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Three McMaster students stand outside McMaster Children's Hospital, smiling.
McMaster University nursing students Sifa Lwesso, Tran Thai and Alessandra Cascioli have been gaining valuable work experience as clinical externs at our McMaster Children’s Hospital.
March 20, 2023

Childhood experiences inspire nursing careers

Health Care: The Next Generation

Staffing shortages triggered by the pandemic continue to impact hospitals across the province, including Hamilton Health Sciences (HHS). One of the innovative ways that HHS is addressing shortages is through the provincially-funded clinical extern program, created by the province to provide additional health-care support to hospitals.

Senior university and college students in nursing, occupational therapy, respiratory therapy, physiotherapy and paramedic programs can apply to work at HHS hospital sites as clinical externs. Students work at least one shift per week, with a typical shift being eight to 12 hours.

A call to nursing

There are careers, and then there are callings. Alessandra Cascioli’s younger brother Joseph inspired her to pursue a career in nursing, caring for children.

“Growing up, I always loved taking care of other people, and especially my brother Joseph.” — Alessandra Cascioli, nursing student and HHS extern

A sister and brother sit together, smiling

Alessandra Cascioli’s younger brother Joseph inspired her to pursue a caring profession.

“When I was 13-years-old, my mother had a baby who was born with Down syndrome,” says Cascioli, now a 21-year-old nursing student and an HHS nursing clinical extern.

Cascioli plans to launch her career at HHS’ McMaster Children’s Hospital (MCH), where she works shifts as an extern in the emergency department while finishing her degree.

“Growing up, I always loved taking care of other people, and especially my brother Joseph,” says Cascioli, adding that he has blossomed into a healthy, happy eight-year-old. “We always joked as a family that I was like his second mother.”

As a teen, Cascioli accompanied Joseph to medical appointments at MCH, where she came to appreciate the impactful role that pediatric nurses play in caring for kids.

“I know from those visits how special it is to be so involved in the care of a child,” says Cascioli. “That’s why I want to practice nursing at MCH. I feel that what we do is so rewarding, especially since we get to see so many kids get better and go home to their families.”

Valuable work experience

While externs aren’t registered health care professionals yet, they make significant contributions by helping with tasks they’re allowed to perform as unregulated care providers. Staff welcome the extra hands-on-deck, and students gain valuable work experience at HHS, recognized for the second year in a row as one of Canada’s top employers for young people.

Alessandra Cascioli is gaining hands-on experience as an extern in the emergency department of our McMaster Children’s Hospital.

Externs help with tasks such as bathing, personal hygiene care, dressing, eating, mobilization, and companionship and support for patients and their families.

Externs can also complete other tasks, depending on their area of care and patient population, when delegated by a regulated health-care professional. These tasks can include capillary blood glucose testing, nasopharyngeal/nasal/rectal swabbing, and removal of peripheral IV and urinary catheters.

Finding inspiration

McMaster nursing student Sifa Lwesso is an extern in MCH’s complex care and intermediate care unit, where children are hospitalized for a variety of health issues including respiratory viruses, pneumonia and chronic illnesses.

Sifa Lwesso is an extern in MCH’s complex care and intermediate care unit, where she’s gaining valuable work experience while finishing school.

Lwesso was inspired to join the nursing profession by her father, who’s a nurse.

“I grew up hearing about his work and how much he loves it.”

She also knows from first-hand experience what it’s like to be an MCH patient. “I had leg surgeries at MCH when I was very young because I fractured my femur,” she says, adding that her strongest memories are of the nurses who cared for her.

“I remember how amazing the nurses were. Their genuine care for their patients really stood out to me. It planted the seed that I wanted to be a nurse someday.”

A caring profession

Tran Thai entered the two-year accelerated nursing program at McMaster after completing a bachelor of science degree in global health and psychology at University of Toronto.

“It’s a privilege to help patients and their families through their journey.” — Tran Thai, nursing student and HHS extern

Tran Thai found meaningful work as an extern, caring for young cancer patients and their families.

“As an undergraduate I found myself loving health care but not knowing what career path to take,” says Thai.

“I loved the opportunities that I had to work with patients, which is why I thought nursing would be a great fit.”

Thai found her calling as an extern with MCH’s pediatric oncology program, where she cares for young cancer patients and their families.

“I’m very much a people person, and being part of a support system for these families during a very difficult time in their lives is something I feel passionate about. It’s really motivating to see how resilient and positive our patients can be in the face of very challenging circumstances. It’s a privilege to help patients and their families through their journey. I learn so much from them.”

All three externs worked during the pandemic, and have experienced the ongoing pressures first-hand including sicker patients with more complex health issues, combined with ongoing workforce and capacity pressures, and longer wait times.

“I know that the pandemic has made it harder for nurses to do their jobs,” says Lwesso. “But I also see how hard nurses work to care for patients under very difficult circumstances, and to me that’s very admirable and inspiring.”

More about our clinical extern program

The program has continued to grow over the past two years, bringing even more potential health-care workers to HHS.

  • Since launching the clinical extern program in early 2021, HHS has hired 126 nursing clinical externs as registered nurses and registered practical nurses after they graduated, as well as seven respiratory therapy externs as registered respiratory therapists.
  • As of February, HHS had 200 nursing externs, 12 occupational therapy externs, 10 respiratory therapy externs, five paramedic externs, and three physiotherapy externs.
  • Our externs work at Hamilton General Hospital, the Regional Rehabilitation Centre, Juravinski Hospital and Cancer Centre, McMaster University Medical Centre, McMaster Children’s Hospital, West Lincoln Memorial Hospital, St. Peter’s Hospital, the Satellite Health Facility and the Virtual Nursing Station.
  • The majority of HHS externs are from McMaster University and Mohawk College, as well as Brock University, Niagara College, Western University, Fanshawe College, and Toronto Metropolitan University. A few are from further afield, such as the University of Ottawa, University of Windsor and Laurentian University in Sudbury.
  • 81 nursing externs are expected to graduate in April, along with nine respiratory therapy externs. In August, 11 occupational and physiotherapy externs will graduate. Most graduates choose careers at HHS. For those who don’t, it’s typically because they’re returning to their hometowns to work.

This story is part of a series featuring students who are gaining hands-on experience at HHS