A Successful Nurse Externship Program in an Inpatient Blood and Marrow Transplant Program

Topic Significance & Study Purpose/Background/Rationale 

• Current nursing programs do not offer curriculum focused on blood and marrow transplant. 
• Blood and marrow transplant nursing is an evolving specialty demanding dedication and expertise. 
• Allowing student nurses the opportunity to complete an externship has led to low turnover and high retention rates in our inpatient program. 

Methods, Intervention, & Analysis 

• Over the past 15 years, our program has hired 17 senior baccalaureate nursing students into our nurse externship program.
• The nurse externship program is a three month commitment, in which the extern functions under the immediate direction of a registered nurse in our inpatient setting. 
• During their three month externship they provide direct patient care.  This allows the extern the opportunity to learn basic nursing skills while giving them experience in the specialized care of a blood and marrow transplant patient.    
• The unit educator meets with the extern and his/her preceptor weekly to discuss progress and goals for the next week and provide feedback and mentorship 
• Upon completion of a successful program, the student is hired as a Patient Care Technician during their senior year, with an ultimate goal of hiring them into a nursing position once they have graduated. 

Findings & Interpretation 

• 30% of our current staff have come through our externship program.
• Our 5-year retention rate is 95.2%
• The average length of employment of our current RN staff ranges from <1 year to 28 years with an average of 10 years. 
• We have a 5-year average turnover rate of 3.9%
• 75% of our current staff are BSN prepared.  63% are Oncology Certified Nurses.  14% are Bone Marrow Transplant Certified Nurses. 

Discussion & Implications

• Giving students the opportunity to experience blood and marrow transplant nursing in a controlled setting has allowed for smoother transitions into the role of RN, allowing for shorter new nurse orientation, low turnover rates and high retention rates. 
• The opportunity of working with experienced blood and marrow transplant nurses provides new nurses with the tools and support needed to be successful in a challenging specialty.