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The nursing internship

The nursing internship. Many good but also some bad memories are connected to this topic. It is still a very entertaining topic which comes up in conversation in every group of medical students during the preclinical part.

Back when I did my internship, a 90-day nursing internship during the preclinical part was compulsory. And it still is to this date. It is not necessary to complete the internship in consecutive months though.

I completed two months already straight after my Abitur before I even began my degree. Without any knowledge of medicine, I started my first day by meeting all the other interns at 8 am. We got our uniforms and then hurried to get to our assigned wards.

In my application, I put down one preferred ward because I had been advised to do so by my neighbour. I did end up getting my preferred ward. A mixed surgical ward where every surgical area was present.

The second day was the first real day. Got up at 05:20. Got ready. Got on my bike at 05:40 and even had to have my protein shake with oats on the way.

At 06:00 I was sitting in a small common room which was heated to 35°C. I was there with about 7 – 10 nurses to perform the handover. Because of the dimmed light and the heat, I instantly fell asleep though. My hardest task, which was also my main task, every morning was to stay awake during the handover. After a few days, I started to write down the names of the patients and their diagnosis. Although in all honesty, I could have skipped writing down the diagnosis.

After the handover, we started to go to all the rooms on the ward. Exciting! On the first day, I only got to tag along and I was surprised how dry the nurses‘ humour was. They seemed to have no shame at all. Back then I thought many tasks were carried out in a very impersonal manner and almost machine-like. Today I know that it is normal for it to be like that.

On the third day, I finally got to do stuff myself. The day before, another intern gave me a quick introduction on how to measure blood pressure, how to measure a patient’s temperature with an ear-thermometer and how to measure blood sugar levels. Quite a lot of information for one day.

When all nurses started to get up and I had to wake up again after being half asleep from 6 – 7 I knew that the day had finally started. Great! I was on my way to my first patient. I wasn’t allowed to measure blood pressure or temperature but I was allowed to wash patients. It was never really shown to me how to wash a patient but only quickly explained by one nurse: „It’s the same as washing yourself“

In the first patient’s room, I asked the patient: „Do you want to take a shower?“. The answer was a surprised: „Taking a shower? Of course!! Am I allowed to do that already?“ My answer: „Yeah why not? It should be alright as long as your cast doesn’t get wet, right?“ The patient who was very keen on taking a shower: „I fully agree.“

I guided the patient to the shower, closed the bathroom door and waited outside. After 30 minutes, a nurse came in and asked what I was doing. I answered: „Washing the patient. He is just under the shower.“ … I then got a quick introduction to how to actually wash a patient and the next day I had to do it with a bowl of water and a washcloth.

Washing patients were quite alright. I had a lot of time to talk to patients and sometimes I even got a tip for putting in a lot of effort. I really liked having conversations with patients so I took about 40 minutes to wash each patient. That was a bit above the average and apparently too slow. After two weeks, I got a new task and was finally allowed to measure blood pressure, pulse and temperature. I then had to insert those vital parameters into the relevant curves. All of this had to be done in 24 patient rooms.

Most days finished my tasks at about 9:30-10:00 and then had to act as an errand boy for the rest of the day. When a patient rang the bell, I was the one who had to attend to him/her.

I helped hand out breakfast and lunch and even got to feed patients from time to time. Obviously again without first being told how to do it. One time a patient choked on a piece of bread. I had not been told what to do in such a situation .. But luckily nothing bad happened though.

Sometimes one of the head physicians came to have breakfast with us on the ward. I was very eager to ask questions. Most of them were very basic and I probably did not leave a good impression but rather just looked uneducated.

That wasn’t a problem though. Everyone starts small.

On rare occasions, I was lucky enough to be allowed to tag along with the doctors and I was very impressed by their vast knowledge. One assistant doctor tried to explain erythropoiesis to me. He earned my respect within 5 mins. Really cool guy (NB he was a surgeon).

One assistant doctor explained the anatomical structure of the hip to me in simple terms and then also explained how a hip – TEP is performed. I was fascinated again.

There were only a handful of specialist skills I acquired during the two months of the nursing internship: Measuring blood pressure, pulse and temperature and (more or less) washing patients;

Of higher importance to me were all the other experiences during that time though. I got the chance to participate in the day to day work on a ward for the first time in my life. I had two months of daily talks with patients and learned a lot about how patients feel during their stay at a hospital, different types of personalities and different ways to deal with illness. I also learned that nurses do not work for the doctors but rather with them. A doctor who is nice to the nurses will be met with the same attitude.

I also got an insight into the sometimes very strict hierarchy in a hospital.

The nursing internship enables every future medical professional to get a first glance at the kind of work performed at a hospital.

My recommendations:

Splitting the nursing internship:

  • 1 month in the surgical department is beneficial but more is not necessary
  • 1 month of internal medicine should be done to get a deeper insight
  • 1 month in a department that you are genuinely interested in is also recommended. This could be 1 month in adolescent psychiatry. 1 month in paediatrics. 1 month in infectiology. 1 month in ENT or even just 15 days each in two different areas. The nursing internship is after all intended to enable you to have a first insight into medicine.

The timing of the nursing internship:

If you have time to do it after the Abitur then you should totally do 60-90 days right away. Doing 30 days right before starting your degree is definitely beneficial as well.

In case you would rather want to travel after your Abitur then please do so and only do a 30-day nursing internship right before your degree.

Keep in mind that during your degree you only have 3 termly breaks to do 90 days of nursing internship. This is because in your 4th termly break you have to study for the preliminary examination and usually you need to have completed the nursing internship at that point anyways to be eligible to register for the exam.

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