Nursing Internship: A Comprehensive Guide

In the world of nursing, practical experience is as crucial as theoretical knowledge. Nursing internships offer invaluable opportunities for students to bridge the gap between classroom learning and real-world application. While terms like "nursing externship" and "nursing internship" are often used interchangeably, understanding their nuances is essential for nursing students seeking to maximize their learning experience. It is important to note that the definitions of the terms "nursing externship" and "nursing internship" are not standardized, and may vary depending on the source and the specific program (associate's, bachelor's, master's, or doctorate level).

Defining Nursing Internships and Externships

Nursing internships and externships are both experiential learning opportunities, but they differ in several key aspects.

Nursing Internships

Nursing internships are typically structured as part of a nursing school's curriculum, often towards the end of the program. Successful completion of an internship may be a graduation requirement. Because they are integrated into coursework, these internships are often unpaid. Students are assigned a specific number of hours to complete, along with assignments like papers and care plans. They may be paired with a specific nurse in a particular setting for the duration of the experience, functioning more in line with RN responsibilities under the direct supervision of another nurse. This allows nurse interns to administer medications and perform basic procedures, similar to their role in a normal clinical setting.

Nursing Externships

An externship is an internship that takes place outside a formal institution like nursing school. Nursing externships are usually shorter in duration than nursing internships, lasting weeks rather than months. They are often available to nursing students who have completed at least one or two years of a nursing program. Prospective externs typically apply for these positions like any other job opening. Nursing externs typically have a lower level of responsibility than nursing interns, often assisting with basic tasks such as taking vital signs. They often function as nursing assistants but have the opportunity to shadow RNs, enhancing their learning and observation skills. Some externships may be paid, offering a stipend or hourly wage, and may include benefits like housing, transportation, or professional development opportunities.

Structuring Experiences Post-Graduation

Hospitals sometimes offer externships to new graduate hires before their nursing licenses are active. This allows new graduates to function as externs, performing tasks similar to certified nursing assistants (CNAs) while receiving additional educational experiences. This eases the transition from school to practice by familiarizing them with basic tasks and the hospital environment before they begin working as registered nurses.

Key Differences: Nurse Extern vs. Nurse Intern

Feature	Nurse Extern	Nurse Intern
Program Length	A few weeks	Several months (up to an entire school year)
Eligibility	Students enrolled in a nursing program with at least one or two semesters/quarters completed	Students enrolled in a nursing program; final-year students are most eligible
Job Responsibilities	Basic tasks similar to a nursing assistant (e.g., taking vital signs, collecting specimens)	Clinical nursing tasks similar to clinical rotations (e.g., physical assessments, medication passes, patient education, bedside skills, overall management of care)
Pay Potential	Paid or unpaid; pay is comparable to a nursing assistant	Paid or unpaid; if arranged by the nursing school, it is likely unpaid as it is part of the curriculum; if arranged independently, pay depends on the facility.
Goal	To introduce students to the real world of nursing independent of school training	To provide an extended opportunity to sharpen clinical skills under the direct supervision of a nurse

The Benefits of Nursing Internships

Nursing internships offer numerous benefits for aspiring nurses, including:

Hands-On Clinical Experience

Internships provide hands-on clinical experience with patient care, allowing students to apply what they've learned in the classroom to real-world healthcare settings. As a nurse intern, you will be working with real patients in a clinical setting. They also allow training nurses the opportunity to connect with patients and follow the progression of care.

Professionalism and Networking

Internships foster professionalism, create networking opportunities, and develop clinical knowledge. Working one-on-one with another nurse can create a professional bond that may help ease any insecurities about the start of your nursing career. These relationships could continue long after the internship is over, creating a support system of people who understand the pressures and strain of working with patients who are frightened and in pain. Along with befriending the people you encounter during your nursing internship, there is also the possibility that you will make connections that could lead to future employment. The healthcare industry is often close-knit and someone you've spent time with could alert you to job openings or serve as a references on the quality of the care you provide.

Skills Development

Skills labs provide opportunities to practice necessary nursing procedures, but internships may allow you the chance to perfect these techniques. Using a skill you aren't yet confident in can be less intimidating when you have a more seasoned professional at your side to help guide you through it. This is especially true if the procedure has the potential to cause a patient discomfort or pain, such as drawing blood, inserting an IV port or placing a catheter.

