Nursing Externships: Everything You Need to Know

Nursing Externships: Everything You Need to Know

Something that sets nursing apart from other professions is that there is a lot more to it than simply graduating and getting a job.


Nursing externship
Sophia M.


April 26, 2023

While in nursing school, you’ll complete clinical rotations and you may also complete volunteer hours, depending on what your program requires. Some nursing students go on to complete internships and then externships following graduation to help prepare them for their first job. This article will tell you all about nursing externships, including what they are, how to get one, and ways to prepare.

What is a Nursing Externship?

A nursing externship is a program between nursing school and professional employment that can help bridge the gap of going from full-time student to full-time nurse. The term “externship” is sometimes used interchangeably with “preceptorship”. Both describe programs for new nurses who aren’t yet licensed, to help them get ready for their first job as a nurse. 

Externships may occur between graduation and licensure, or they sometimes can be completed while you’re still in nursing school. You’ll typically be working in a clinical setting shadowing another nurse to gain experience. There can be some classroom aspects to a nursing externship as well. 

Some general aspects of a nurse externship include the following: 

  • You may complete your externship in preparation for a job you’ve already been hired for.
  • Usually, an externship will pay a similar amount to what you would get paid for an entry-level job.
  • Externships may require you to sign a contract to work for that hospital following completion. 

What Are the Benefits of Doing a Nursing Externship?

Let’s be real, going to nursing school is a whole lot different from working as an actual nurse. Your teachers will do everything they can to prepare you for real-world nursing work, but there is only so much they can really do. A nursing externship helps to prepare you and lessens the culture shock that comes with integrating into the profession of nursing as a new graduate.

Many new nurses feel like they’ve been “thrown to the wolves” when they start their first nursing job and are quickly expected to know what to do and how to do it. Externships give you a period of time in which you’re working as a nurse but are not entirely on your own yet. This allows time for trial and error and additional learning in the environment in which you’ll be working, so that you can be better prepared when the time does come for you to be on your own. 

One study looked at the benefits of nursing externships for students, stating: 

“Anxiety, insecurity, and fear of failure are associated with the transition from student to practicing nurse. Because of the additional clinical experience gained in an externship, students likely are more self-confident when they assume the RN role.”

This study looked at four different factors to determine the effectiveness of externships: confidence, decision making, transitioning to the RN role, and interacting with professionals. 

These are all important and challenging aspects of becoming an RN. Confidence takes time to build, and the only way to become more confident as a nurse is to gain actual experience. Your confidence as an RN helps you build trust with coworkers and patients. 

Deciding what needs to be done for a given patient feels like a lot of pressure when you’re just starting out. Getting used to the role and responsibilities of being an RN takes time as well, and early exposure is hugely beneficial. Externships help new nurses understand more about what their role will be, including their limitations and the basics of delegation. If you ask me, one of the most intimidating aspects of being a new nurse is interacting with other nurses and doctors. I always felt very nervous in the beginning, so I can see where an externship would help a new nurse prepare for this. 

This study looked at an externship as something that is completed before graduating, so it is important to note that “externship” can mean different things in different settings. 

Are There Any Downsides to Completing a Nursing Externship?

There really aren’t many downsides to completing a nursing externship, other than the fact that it could take up some valuable time in your schedule. It is important to always weigh whether something is worth your time – especially as a nursing student. So, if your schedule is so packed that your grades and mental health are suffering, yeah, maybe don’t try to go above and beyond to complete an externship while you’re still in school, since it may cause you more harm than good. However, if you can fit it into your schedule, you will definitely benefit from it. 

It may be expected by your employer that you will apply to work for the hospital where you completed your externship once you’re out of school or licensed; however, you shouldn’t feel obligated to settle if you’re not happy there. Another great benefit of nursing externships is that they allow you to “feel out” a hospital to see whether it’s somewhere you think you’d like to work in the future. 

Nursing Externship vs Internship

The terms “externship” and “internship” are often used interchangeably and can mean different things, depending on the hospital or institution. Generally, an internship is longer than an externship. Internships usually last six months to a year. Externships can be as short as a few days or a week, but they can last up to a few months as well. Externships are sometimes unpaid opportunities in which you simply shadow a nurse and observe, whereas internships are usually more involved. 

Keep in mind, the exact definitions of these terms vary greatly depending on where you work, so always pay close attention to the job posting when applying to these opportunities. Some externships can be started while you’re still in school, while others may require you to be finished with your degree. 

Nurse residencies are similar to internships and externships but they are specifically designed to be completed after licensure. Usually, a residency will require you to sign a contract to work at the hospital after you’ve completed it. It is basically an entry level nursing job with an extended training period and classroom time to help prepare you. 

How to Get a Nursing Externship

To get a nursing externship, you’ll have to apply for the position and go through an interview process. You’ll want to go over some nursing externship interview questions to prepare, such as why you want to be a nurse, where you see your career going in the future, and what about that specific position is appealing to you.

Nursing externships will sometimes feel competitive (just like most aspects of becoming a nurse), but that shouldn’t stop you. 

You may need professional references or a letter of recommendation from one of your professors to complete an externship. Before applying, you should have your resume up to date as well. 

How to Prepare for a Nursing Externship

A nursing externship can be whatever you make of it. You should try to take steps to get as much out of it as you can. Preparation can be key here. Before your first externship day, get everything you need prepared the night before, such as packing your lunch and washing and ironing your scrubs. Try to find out what your schedule will be like ahead of time to prepare, but you may have to wait until your first day on the floor for this information. If you aren’t familiar with the hospital, get there plenty early so that you have time to find parking and walk to the hospital floor where you’ll be working. 

During your externship, you should do the following to ensure that you get the most out of it:

  • Ask a lot of questions. Never be afraid to speak up and inquire about things; you are there to learn. 
  • Be present. Try not to be too in your head or distracted during your externship days. 
  • Stay positive. It’s easy to freak out when you’re new in a professional setting, especially if you’re still a student. Try not to let your colleagues intimidate you (remember they all started somewhere too). Being positive and kind to others helps you stay in a good mood and make a positive impression.
  • Keep yourself busy. If you have slow times during your externship where you’re not sure what to do, do a lap around the unit and ask if anyone needs your help. Even if you’re not busy, there’s a good chance that someone else is and could use you. 

Is a Nursing Externship a Good Option for You?

Nursing externships offer valuable experience with few downsides. So, I’d say for most people that they’re worth it. The only reasons I’d give to not do an externship would be if it’s unpaid and you need to use your time to make money; if it requires you to sign a contract you’re unsure about; or if your schedule is so full that it’s affecting your well-being. Other than those circumstances, I’d say go for it! 

Final Thoughts

Nursing externships are a great way to get your foot in the door and prepare for being a real world nurse. They offer plenty of benefits and few drawbacks. If you do complete one, you’ll likely be glad you did. However, keep in mind that if you don’t, it won’t ruin your nursing career, and you’ll still get where you need to go.

We've been there.
We get it.

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