Nurse Extern?? What's that about?

rocababy119 · Jul 14, 2013

I work at a hospital, and here Clinical Nurse Externs are the same as clinical technicians or CNA's only difference is they've completed their fundamentals of nursing class.. So in turn earned the name CNE and a nice little raise... But still do the same exact job.

Jooliaghoulia · Jul 16, 2013

Here in TX, it's about the same pay as CNA's in the hospital systems I'm familiar with. However, in some systems, the nurse extern has all the CNA duties, plus whatever duties your school documents you've been checked off on, and the facility agrees to allow you to do supervised by an RN. So, here no med admin, assessment, but for example my facility will allow me to start an IV, ostomy care, central line dressing changes, start foleys, etc.

So some things are absolute no's, others are up to the facility. If you work as an extern at my facility, while you have to be a student to be an extern, you are NOT there in the clinical student role. So the rules can be quite different.

Make sure you talk with your director/manager and be ABSOLUTELY sure what you can and cannot do, independently and supervised. A few RN's will assume if you say "yes" that it's ok, others will supervise you getting ice chips :) Some will leave without asking if you feel you need supervision, because they expect you speak up if you do- so be vocal about when you need it. Safety first and good luck!!! It's been very, very good for me and I will have a much easier time getting a job I want when I graduate.

rngraduate2014 · Jul 16, 2013

Here in MD the job is the same as a Nurse Tech however it has the advantage of a job offer upon graduation. Even before sitting for the boards (offer not job) with out trying to figure out the ok now I need a job part. So its a good option.

green34 · Jul 17, 2013

Well, where I live the nurse externs are hired through the hospital and are employees of the hospital. The only thing I can think of how they do it with schools is that it is part of financial aid or something. The nurse extern does the same thing as a nursing assistant only with a small bump in pay and maybe more skills than the patient care tech but mainly the same thing. We call our nursing assistants patient care techs. Sometimes they are just sitters.

I'm near PA (in a state boarding it) and we pay them 13.36 plus shift differentials.

ToyaB · Aug 6, 2013

Thanks for the tips! I will certainly keep them in mind. I'm definitely going to go for it. The benefits are enormous.

Swellz · Aug 7, 2013

I'm in PA as well, and externships vary by health system. My friends had different experiences: one was more of a shadowing program, but most were comparable techs/CNAs or sitters for 1:1s. I was allowed to practice certain skills with nurse supervision (Foley insertion, trach care, etc) but not phlebotomy, like some externs at other hospitals. I got $14/hr + shift differential, and my schedule was every other weekend, unless I wanted more.

It often felt like the true educational aspects of the program were lost while I was running around the floor; however, I gained a HUGE appreciation for ancillary staff and my time management improved. Coming back to clinicals after summer break, it was obvious who had worked with patients over the summer and who hadn't. It was definitely worth it.

The big perk? Getting hired as a nurse on the same floor when I graduated

ToyaB · Aug 22, 2013

" I got $14/hr + shift differential, and my schedule was every other weekend, unless I wanted more.

It often felt like the true educational aspects of the program were lost while I was running around the floor; however, I gained a HUGE appreciation for ancillary staff and my time management improved. Coming back to clinicals after summer break, it was obvious who had worked with patients over the summer and who hadn't. It was definitely worth it.

The big perk? Getting hired as a nurse on the same floor when I graduated"

That's encouraging! I was looking into my program and they also say the standard is every other weekend, but the site does not mention whether or not they allow you to pick up extra time. I was hoping to be able to work 2-3 days per week while I'm in school-- like 24hr per week-- and then in the summer time to go at it full time. Has anyone heard of anyone being able to do that as a nurse extern??

THELIVINGWORST, ASN, RN · Aug 22, 2013

Meh I would hate to have more responsibility without that RN pay :/

llg, PhD, RN · Aug 22, 2013

Meh I would hate to have more responsibility without that RN pay :/

Don't confuse "performing a technical skill" with "having professional responsibility." There is a big difference. I don't think it is legal anywhere for an extern (or any non-licensend ancillary worker) to be given RN-level responsibility -- and I have never heard of any hospital trying to do that.

THELIVINGWORST, ASN, RN · Aug 22, 2013

Don't confuse "performing a technical skill" with "having professional responsibility." There is a big difference. I don't think it is legal anywhere for an extern (or any non-licensend ancillary worker) to be given RN-level responsibility -- and I have never heard of any hospital trying to do that.

What I mean is, what if I mess up before I am licensed? Does the hospital get sued, the RN supervising me? Could that affect my future licensure? The thought of performing skills based on my progress in school before being deemed a prudent and safe nurse by the NCLEX scares me.

But maybe I'm just looking at it the wrong way.

llg, PhD, RN · Aug 22, 2013

What I mean is, what if I mess up before I am licensed? Does the hospital get sued, the RN supervising me? Could that affect my future licensure? The thought of performing skills based on my progress in school before being deemed a prudent and safe nurse by the NCLEX scares me.
But maybe I'm just looking at it the wrong way.

Yes, I think you are looking at it the wrong way. As an extern, you are not held to the same standards as an RN, you are held to the standards of an extern. ("What would a prudent extern do ...")

The chances of you being sued or being charged with a crime are no greater for an extern as they are for anyone else -- a student, a nurse, a CNA, etc. It's the risk we all take any time we take care of patients. To give up the chance to get paid supervised clinical experience because you are afraid to perform skills is short-sighted.

However ... certainly there are some extern programs that are of better quality than others. For example, some provide more supervision and teaching than others. Be sure to investigate the particulars of any program before signing up to be sure the externs are not just "thrown into the deep end of the pool" or anything.