Kuldeep is an Extern Mentor Coordinator (EMC) at Sunnybrook Health Sciences Centre in Toronto, and coordinates the onboarding for incoming clinical externs who join our interprofessional care teams while enrolled in nursing school. She also mentors new nurses in the New Graduate Guarantee (NGG) program, a Ministry of Health program that matches nurses with employers and provides nurses with a mentor and increased support in their new nursing role. After one year, participants are guaranteed a position with the employer.

Kuldeep, a registered nurse, says when she was offered the opportunity to become a mentor, she was happy to accept.

“What I love about it is that you bring someone into a personal space and you’re going to advocate and help nurture, coach, shape and guide them to have the best nursing start to their career,” Kuldeep says.

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In her role as a mentor for NGG nurses, Kuldeep and other mentors provide support to registered nurses and registered practical nurses by helping them transition to their role while they gain clinical skills and autonomy.

Since clinical externs are still nursing students, the mentoring process is slightly different. Mentors spend time ensuring externs understand their specific role on the interprofessional health-care team, and supporting them in their learning process.

“What I love about my role as a clinical extern mentor is that I can become a part of their learning journey. Sharing my clinical experiences and all the little tricks I’ve learned that have helped me to adapt to change,” Kuldeep says, adding that’s been especially important during the pandemic. “It makes me smile when I know they feel supported.”

Starting a new career in nursing can be overwhelming, but when experienced nurses provide mentoring, it gives clinical externs and new nurses a safe place to learn. Kuldeep says cultivating a strong relationship between the mentor and extern or new nurse is important for success.

NGG nurses connect with their mentors on a weekly basis, and new nurses can easily reach their mentors with any questions. EMCs will touch base with clinical externs at least a few times per week via text, phone call or visits to the unit.

“This builds a relationship and a trust and shows them we’re here to support you and transition you into your new role,” Kuldeep says.

Kuldeep says Sunnybrook’s mentors are experienced nurses who want to support new nurses and nursing students and help them develop the knowledge, skills and judgement necessary to provide high-quality patient care and be successful in their careers.

“We all want them to succeed,” she says. “Not only does the hospital need nurses, but we need good nurses and one way we can do that is by being there as a mentor.”

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“It [is] a really great learning environment and people are super eager to teach you,” Ashlynn said. “Also, there’s … lots of unique things that you only see at Sunnybrook.”

In 2020, the COVID-19 pandemic ended her consolidation hours — a for-credit placement required for her nursing degree program — but since she was still interested in working for Sunnybrook, she was referred to the clinical extern program. Clinical externs are nursing students who gain on-the-job training while increasing their understanding of interprofessional roles within health-care teams. Not only is it an opportunity for students to gain confidence as nurses, but the externship program also enhances the overall quality of care for patients and families.

Ashlynn was interested in learning more about cardiology and, as an extern, she was assigned to that unit where she says she was warmly welcomed, received excellent teaching and was able to assist in providing high-quality care to patients and their families.

“I learned a ton,” she says.

Following her externship, Ashlynn registered for the Nursing Graduate Guarantee (NGG) initiative, a program offered through the Ministry of Health that matches nurses with employers and provides nurses with a mentor and increased support in their new nursing role. After one year, participants are guaranteed a position with the employer.

After completing the NGG, Ashlynn was hired into the Acute Care Nursing Resource Team (ACNRT). While working as a member of that team, Sunnybrook sponsored Ashlynn in the completion of her Emergency Department certification. Now that she has completed the Emergency Department certification, Ashlynn has started her newest role as a registered nurse in Sunnybrook’s Emergency Department. She says the mentorship she received as an extern and in the NGG program has helped her feel prepared to succeed in her newest role.

“I had a good foundation. My transition into independent practice was I think as smooth as it could have been because of the support I got,” Ashlynn says.

Ashlynn credits Sunnybrook for investing in its nurses. Becoming a nurse during a global pandemic isn’t easy, and moving into more independent practice where she will have greater responsibility can be a little scary, but she says she has never once felt as though she has to manage these feelings on her own.

“Being independent in my practice doesn’t mean being alone in my practice when I’m at Sunnybrook,” she says.

The support and mentorship is valuable, but Ashlynn says it doesn’t mean it’s made the work easy. And for nursing students who are considering employment in a hospital setting, she advises not getting stuck on how difficult or scary it might be.

“It’s challenging, but if you’re in the right environment that supports you, the growth that you get as a nurse and a person is worth the difficulty,” she says. “When you’re in a new environment that builds you up like that, you become a better nurse and what scares you now just won’t scare you later.”

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Still in nursing school, Laura jumped on the opportunity to work in a hospital setting during one of the most turbulent and unprecedented times in health care.

“There were so many unknowns, especially at the beginning of the pandemic,” says Laura, who joined Sunnybrook in April 2020. “I just felt like I was able to make the decision to jump in there… I wanted to be a part of it. I felt like I was in a position to be able to help,” she says.

The clinical extern program has been in place at Sunnybrook for a number of years, but was recently expanded when the pandemic was declared.

The program invites nursing students to work part-time as members of a health-care team, gaining hands-on patient care experience, while also supporting interprofessional teams that could benefit from additional support.

Before the pandemic, around five externs were hired at Sunnybrook each year. This year, 51 externs have joined our hospital care teams, with a goal to recruit a total of 75.

“Every day, all of the nurses I’ve worked with have been so thankful for everything I’ve been able to do for them. It’s neat to be in a position to help them out and also be able to learn from them,” says Laura.

The COVID-19 pandemic has placed increased pressures on nurses across the health-care system as workload demands have increased, the patients they’re caring for are more critically ill, and as the country faces a growing shortage of nurses in the workforce.

Externs play a key role in supporting hospital teams, by providing direct patient care and clinical unit support. Their responsibilities and care tasks may include participating in patient assessments, taking vital signs, assisting with comfort measures and patient safety, supporting safe feeding, and more.

For Laura, it has been these opportunities to spend more time with patients that has made the externship experience so valuable for her.

“In an externship, it’s patient-focused. I need to make sure I’m doing what I need to do for the patients I’m assigned to,” she says. “That’s one of the things that’s been the most impactful for me.”

While externships are not integrated into a nursing student’s learning curriculum, the program functions as compliment to the education students receive through school, says Tracey DasGupta, Director of Interprofessional Practice at Sunnybrook.

“Externships enable students to move into a clinical setting, become comfortable in this setting and become members of an interprofessional care team within the hospital,” says Tracey.

“It’s a win-win as externs become a part of our care teams, they help support patient care and help maintain safe, quality care within the hospital,” she says.

For Laura, participating in the externship program has helped build her confidence as a new nurse, make connections, and has helped reassure her in her decision to pursue nursing as a career.

“The additional experience in the hospital gave me a ton of confidence as I was heading into my final semester of school, and again now as I am looking forward to starting out as an RN. I loved being part of the teams on each unit, and having the chance to learn from so many nurses and health-care professionals has been invaluable,” she says.

“I feel grateful to have found this opportunity.”

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