Sitting in my last day of NCLEX review at the hospital, I think these 8 weeks have been quite an experience.  On the cardiac care unit at this particular hospital, the ratio is generally 2 or three patients per nurse.  I was very lucky to work with a number of different great nurses on the unit as my preceptors and learned as many tidbits of medicine that I could.  I can't pinpoint the single most important one, but here is a list of the things I learned. 

1.  Relationships matter-when pharmacy likes you, you get your meds; when you work well with your coworkers, you get help, and overall teamwork is necessary. 

2.  Clinical skills- all those skills I learned in school and practiced on mannequins I've now done on the unit; suctioning, packing wounds, inserting catheters, IVs, NG tubes, hanging and giving meds, and assessments (all under the careful watch of my preceptors, of course).

3.  Documentation- if it's not documented, it's not done...we've heard it so many times in school, yet it's so important.  Sometimes it's not a big deal, like when you have a stable patient and it's his/her temperature...but other times it's critical...did that patient get his/her last insulin injection?...Important. 

All in all, my summer externship program was a great learning experience.  For those students coming in, I highly encourage you to do it on your break, not necessarily for money (it's a little...not a lot), but to practice those skills, learn differnt ways of organizing and get more patient time.