What should I do? Regarding a possible nurse extern position...

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  • Specializes in OB-Gyn/Primary Care/Ambulatory Leadership.

This has been crossposted at a few other places I hang out because I'm trying to get some varied opinions, and I thought I could get some good feedback from other students who are in a similar boat right now.

I had an interview yesterday and it went really well. This is for a "nurse extern" position at a very well-respected hospital in Phoenix. A nurse extern is assigned to a preceptor - an experienced RN in sort of a mentor/apprentice role. She works the same shift as her preceptor and basically just assists her and learns all about the role. During the school year, I would need to commit to at least 24 hours (two shifts) per month, but can work up to 4 shifts per month. During winter and summer break, I must work fulltime (36 hours/week).

When she found out I wanted to work in "couplet care" (postpartum) she was very positive that I would probably be able to get the department I want. Apparently postpartum is considered a lot less "glamorous" than labor and delivery, which is a much more sought after unit. In addition, more people want day shift than night shift, so the fact that I want to work nights is also a point in my favor that I'll probably get the unit I want.

The downside: I live 1 1/2 hours away from the hospital. That's a pretty sucky commute. During the school year it wouldn't be too bad - one day a week. But when I'm doing fulltime, it's going to be hard, I have no illusions about it. I'll see very little of my kids and husband for three days out of the week. Jack is willing to pick up the slack to make it work if I decide I want to do this. The other bad part is that it requires a commitment on my part. An externship offers wonderful teaching opportunities that you can't always get in a regular school setting. In addition, the externs get tuition reimbursement (up to $2500/year) and are eligible for scholarships. When they hire an extern, they're grooming them for a staff position as an RN when they graduate. They just invested a lot of time and training in you as an extern, so they want to keep you. As such, they have a contract. For every month you work as an extern, you are required to put in that many months as an RN after graduation. Starting where I'm at, that's 18 months as an extern and 18 months as an RN. A three-year contract, essentially. I can buy out the contract at $100/month for every month I still have left. So for example, if I work for 6 months as an extern and decide that I just don't want to do it anymore, I will owe them 30 months - $3000. Plus, the money I'm given for tuition reimbursement or scholarships (prorated).

The pluses: I'd be able to work as a pseudo-nurse as early as three months from now. I'd be working in the area I want to be in - helping new moms and babies. I'd get my foot in the door if I want to cross train to labor/delivery (which I would). It would look great on my resume. At our local hospital, they won't hire anyone in OB unless they have a year prior experience in that department. So this would give me that experience in order to get a job in OB at our local hospital. I won't have to come up with any tuition out of pocket for next year (not a HUGE deal since tuition is dirt cheap at CCs, but still, it's a benefit).

Edited to add: Another plus - the salary, while certainly not RN pay, is not too bad, especially when you add in the shift differential. I would be able to quit my my part-time, work-at-home job that seems to suck so much of my time because I'm always either on the computer or thinking that I should be.

If it was JUST the commute, or JUST the contract, it would be an easier decision to make. But the two together has me unsure if it's the right thing to do.

TIA if you made it this far and if you have any thoughts or opinions.


1 Article; 135 Posts

Nope. I would not consider signing a contract. What if, for instance, you had a family illness and could not fulfill it? It's a big risk to take! What if you start working there and discover you HATE it? Or the environment is not what you thought it would be--preceptor is nasty,manager unreasonable, whatever.

If you really want to get into L&D or postpartum, you will get there eventually. Even if you have to work a year of med/surg first, at least then you're not beholden to anyone....just my two cents...

Altra, BSN, RN

6,255 Posts

Specializes in Emergency & Trauma/Adult ICU.

Kerry, I responded to your other thread about this topic, too.

My biggest concern: if you are obligated to stay at the hospital for a certain period of time as an RN, and the hospital is obligated to have an RN position for you - where is the guarantee that the available position will be in an area that you want? The mentoring while you're an extern is great, but that doesn't automatically open up a position in the OB staffing matrix when you graduate.

Just something to think about. Let us know how it goes & what you decide. :)

Ok, Kerry, read this one again and what is up with that???

I mean, if you are doing JUST tuition reimbursement I get them wanting to pro rate and you pay it back. But, why are you under a seperate contract bound around the nurse extern position. You are working for them in an almost-RN capacity. They way I took your post is you have to actually pay them $100 a month for every month you were SUPPOSED to work if you quit during your externship? Is this simply because you are repaying your tuition? You said 18 mos to go extern, 18 mos tuition pymnt by them. Basically three years. 30 mo x 100=3000. I don't get it though, you are paying them for basically LETTING you work for them and get paid? If it is the hospital I think it is, it says in there paperwork that there is a max of two years owed to them no matter what. Is it a seperate contract for nurse extern AND tuition reimbursement? If it is, no way would I pay them to employ me. You would literally be better off getting a CNA position (or entry something) at the same hospital and then using the tuition reimbursement. Would this change things?

If it is the hospital I think it is, my sister in law did that commute. She worked full time. It ended up being too much for her and she quit after about 6 months. It would be especially hard if you worked odd hours and were driving home extremely tired. She was.

I suppose you have looked into the hospitals in your area? I can tell you that my sister in law had good things to say about that hospital....??


Hey, I guess it depends too on how you are paying for nursing school, right? If you do pay for all of school yourself, would this sort of position and contract be all that bad? Does the repayment end up being more than if you had just paid for school yourself? Plus, you are making more right now than a CNA.

Everyone always has these strong opinions against contracts, but you really are not bound to work there. You can quit. You just have to be prepared to pay them back. If this would be impossible for you under any circumstances, it would be my advice to decline the position. You do not want to be forced to work anywhere, I will agree with that!!! My decision to accept the position would be based on how I plan to (or am paying for) college. If you are currently getting scholarships, then I don't think I would do it. If you are paying out-of-pocket, I would do it. Do they know where you live??

Alright Kerry..Just got your PM...

I thought it was a different hospital. I will tell the hospital I thought it was sounds like they got a whole lot better deal, but I don't think you can do it till after your second semester.

I understand all your concerns. I wish you luck finding something else!!!:)


Oh, and too, the hospital I am talking about pays $13.00 an hour after second semester nursing school....:)

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