanted to work in a department that would maximize my learning in an 8-week span. Knowing that I was most interested in trauma, I found the hospital with the program that matched my interests and began the three-part application process: the written application, an interview with the human resources department, and a second interview with the trauma department.

After submitting an application and waiting patiently, I was selected for an on-site interview. I was ecstatic! I looked forward to showing them that I was exactly the extern candidate they were seeking.

Because this was my first professional interview, I was extremely nervous, but I learned that being prepared helps relieve the jitters. For example, I knew that first impressions matter, so I put together my most professional outfit—and what I didn't have, I borrowed. Some people make the mistake of dressing inappropriately for an interview. Don't be that person.

To prepare for the interview, I researched the hospital's mission and vision statements and compared them with my own values and beliefs. Work is a relationship, so it's more than fair for job seekers to have questions for the prospective employer to ensure a good fit. I compiled a list of questions to ask about their environment and how the externship program works.

During the interview with the human resources department, I answered such questions as, "Why do you feel you're a good candidate?" and "How do you define teamwork?" Because I'd anticipated these questions, I answered with confidence. I asked the human resources department questions such as, "What's expected of me as a nurse extern?" and "What kinds of responsibilities will I have as a nurse extern?"

After being selected for a second interview with the trauma department, the interview process started all over again. I compiled another list of questions about the trauma unit and what nursing management would expect of me as a nurse extern. I thought my interview with two of the unit managers went very well. They asked me questions that focused more on nursing, such as, "How often would you turn a patient?" and "What kinds of patients have you cared for in the past?" They also asked me about my previous experience as a certified nurse's aide.

After a few more weeks of waiting, I learned that I'd earned the position. It was time to buckle down and prepare myself to be a nurse extern.

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Putting skills to work

I was scheduled to work three 12-hour shifts per week. On those days, I met with my preceptor at 0700 and participated in the morning shift change report. We were generally responsible for three patients, but depending on the census, sometimes we had only two. During report, I wrote down everything I deemed necessary. Because I was working on a trauma unit, I'd start with the patient's mechanism of injury, the injuries sustained, and the systems affected. After report, I researched my patients' injuries, chief complaints, and medications.

Figure. Ex

Figure. Ex

With the exception of medication administration, I was encouraged to become involved with every aspect of nursing practice. In collaboration with my preceptor, I was permitted to plan patient care, participate in providing care, and document care.

After spending my mornings researching my assigned patients, I participated in rounds with the physicians, nurse practitioners, and my nurse preceptor. Rounds were extremely beneficial because I was part of the safe, holistic care of each patient. I was able to get a glimpse of what it means to be a professional nurse by communicating as a patient advocate. As weeks went on and I became more comfortable with my preceptor and the nursing staff, I was able to give report to the next nurse. This was a great experience because I not only gained confidence but also learned effective verbal communication skills using a systematic process.

Every day was a learning experience with something new and exciting to accomplish. I assisted residents with chest tube placements, and with the assistance of my preceptor, I inserted indwelling urinary catheters, changed central venous access device dressings, inserted nasogastric tubes, and removed arterial lines, among a long list of other duties. I took the opportunity to learn as much as I possibly could.

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Accomplish your goals and believe in yourself

This gratifying experience gave me the confidence I needed as a person, a student, and a future professional nurse. As the externship was nearing its final days, I was sad to see it end. As an extern, I'd learned new nursing skills and mastered others I'd been taught in school. I was very pleased with the relationship I developed with my assigned nurse preceptor. I valued working side-by-side with her, as well as with the whole nursing team. For me, the experience validated the value of teamwork as the basis for quality patient care.

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8 tips for success

  1. If you can, choose a unit that best matches your interests.
  2. Most externships require two reference letters from your clinical instructors. Contact these instructors, tell them about the position you're applying for, and request a letter of recommendation for the facility. Also get the instructors' phone numbers or e-mail addresses and keep them handy.
  3. Brush up on your nursing skills, such as taking vital signs, assessing lung sounds, and reviewing critical lab values.
  4. Be prepared every day and be on time. Punctuality is a must!
  5. Have a discussion with your preceptor to determine if there are certain situations where you shouldn't be involved. Then, follow your preceptor everywhere you can. Don't worry that you're "bothering" your preceptor, who's there to teach you.
  6. Don't be afraid to ask questions—you aren't expected to know everything.
  7. Keep a daily log of new learning experiences.
  8. Be a team player. Show that you're there to learn and help.
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1. Southwestern Medical Center. Hospital externships, internships, and continuing education .
2. Washburn JT. The influence of participation in student nurse extern programs on NCLEX-RN pass rates for first-time candidates. Masters Theses and Doctoral Dissertations. Ypsilanti, MI: Eastern Michigan University; 2006.
3. 2011 U.S. Summer externship and opportunity resource guide .
© 2011 Lippincott Williams & Wilkins, Inc.