If you’re a nursing student, you have a lot to think about. Beyond classes and clinicals, you’re also pondering your future as a fully employed nurse.
What kind of patients and co-workers will you have? What kind of department will you work in? Will you like it there? What will you do each day? What will it be like to apply what you’ve learned to real life?
The transition is exciting. The transition is scary. A nursing internship, though, can take away some of the fear and uncertainty. It can also help a student land that first job.
Sanford Health offers two types of nursing internships throughout the Midwest. A summer program, the Sanford Student Nursing Intern Program (SSNIP), lasts 10 weeks and had 200 participants this past summer. The second program, the Extended Sanford Student Nurse Internship Program (ESSNIP), is offered to students who participated in the summer program. Program length is four to eight months, running concurrent with the academic year until the student graduates from nursing school. There are 94 students participating in the extended program this fall.
Internship ‘was my best decision’
Kayla Johnson graduated in May from nursing school, after completing both internship programs. She now works as a registered nurse at Sanford Bemidji Medical Center in Minnesota and credits each program for preparing her to begin her first nursing career job.
“I definitely think it was my best decision of preparing myself for being a new nurse,” Johnson said. “I walked into (the new job) feeling like I should have failed right away like every nursing student thinks that they will when they get thrown into a new situation, and I didn’t.”
Johnson’s summer nursing internship in 2018 consisted of five weeks of medical-surgical and emergency room nursing at Sanford Bagley Medical Center and five weeks in obstetrics-pediatrics at Sanford Bemidji. These experiences led her to change course from a lifelong dream.
“Always, what I’ve ever wanted to be was a baby nurse. And ER really caught my attention, too,” Johnson said. Her internship offered a firsthand view of each.
“And I realized, after being in both of those roles, that OB-peds was not my thing,” Johnson said.
“I really like the excitement,” she said. While labor provided that, “the excitement of ER and trauma situations was so much more.”
For her extended nursing internship in the four months before she graduated from Bemidji State University, Johnson worked again in the Sanford Bagley emergency department. And although she’s working as a medical-surgical nurse right now, her long-term goal is to land back in the emergency department.
Johnson experienced firsthand one of the program’s end goals, according to Ann Massey, who leads the Sanford Health nursing internship programs. Students can “learn where they want to be and where they don’t want to be.”
Another goal of the paid internship program is to provide students with work structure, learning and experiences that reflect real-world jobs, to build upon typical nursing school clinicals.
These experiences provide the interns an advantage when they do start that first job. “They’ve already gone through what we call a reality shock, coming into this large organization, working 12-hour rotating shifts, weekends and holidays,” Massey said. “They’ve already done this as a student, so they start their new role as a nurse much more confident. They know what they’re getting into.”
Each intern is assigned to a preceptor coach, a registered nurse in the department where the intern works. The intern’s workweek follows the preceptor’s schedule. The intern practices nursing skills within an arm’s reach of the preceptor. Interns and preceptors get to know each other so well that Johnson now considers hers to be a best friend.
Life lessons came along with her internships. “I’ve learned how to talk to patients, how to talk to patients’ families and how to do my skills” with confidence, Johnson said.
Observation is part of program
The Sanford Health nursing internship includes 36 to 40 hours a week of clinical time, plus a classroom component. For that, Massey said, “we focus more on the art of nursing.” It can involve reading books, journaling, online learning and participating in a discussion board activity.
Monthly topic discussions range from ethical awareness to communication to teamwork. These topics are areas that can be best learned when applied in the work setting. The extended internship student reflects on how they observed their preceptors handling certain situations, and what the results were.
“If you have an emergency, what does your preceptor do? Who does she call?” Massey offered as an example.
Or, “when you have an abnormal finding and your nurse needs to call the physician, how are they relaying that information? What information are they actually giving? And what are they asking for as an intervention?”
Johnson observed a lot about teamwork during her nursing internships. “I saw many (emergent) situations, where teamwork is the most important thing,” she said. “And it’s so amazing how people come together in such a critical situation and work together to help this person that they don’t even know. They come from every single floor. They have no idea who this patient is, what their story is, and they do everything they possibly can to save their life.”
Variety of locations, same uniform
The structure of the programs and requirements can vary somewhat by state and by location. For example, while Bemidji offers a summer internship split into two five-week sessions in two different departments, other sites offer one department for 10 weeks, with the opportunity to spend 12 hours in two other departments during that time.
“It gives them an opportunity to see what else is out there,” Massey said.
Most of the extended internships are inpatient, ranging from the NICU to critical care, to even the operating room this year for the first time. Summer internships vary, too, especially by location. In addition to the four main Sanford medical center locations — Bemidji; Sioux Falls, South Dakota; Fargo and Bismarck, North Dakota — interns are placed at rural sites as well. These sites can range from Winner, South Dakota, to Sheldon, Iowa, and Jackson, Minnesota.
Massey references the rural sites as “one of the hidden gems of the program.”
“In those rural sites, they get such a well-rounded experience,” she said. They can see pediatrics, OB, surgery, emergency, critical care and medical-surgical. “You’re gonna get it all.”
A “uniform” consisting of a white top and navy bottom identifies, for everyone they work alongside, what role they represent and which tasks they can and cannot perform as an intern. It also helps directors connect with interns — who hold great potential for becoming their next employee.
Avenue to employment
These nursing internship programs benefit both students and Sanford Health.
“We tend to hire participants that apply for nursing positions,” Massey said — up to 95%, in fact.
The internships create an avenue for student recruitment, providing a steady stream of new nurse hires. And not just any new nurses — nurses who have had additional experience as students, with enhanced confidence in communication and teamwork.
The interns have a head start. “I think they develop the beginnings of a professional identity as a nurse,” Massey said. “They’re not just a student. They’re actually seen as a part of the team. Their voice matters. I hope they see that they can and do impact patient care.”
Johnson has started her career as a registered nurse, but that doesn’t mean her education is over. In medical-surgical and orthopedics, she sees patients ranging in need from joint replacements to blood transfusions to appendectomies. “I’ve learned something new every single day,” she said.
Her nursing internship was the pathway to lead her there.
“I learned how to be a nurse, which was the best part,” Johnson said.
“It’s all of the things that you learn through a book, but when you put it into a real-life situation, it makes so much more sense.”
Applications are open through Oct. 25 for the summer 2020 nursing internship program.
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