Getting the RNs to know im an extern :)

registerednutrn, BSN, RN · Jun 14, 2008

Congratulations on getting to be an extern. The hospital I just left just started an externship program and you had to be a senior level student to enter into the program. From what I understood of the program the extern's would be going with a preceptor (an experienced RN) and doing what the nurse did not cna work. You would be expected to be able to preform skills the same as an RN including giving meds (with RN's supervision of course) Basically it is like and extended clinical with pay. Don't be afraid to speak have it made clear from the beginning what is expected of you. Hope this helps and good luck

racing-mom4, BSN, RN · Jun 14, 2008

HI, congrats on finishing your 1st year of nursing school and landing really good extern job. You need to ask your nursing mgr these questions though as I am pretty sure it varies state to state.

Indiana used to recognize a nurse extern (someone who had completed 3/4 of their nursing program) that would be allowed to shadow an RN and take on their own small assisgnments as long as the RN over saw.

As of May of 08 we no longer do. Reason being Indiana participate in quick results from Nclex, you can test with in weeks of graduation and have a lic number sometimes that same day.

Your nursing mgr will know everything you are and are not allowed to do.

Have a great summer!!

tachybradyRN · Jun 14, 2008

Tomorrow's my first day as an extern. In my facility, I can't give meds.. but I can possibly place & d/c Foley's, do FS's & other CNA-type stuff, possibly hang IV fluids & d/c IVs, etc. I'm nervous too, but I'm sure we'll be fine. What are your shifts like? I do three 12.5 hr shifts/week with a preceptor, have to attend class every Wednesday during my shift, like a lunch & learn, have to journal once a week, and have to give a presentation at the end.

MikeyJ, RN · Jun 14, 2008

Where I live, they call "externs" nurse apprentices (I assume it is very similar). My hospital and unit are amazing to me and essentially allow me to do everything. I am assigned to a nurse who then gives me half of her patients (usually 3 or 4) and I do everything for the patient, including charting.

There have been a few occasions where we have no CNA's and they ask me to do CNA work (mostly just the vitals and weights), and I have been a patient sitter as well. But it is rare that I do either.

The purpose of being an "RN extern" is not to do CNA work, thus I am not sure why they are having you do that.

And I noticed something interesting in the OP post -- you stated that the CNA's can put in foley catheters and draw blood?? Both of those duties seem to be outside of the CNA's scope of practice.

jr8456 · Jun 14, 2008

hey all!
i'm a survivor of my first year of nursing school (still cant believe it) and after much struggle finally landed a job as a nurse extern at a select specialty hospital.
ive never worked in health care before...so that alone has me very nervous.
whenever i was in clinicals i got "nervous stomach" just from having to walk in the patients room because i feel so unsure of myself.
i'm really hoping this job will help me with that.
the thing is, i guess select has only had 1 or 2 other externs in recent years, and i will look the same as the cnas *and doing cna work too of course :)* but i would really like the nurses to know that id love for them to show me the ropes and expose me to anything they could...but i don't wanna be annoying and bother them because i realize how busy they are. how would you like to be approached? i'm very nervous!
ps-also..does anyone have extern experience? in my interview i was told as an extern i would be able to place foleys, draw blood and do sugars...but talking w/one of thier cnas, she already does all that. so im a bit confused as to what the difference is...i guess ill try and get it clarified after orientation :)

first off, congratulations surviving your first year of nursing school! :yeah: i understand 100% how tough nursing school could be since i only graduated 1 month ago. :specs: i too was a nurse intern at a big hospital in town and i know you are very nervous, but understand that you made the best decision to do an externship during your time off. it is going to benefit you sooo much. it will also give you confidence when speaking to patients. my internship helped me think critically and i think it also put me at a greater advantage then my other classmates when we came back to school. i was able to visualize the patients i had when the teacher taught class and it helped me tremendously in my test taking. as an intern/extern you can work in the scope as an na, or an naii in my state. i worked with my preceptor and she allowed me to assist her in assessing, treatments, etc. i could not give meds because i was to work in the role as an na. in clinicals you are covered by the school's insurance, but since you will not be licensed as an rn, you will not be able to administer medications. you will be working with an rn and you will be the na/extern for that group of patients. you should not have a cna assignment because you are there for an externship. by all means help out if there is no na available, but don't fall into the trap of doing na assignments because the nurses will look at you as the na for the floor and will continue to give you those assignments. the best advice i can give you is to familiarize yourself with the drugs that your patients will be getting, understand the disease processes (patho), familiarize yourself with the labs and relate them back to your patient, and do a couple of care plans. your senior year will be a breeze if you successfully do these things, and you will conquer the nclex! take advantage of being there. become one of the team, make a good impression! the nurse manager offered me a position before i even graduated! (i am in orientation now). -jr8456, rn

