Externships--check in!

cheleandco · Jun 22, 2004

I'm with you - way in over my head at times. But for me that's good because at the end of my 8 weeks, I'll be really way ahead in the critical thinking department. My externship is in the PACU - hospital setting. I choose the PACU as a great way to sharpen my assesment skills and to see if I wanted to pursue perioperative nursing. Here, things move very fast at times - as I am sure they do in the ED. So far I've gotten a great welcome. They don't see many externs in the PACU. Only 1 nurse I've met was very assertative that I should be on a med/surg floor and not where I am. So many personalities...so little time.

Best of luck to you. let us know how it goes!

purplemania, BSN, RN · Jun 22, 2004

you are absorbing much more than you realize. Observe therapeutic communication between nurses and patient/family. Try to predict what the nurse or MD will do next (you will begin to see patterns and that will help you in the future). I am glad you are getting this experience.

JudithL_in_NH · Jun 25, 2004

Any other externs out there? :)

LauraLou · Jun 25, 2004

I am a little disappointed in my externship. They don't let me do as much as I had hoped. They let me d/c Foleys, but I can't insert them or d/c IVs. I spend most of my day making beds and taking vital signs. It is physically exhausting but not mental challenging.

On the plus side, I have learned a lot about the realities of being a nurse. I now know what questions to ask when interviewing for a job, such as how much do you float, how often do you cancel shifts, how is scheduling handled, etc.

So while this summer isn't as much of a technical learning experience as I had hoped, I have learned a lot about what it is like to be a hospital nurse.

PSUNURS05 · Jun 26, 2004

I am doing an externship in the MICU.....great experience, great staff, very informative, very educational....I don't really have a preceptor I just go around and stick my nose into whatever is going on...When I see someone (nurse) get up, I follow them. I do have one nurse who has taken me "under her wing" so she lets me do stuff under her supervision (shots)....I started my first IV today...sucker went in first try......did 4 foleys this week (2 men and 2 women...men aren't as easy as you might think...finding the hole is easy, but)...d/c'd foley today....I take out IVs, hang (spike) IV bags, do drips, ET tube suctioning, run EKG strips, enteral feedings...and of course my favorite...the bed bath (;-)....my facility does their baths during the 3-11 shift and I was on 3-11 all week..I am just slow and it annoys me because it is basic....they want me to work for them when I graduate....Apparently the externs they had in the past would sit and read magazines (People)....

one nurse told me it isn't what you know.. just that you show some INITIATIVE......

However, I am torn between ICU and OR.....but that's another story for another day...

cheleandco · Jun 26, 2004

How true about showing initiative -the day goes faster and you'll be surprized just how much your absorbing.

I'm not allowed to start iv's or do push meds but I do everything else in the PACU. Started about 6 piggy backs and have had allot of impromptu lessons from a Dr. who is studying for his boards. Our PACU jumps with about 40 same days per day. If anything I hope to get my mechanical skills down so then I can then concentrate on critical thinking.

As for the OR or the ICU the nurses at my place can do both - it falls under critical care nursing or AORN. They say if you get your assessment skills down tight you can pretty much work anywhere. They all have stressed to get a year on the med surg floor to better see the process of healing.

Wish you the best!

sweetyjen · Jun 27, 2004

Hi! My externship is on a Med Surg floor. I am allowed to do about anything besides give meds. It has helped out so much to see the routine of things and I am now starting to get my own routine down. I work with 1 nurse for the entire summer. We are allowed about 4-5 "observation" days where we go to other areas that we're interested in. I have been to the ER , outpatient diagnostics, and am getting ready to follow the IV nurse and then go to labor/delivery. We also have classes we attend every once in a while. We had basic dysrhythmias, getting ready to have an IV therapy class and then IVP class. So far all I have really done is drop an NG tube, take out foleys and IV's, dressing changes, basic things like that. But this experience is so helpful, and will help out so much for the fall. How are some of your extern programs organized? Do you have classes and meetings? I would be really interested in knowing how other people's externships are going and what all it involves!! Thanks! :)

JudithL_in_NH · Jun 27, 2004

In our program, we attended a week-long orientation which is the same as what new nurses go through. It included several hours-long classes on diabetes management, restraints, and respiratory therapy, as well as the nitty-gritty of hospital policies, legal issues, delegation, the computer system, etc. During the course of the program, we have two individual conferences with the Externship Director, and a group "graduation" (there are 12 of us) that we can invite our familes to on the last day of the program.

We are allowed to do anything we have been trained for in school, but may not pass any meds or connect any IVs to patients, though we do spike the bag and prime the tubing, then hand it to the preceptor to attach, but then we get to set the drip rate (manually); we can't touch the IV pumps or the PCA pumps.

So far I've done a couple of straight caths, d/c'd about a thousand IVs, dressed several wounds (interesting, since I'd never worked with "fresh" wounds before), assisted during a trach re-insertion, translated for a few patients (fun!), comforted a ton of frightened pts/families, done a dozen or so EKGs, some orthostatics, a handful of blood glucoses, and more urine dips and re-vitalizing than I can count. I've been promised any NGTs and Foleys on my shifts, but so far there just haven't been any :-( They're letting me have a go at triaging the pts that come in by ambulance as well. I also do my share of making beds and hauling pts to xray.

My goal really is to get as much hands-on experience as they'll give me. I had never d/c'd an IV on a human before (just the lab mannequins at school), so, while it's not the most complex skill, I'm thrilled that I can now call myself the "Queen of D/C'ing IVs" since I've done so many. Everything I get to do makes me feel more competent and less of a bumbling student!

We can request to float to other units that interest us, and I'm planning days in PACU, the wound center, and with respiratory therapy (I REALLY want to work on the subtleties of lung sounds--right now I feel that I can basically tell you if the pt is breathing or not, and that's about it.) I can also follow pts if they go for specialized procedures--but so far the most interesting thing has been to hang out in CT a bit.

We can go to any courses offered by the Education Department, but they all but shut down for the summer which is too bad as I was hoping to score EKG interpretation and IV therapy, but they don't offer anything until September, and by then the program is over.

It's a great experience, and I'd really recommend it to anyone who can snag an externship position!