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Humber Journal of Nursing

The Role of a Clinical Extern

Updated: Dec 14, 2023


Marcus Tamir

September 2023


Intro


Finding relevant work experience as a nursing student has never been easier, as there are more job opportunities now than ever before. The most common job opportunity for nursing students is the Clinical Extern role. A Clinical Extern is an unregulated provider who works alongside nurses, physiotherapists, and occupational therapists in clinical settings. The position is typically filled by nursing students however, physiotherapy, paramedic and occupational therapy students are often eligible to apply. As a result of taking on this role, my summer was busy. I had the amazing opportunity to work as an extern while also finishing up some extra electives. While it wasn’t easy, working as an extern provided me with some of the most valuable clinical experiences I’ve ever had.

How to Become a Clinical Extern

Most Clinical Externs are hired in acute care hospitals; however, many rehab hospitals and nursing homes also have positions available. Before you apply, make sure that you are eligible to become a Clinical Extern. From what I’ve seen, most hospitals in Toronto usually require at least two years of education in either a BScN program or one year of an RPN program to be eligible for hire. Once you’ve confirmed you have the necessary background, then you apply online or in person. Make sure to apply early! I applied for my extern role, in January of 2023 for a summer position. There are hundreds of nursing students who also want to be externs, so make sure to apply early and to as many sites as you can!

A great way to find offers for externships is to look on websites like Indeed or LinkedIn for any facilities that are hiring. Going directly to the hospital website also works quite well. With that said, find out if the hospitals you’re interested in working in are having job fairs; there is usually a number being held in February and March. It’s a great benefit for you as an applicant to have an opportunity to make a great first impression; and they’re much more likely to remember a face and a voice than a name on a resume. If you do go to a job fair, do not dress in scrubs. Wear business casual attire: even nicely fitting dark wash denim and a professional shirt would work well. Before you go, look up which hospitals are going to be present at the fair, and bring a resume for each hospital you intend to apply to. I would recommend getting there early because these fairs can become very busy. The recruiters will review your application and if they believe you’re a good candidate, they will contact you for an interview. Once your application is in and reviewed the hiring process is the same as many other jobs.

Nailing the Interview

Congratulations! You’ve officially made it to the interview stage. Your resume was outstanding enough to have recruiters consider you over other applicants. But it’s not over yet. While the extern interviews aren’t the hardest things you’ll do as a nursing student, that doesn’t mean you shouldn’t be ready for them. In my interview, I was asked questions such as: “Why is it important to wear PPE in the clinical setting? How do you collaborate with fellow healthcare staff? Why do you want to be a clinical extern?” etc. Make sure your interview answers are well thought out. For example, when asked why you want to be an extern, don’t say “Because it’s the best opportunity for nursing students”, say “Because I want to help others as soon as I can in the ways I am able”. All in all, prepare well but keep your cool!

The Scope of an Extern

As a Clinical Extern, your scope encompasses that of a PSW, plus some extras. That means brief changes, bed baths, getting patients to the washroom, to a wheelchair, etc. Some hospitals have Enhanced Clinical Extern Scope of Practice, which adds some extra duties to your list of existing ones. Depending on where you work, enhanced clinical externs have different scopes. For example, I am an enhanced extern, and I am allowed to perform Vital Signs, Braden Risk Assessments, Falls Risk and CAM assessments on top of my regular duties. Other hospitals may have different scopes regarding the enhanced role. For more regarding the scope of regular and enhanced externs, click these links: https://www.oha.com/Bulletins/MOH%20Extern%20Program%20Guide%20for%20HCOs%20(2021-01-08)%20173-2021-01.pdf (Regular Extern)

Conclusion

Becoming a Clinical Extern is not easy, but it provides some of the most valuable clinical experience you can gain. As an extern, you are constantly shadowing nurses and other HCP’s and get to understand healthcare from the inside. Unlike clinical placements, once you become an extern, that’s basically it. No strict evaluations, no self-reflection. This role lets you really take in the realities of being a frontline worker. Becoming a clinical extern has been one of the best decisions I’ve made as a nursing student, and I hope that many more nursing students choose to become externs in the future.

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