2bvegannursesFTW · Jun 15, 2008

tomorrow's my first day as an extern. in my facility, i can't give meds.. but i can possibly place & d/c foley's, do fs's & other cna-type stuff, possibly hang iv fluids & d/c ivs, etc. i'm nervous too, but i'm sure we'll be fine. what are your shifts like? i do three 12.5 hr shifts/week with a preceptor, have to attend class every wednesday during my shift, like a lunch & learn, have to journal once a week, and have to give a presentation at the end.

i will work 12.25 hour shifts :), with computer classes i believe...my orientation starts monday,ill be orienting with cnas however, not externs,i'm the only extern . i applied to be a cna, but then they told me they had an extern position and hired me in as that instead. i know i cant give meds...but im hoping i get to do more than just cna work

2bvegannursesFTW · Jun 15, 2008

the purpose of being an "rn extern" is not to do cna work, thus i am not sure why they are having you do that.
and i noticed something interesting in the op post -- you stated that the cna's can put in foley catheters and draw blood?? both of those duties seem to be outside of the cna's scope of practice.

i thought those tasks were out of their scope too...but apparently not in this facility. so i'm a bit confused...it sounds like they want me to do cna work...but i'm really hoping i will eventually be more than that..

Batman24 · Jun 15, 2008

If you are an extern you should be working with an RN. You shouldn't be given a CNA assignment as that isn't what you are there for. Make sure you get the training you are there to receive.

If you want everyone to know you are the extern that's easy. Just say, "Hi. I'm x and I'm an extern" to all those you meet. It's short, sweet and honest. Good luck. Keep us posted. :)

mom2michael, MSN, RN, NP · Jun 15, 2008

CNA scope of practice varies greatly from state to state. With that being said - your extern job will also vary greatly depending on where you live and the P&P of the facility you are working at.

Where I live, nursing externs are 2nd year nursing students who fill the position as a tech. It's a way to get the facility to hire you "early" and get you trained and familiar with an area of interest to you and then hope that you will stay post graduation. You are trained to perform CNA duties because that is all that is allowed. My state's nurse practice acts dictates what a nurse extern can and can not do and it tends to favor to the side of things that one can not do.

Your orientation may enlighten you more when you begin that. Actual practice questions and what you will be allowed to do and not allowed to do will probably need to be directed to your education person or your clinical coordinator.

Congrats on your job!!!! Go in with an open mind and an open heart and you'll learn oodles over the next year regardless of the tasks they assign you!!!!

llg, PhD, RN · Jun 15, 2008

As mom2michael said, CNA roles and extern programs vary from place to place. So, don't base your expectations on what someone else has experienced in another place.

You said that you would clarify your role "after orientation." That would be a big mistake. Don't wait that long. The purpose of your orientation is to learn your role. So, you should be asking your questions and clarifying your role during orientation.

Another piece of advice ... While you should introduce yourself as a nursing student extern and not as a nursing assistant, be careful about using phrases such as "only a CNA" ... and saying that you "don't just want to do CNA stuff," etc. You might find that a lot of those CNA's are also nursing students. You might also find that a lot of those CNA's are highly respected and liked by the nursing staff. If you get too "uppity" about the difference in your roles, you may offend some people. You might also be giving a very bad impression of yourself by seeming to be disrespectful and unsupportive of the other members of your team.

In the extern program that I coordinate, that's one of the biggest mistakes an extern can make. While externs are allowed to do more things than CNA's in my hospital, we expect them to do whatever the patient needs. They probably spend about 50-75%of their time doing CNA stuff and 25-50% of their time doing things like giving meds, etc. and taking advantage of whatever learning experiences present themselves. When they are doing CNA stuff, they are expected to do it cheerfully. Anyone who seems to think they are too "high and mighty" to bathe a patient, put them on a bedpan, etc. makes a very bad impression.

My advice: Just focus on being pleasant and helpful. Introduce yourself and get to know your new coworkers without making a lot of demands at first. As part of the "get to know each other" process, express your interest in learning as much as you can. Then, as you demonstrate that you are a pleasant and helpful person to have around, they will take you under their wings and be happy to teach you.

Use your orientation time to ask your questions and clarify your role.

Good lucK!