How a Binghamton student’s summer externship confirmed her nursing career path

Binghamton University undergraduate nursing students gain practical experience throughout their program by completing clinical placements at various healthcare organizations and engaging in simulation and practice experiences. While not required - and very competitive - many students also participate in externships the summer before their senior year.

Casey Tully, a senior in the traditional nursing program at Decker College of Nursing and Health Sciences, spent her summer externship at The Valley Hospital, a 370-bed facility in Paramus, N.J. Although Tully was already familiar with Valley Hospital since it is near her hometown of Warwick, N.Y., she hadn't been there since its relocation from Ridgewood to Paramus in April.

BingUNews caught up with Tully to find out about her experience and what advice she has for other nursing students.

Q. You were placed in Valley Hospital's Rapid Decisions Unit. What is that?

When I got the assignment, I had never heard of a Rapid Decisions Unit! The RDU is a new, 10-bed observation unit at Valley. It's where they send patients who don't meet the criteria to be admitted but shouldn't go home yet so they can be monitored and evaluated. Most of the patients came to the RDU from the ER. The patients were usually admitted or discharged within 24 hours, but some stayed for two days.

Casey Tully (back row, third from right) and the summer 2024 cohort of externs at The Valley Hospital. Q. How did you end up in the RDU?

During my externship interview, they asked if I was interested in any particular unit, and I told them I didn't know what I wanted to do. One of the nurses said that was fine and I should go out there and absorb as much as possible. Since the RDU was a new unit for them, they had never placed an extern there. We were all figuring it out at the same time.

Q. Who oversaw your training?

I worked with the same nurse preceptor for the whole eight weeks. I followed her schedule, which was three 12-hour shifts a week. She was terrific, and she had a lot of experience in orthopedics and labor and delivery. She shared her experiences with me and helped me a lot.

Q. What was a typical day like? What types of tasks did you help with?

When we arrived every day, we got our patient assignments and a report from the nurses on the previous shift. Our team had three nurses: one charge nurse and two RNs. Each RN was assigned five patients. After the briefing, we checked on our patients.

Image Credit: Jonathan Cohen.

I gained experience and grew over the eight weeks of the externship. I practiced the hands-on skills I learned in the Innovative Simulation and Practice Center at Decker and learned many new skills.

Casey Tully

I took vitals, helped prepare patients for tests or procedures, assisted with post-operative care and gave discharge instructions. The doctors sometimes performed minor bedside procedures, and we helped with that. I also connected patients with other hospital team members like social workers or pharmacists.

One of my standout memories involved a family that was confused about the medication list they had gotten, which kept changing. My preceptor suggested that I write a complete list for them and explain what each medication was for. I was happy to help!

At the end of the day, we updated the next shift about our patients.

Q. Did you get to see any other units?

Yes, there were three days when externs could leave their units for four hours and gain another experience. I went to the cardiac catheterization lab, the operating room and physical therapy. In the cardiac cath lab, I stood next to the doctor, who showed me what he was doing and explained everything. It was so interesting; I was thankful he took the time to do that. I shadowed the PTs on the ortho unit, where they helped people ambulate after their surgeries. It was interesting to see how PTs work with the nurses.

I also shadowed an ADT - admissions, discharge and transfer - nurse, a position I didn't know existed. They assessed patients being transferred and completed the paperwork/documentation. It was really helpful, especially in the ER, which was always packed at Valley.

Another great part of the experience was the education days. These were four-hour-long classes where we learned skills, such as de-escalation training, or participated in simulations. I did a simulation with the other externs in which we had to perform emergency CPR on a manikin [patient simulator].

Q. Did you feel prepared clinically for the externship?

I definitely felt prepared because I always learn something from clinicals and simulations, so when I got to Valley, I felt confident that I knew how to do a few things. But I gained experience and grew over the eight weeks of the externship. I practiced the hands-on skills I learned in the Innovative Simulation and Practice Center at Decker and learned many new skills. I felt more confident going into my senior year.

Resources to help you land an externship, internship or job!

Binghamton University's Fleishman Center for Career and Professional Development offers services to help students, including professional photographs for LinkedIn profiles, assistance in creating a resume and writing cover letters, conducting mock interviews and providing private rooms for video interviews.

"The mock interviews were really helpful, so I felt prepared," Tully said. "Nothing in that interview really caught me off guard."

Q. What part of the job did you like the most?

I liked talking to the patients and dealing with their families. A few of my patients were retired nurses or nurses well into their careers, and it was interesting to hear about their experiences. The families were so stressed, and it felt good to help them, even if it was only showing them where the cafeteria was, making them a cup of tea or giving them something to eat.

Q. Did your externship help you clarify your decision to pursue nursing as a career?

My externship definitely confirmed my choice to pursue a career in nursing. It reinforced my love for hands-on patient care. There were many times when I felt I had a positive impact on the patients; I loved talking to patients and developing rapport. Being a part of their care and discharge process was special. The gratitude and appreciation the team received was rewarding, and it felt like I was making a real difference. I am really looking forward to a career in nursing!

Q. Do you miss working at Valley Hospital?

No, because I still work there! All the student externs were offered the chance to stay in a patient care associate position if they wanted to. The manager for the RDU also runs the orthopedic unit and asked if I wanted to be a PCA there, so I work there twice a month. It aligns with my school breaks.

Q. What advice do you have for other nursing students before they embark on externships?

Be open-minded! You might get thrown into something you end up loving or where you learn a lot more than you thought you would.

Q. Do you know what type of unit you'd like to work on once you graduate and pass the nursing licensure exam?

I'm hoping to work in critical care nursing.

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