Hospital Turns to Externs to Fight the Staffing Shortage

Northwell Health, New York’s largest healthcare provider and private employer, is using students to ease the ongoing worker shortage at all but three of its hospitals. The program, which has been around for thirty years, allows junior-level students to work alongside experienced nurses in various departments. But unlike an internship, they are being compensated for their time. The health system says it’s also a great way to recruit and retain nurses when many hospitals are running low on staff.

The program has been particularly impactful for Maureen Kenney, MSN. Both of her twin daughters Emily and Elizabeth, 26, are now working in hospitals across the state after completing the 2021 nursing externship.

“My sister and I always wanted to be a nurse like mom. When we were in high school, actually, both of us did a junior volunteer program in Huntington Hospital. So even as teenagers, we were exposed to healthcare and what our mom did,” said Emily, who is currently working the night shift at the ICU in Northwell’s Huntington facility.

Elizabeth added that their mother inspired them to be nurses at a young age. “I am interested in the medical aspects of nursing,” Elizabeth said. “And then when we heard that Huntington offered the extern program, we thought that it would be a great way to see nursing firsthand at the bedside.”

The externship is an eight-week long summer program for juniors seeking a bachelor’s degree in nursing. Many hospitals participating in the program keep in touch with students long after they graduate. And most of the grads go on to work in Northwell hospitals. Of the one hundred nurse externs who completed the summer program in 2021, 62% eventually received permanent nursing positions within Northwell.

The company says hiring externs has helped it create its own pipeline of nurses. Both Emily and Elizabeth said they have gained valuable experience through the program. And their mother is grateful they got to be a part of it.

“It’s a wonderful experience for nursing students to get a hands-on, day-to-day reality of what nurses do based on getting to work with some co-workers, whether they be on the unit, the nurses, the nursing assistants, secretaries, the doctors,” Maureen said. “It’s a little different than what they get while they’re in nursing school, and it gives them the opportunity to see what areas they would like to go into.”

The externship gave both students the opportunity to shadow nurses in multiple departments until they found the right fit.

“I’d be floated to the ICU at Huntington here and there. And when I worked there, I loved it and I could speak to the nursing supervisors and request [to] float over to the ICU,” Emily said.

For Elizabeth, her experience eventually led her to pediatrics.

“It was nice to be able to still come home and learn things at nursing school and different skills and then come back to work at Huntington and be able to apply what I’ve learned or see firsthand what I’ve been learning throughout school,” she said.

Multiple schools in New York participate in the program as a way of attracting students. Emily graduated from State University of New York at Plattsburgh in 2022, while Elizabeth earned her degree from Mount Saint Mary College in Newburgh.

Both women are now passing on what they’ve learned to the next generation of externs.

Kathleen Casler, RN, senior director of clinical professional development at Northwell, said the program has become an invaluable tool over the last few years, especially as senior nurses continue to retire at an early age.

“It provides nursing students the opportunity to understand how the hospital environment works in a way that they don’t get to see during traditional clinical experiences. [It also provides] the nursing team and the rest of the unit team the opportunity to get to know that nursing student,” Ms. Casler said. <sic>

The hospital also has a dedicated pool of talent from which to draw.

“It’s really mutually beneficial. It provides a compassionate learning environment for the nursing student as well as for the nursing team to get a deeper understanding of what the current experience of our nursing students is as well as how they can help to support their transition to practice,” she explained.