A win-win approach to care

Nursing student Isha Rai always knew she wanted to be a nurse.

"When I was a little girl, my brother became seriously ill. There were many hospital visits,” recalls Isha. “As I grew older, I knew I wanted to pursue a career in health care and help others.”

Isha is making strides toward her goals through a new training program at St. Joseph’s Health Care London (St. Joseph’s) called Clinical Externs in Nursing (CEN). Not only is the program ensuring that Isha gets the opportunities and experiences she needs, it’s addressing a critical shortage of health care professionals in Ontario.

The CEN program, funded by the Ontario Ministry of Health, serves as a recruitment and retention strategy. It allows hospitals to supplement their existing workforce by providing nursing students with opportunities to work under the supervision of registered staff in various clinical areas of the hospital.

The role differs from student placements required during nursing school in that CENs are hired by the organization as ‘unregulated health care professionals’. The paid CEN role is an additional placement a student can take on if selected.

“The CEN employed position serves as a transitional role, allowing students to gain clinical expertise, specialty knowledge and self-confidence during their transition from student to registered nursing roles,” explains Carmen Marsh-Lansard, Professional Practice Coordinator at St. Joseph’s. “Additionally, externships enable CENs to immerse themselves in the culture and work setting at St. Joseph’s, enhancing their communication and interprofessional collaboration skills.”

At St. Joseph’s, CENs are nursing students who are entering into their second, third or final year of studies to become a registered nurse or registered practical nurse. Since July 2023, the organization has employed 44 CENs, whose tasks often involve helping with patient meals and daily needs, participating in therapeutic activities, assisting with treatment plans, monitoring patient vital signs, and collaborating with other health care professionals.

“All the nurses and staff I work with appreciate the extra help I provide on the unit," says Isha, who works in St. Joseph’s Mental Health Care Program at Parkwood Institute. "It's rewarding to feel like I'm contributing to their work while also learning from their expertise.”

Clinical extern Riley Ellis, a fourth-year nursing student at Western University working in the Post-Anesthesia Care Unit at St. Joseph’s Hospital, also appreciates the mentorship she has received from the nursing team.

“The nurses I work with on the unit have been great mentors and teachers,” says Riley. “They take the time to make sure I understand what’s happening or answer any questions I might have. This helps build my confidence when speaking with patients.”

Through their work experience, CENs become excellent candidates for nursing recruitment. Sebastian Krawczyk, for example, was among the first CENs hired into a permanent position at St. Joseph’s. After completing his externship and graduating from the nursing program, Sebastian joined the Specialized Geriatric Services care team at St. Joseph’s Parkwood Institute.

“Working in a hospital as a new graduate can be very intimidating,” says Sebastian. “The externship helped me feel more comfortable working in a hospital setting and provided me with a strong foundation for patient care and my current role.”

Once clinical externs have completed their formal education, St. Joseph's looks for opportunities to hire them into full and part-time roles.
 

"As the health system seeks innovative ways to expand the health care workforce and improve patient care, clinical extern programs can serve as a valuable step forward, benefiting the extern, the organization and our community," says Karen Perkin, Vice President of Patient Care and Chief Nurse Executive at St. Joseph’s.

Isha, whose brother has since made a full recovery, remains excited about the future and what lies ahead.

"I'm glad I had this experience at St. Joseph’s. It has greatly improved my confidence and I can't wait to start my career."