Confidence Building

Internships give you the opportunity to practice and perfect clinical skills. As you learn and repeat each skill, you can gain proficiency while expanding your knowledge and enhancing your confidence. Nurse preceptors may even allow you to perform certain procedures that you've practiced only in the skills lab.

Understanding the Healthcare Environment

An internship helps familiarize a student nurse with the day-to-day aspects of clinical settings. "It also helps them to see the politics of healthcare, how processes like policies and procedures are managed -- small things that you won't necessarily get in a book," said Ottamissiah "Missy" Moore, BS, RN, WCC, DWC, CHPN, CAEd, a nurse educator, preceptor, and mentor based in Washington, D.C.

Interprofessional Collaboration

During a nursing internship, you'll learn to collaborate with an interdisciplinary team. You'll be able to give reports, join huddles, and work alongside healthcare professionals like physicians and occupational therapists. Working with a broader healthcare team will provide you with a greater understanding of each profession's roles and responsibilities. This type of teamwork can also enhance your own skill set - both clinical skills and soft skills.

Career Opportunities

An internship not only familiarizes you with the care environment but also helps you home in on what specialties and settings interest you. Internships also present opportunities to land employment at the facility or organization where you're interning.

How to Find Nursing Internship and Externship Opportunities

Finding nursing internship and externship opportunities requires dedication and a willingness to put yourself out there. Here are several strategies to consider:

Online Search

You can find many of these programs through a basic internet search. Job boards (like Indeed.com, ZipRecruiter.com, and Glassdoor.com) post opportunities too. You can also search for local job fairs and recruiting events for nurses.

Read also: The Benefits of Recitation Classes

Networking

Sometimes finding the right opportunity is simply a matter of asking for a chance. Try reaching out to local nursing homes, hospitals, and clinics for opportunities. Show that you are prepared by doing your research about the facility. Bring your resume, transcripts, and recommendation letters. Professional networking in nursing is a great way to start preparing for these opportunities. Find a nurse mentor who can help you find opportunities in the future.

Career Services Department

At your college, check with your career services department. This resource is part of your tuition, so use it! Ask them for assistance in finding one of these opportunities. You can also ask your professors or any other healthcare provider you may know.

Start as an Extern

If your goal is to find an internship, start out as a nurse extern first to get your foot in the door. A facility may choose to offer you an externship over an internship to reduce costs and legal risks. If permitted, introduce yourself to managers in various departments and offer help as needed. Make yourself memorable. You may be invited back as an intern one day.

Preparing for a Nursing Internship or Externship

There are simple things you can do now to prepare for a nurse internship or externship. Start by learning what to expect, like common nursing internship dos and don’ts.

Maintain Good Grades

Keeping your grades up will show that you are a dedicated hard worker. Once you are ready to apply for these opportunities, you can show that you are a capable candidate for the position.

Get Close to Your Nursing Instructors

While nursing instructors primarily teach, they can also connect you with the right person who may offer you an opportunity in the future. Ask them for recommendation letters and, if possible, keep in contact with them. If you have already graduated, try reaching out to your most recent instructors.

Volunteer

Volunteering shows that you can be committed to something for a cause. If facilities see that you have volunteered in the past, they may be more likely to offer you a volunteer nurse extern/intern position.

Standing Out During the Application Process

As you prepare internship applications and practice interview skills, focus on promoting your strengths and accomplishments to stand out.

Highlight Your Work Ethic and Abilities

Highlight your work ethic and abilities as a student -- especially during clinicals. Did you inquire if colleagues needed extra assistance during challenging scenarios? Did you ask if you could observe during special procedures or patient care? These attributes show that you go above and beyond what's expected of you as a student nurse. A recommendation from a clinical instructor may be required with an internship application, so make sure your faculty and preceptor are familiar with you and what you're capable of.

Know Your Strengths and Weaknesses

Know your strengths and weaknesses in the clinical setting. Be ready to explain the details of your clinical experiences and to answer questions about how your patient care has benefited others or how you overcame difficult situations.

Elaborate on Your Ability to Work with a Team

Teamwork is crucial in healthcare, so when you're being interviewed, you should describe your clinical experiences as a member of the healthcare team.

Become More Involved

Become more involved in your school's organizations. Participate in community service activities, school improvement committees, school program initiatives, or volunteer abroad. These types of projects will show professional commitment and versatility.

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