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It’s been three years since we welcomed our very first cohort of nurses to The Ralph’s Referral Nursing Internship Programme (throwback to the announcement!)

The 12-month internship is designed specifically for qualified veterinary nurses (RVNs) with no prior referral experience, and aims to bridge the gap between primary care nursing and referral nursing.

In this insightful conversation with Katie, Heather, Louise and Evie (who were all part of the first cohort), we reflect on the before, during and after of their referral nursing internship experience.

Evie and Katie now work as Emergency and Critical Care (ECC) nurses in our Intensive Care Units (ICU), Heather is an Internal Medicine Nurse, and Louise is a Feline Nurse in our Cat Ward and Cat ICU.

Without further ado, let’s have a chat with them..!

Why did you apply for a referral nursing internship at The Ralph?

Katie: One of my ex-colleagues suggested I apply. I was very apprehensive and needed some convincing: I was only about a year qualified and I didn’t think I would be good enough. But I thought the internship would be the best insight into referral nursing and even if it wasn’t for me, at least I could say I had tried.

Heather: I had heard good things about The Ralph beforehand, as well as it being the first time I had ever seen a rotating nurse internship. I was always interested in referral nursing however was unsure if it was for me. I also thought referral nursing was big and scary so I was unsure whether it would be something I could do. I thought this internship would be a great way to dip my toes in, see what referral is all about, where (if anywhere) I would fit in, and if I would enjoy it.

Louise: When I worked in first opinion practice, The Ralph would always do their best to help our patients, and I loved the things considered by The Ralph, for example having two completely separate entrances and wards for dogs and cats to help reduce their stress levels. I really wanted to push myself out of my comfort zone and experience the referral side of nursing. I was keen to learn more clinical skills and the rotating internship was a great stepping stone because I got to experience and learn from each department whilst not feeling as much pressure on myself because I was in a training position. 

Evie: I had always had an interest in referral nursing, but I wasn’t sure what department I wanted to work in. I thought that this was an amazing opportunity for nurses in first opinion practices to experience referral nursing. The internship would give me the opportunity to work in all the disciplines, and on completion of the internship program I would get the opportunity to work in my chosen discipline. I wanted to gain more knowledge and experience but I wanted to work somewhere that would support me while I learnt about referral nursing. I had also heard great things about the compassion and ethos of The Ralph from colleagues and nursing friends that had started working there.

What was the highlight of your time on the internship programme?

Katie: The highlight of the internship for me was making lifelong friends. We were all fairly ‘new’ RVNs. Watching your friends’ confidence and nursing skills grow and develop was definitely the most rewarding part of the program. 

Heather: Internal medicine – the support and encouragement I received from the team helped build my confidence and nursing skills.

Louise: Being able to work with some of the most incredible clinicians and nurses and getting the opportunity to learn from them. Also making some friends for life, my fellow interns really got me through the internship and I would not be where I am now without them all!

Evie: The highlight of the internship for me is the friends that I’ve made. The first cohort of eight nurse interns all started at the same time, and we all stayed at The Ralph (in one way or another) after the internship.

What was the most challenging aspect of the internship?

Katie, Heather and Louise: The most challenging part of the internship was the first week in each rotation, and the constant change of moving on to a new service just as you start to feel confident in the previous one. With that came a lot of learning and settling!

Evie: The most challenging part of the internship for me was finishing my top-up degree while completing the internship. It was hard to balance them both. But I made it to the end and graduated with a first class honours (within my degree I completed RECOVER CPR training, Associate Fellowship (AFHEA), clinical coach training and OSCE examiner), I’m so proud of myself for completing both of them at the same time.

What advice would you give yourself if you were to go back and do the internship again?

Katie: I would tell myself that it’s totally okay to have lots of questions. It doesn’t reflect poorly on you or make you a “bad” nurse. It shows that you are genuinely interested in the service you’re working in and that you’re wanting to expand your knowledge. On the flip side, it’s also okay to have days where you don’t ask questions. This doesn’t mean you’re not interested in learning, it’s probably that you’re still processing and piecing together the information you were given yesterday. 

Heather: I think it would have to be the same advice I gave myself at the time of the internship: stick with it! It’s an incredible opportunity to learn and understand conditions and cases you would have never seen before.

Louise: Try not to be so anxious! You are in a training position and nobody expects you to know everything. 

Evie: I would tell myself that you don’t need to know everything and that’s ok, you’re there to learn. There is so much more to learn and it continues to drive me every day to keep on learning. 

How has doing the internship influenced your permanent role at The Ralph?

Katie: The internship allowed me to explore all my options. I really enjoyed cardiology and oncology, but I knew I wanted to work in the Intensive Care Unit (ICU). I don’t think I would have had the confidence to move from first opinion straight to referral ICU nursing without the internship.

Heather: The internship made me fall in love with internal medicine – something I would have laughed at before joining The Ralph – and now I can’t imagine doing anything but medicine! Not only did it show me where my passion lies but also made me versatile, competent and confident to help other departments when needed for example ICU, wards and anaesthesia.

Louise: When I first started at The Ralph, I got to spend a few shifts in the Cat Ward specifically. I started my ISFM feline nursing certificate as an intern and it really was incredible to be able to work in such a cat friendly hospital whilst learning the theory behind it all. Now I am a Feline Nurse in the Cat Ward and Cat ICU!

Evie: My final rotation of the internship was in the Emergency and Critical Care (ECC) department. I have been working in this department ever since and I genuinely feel that the internship has shaped the nurse that I am today. I think that rotating around the different disciplines gave me an insight into the day to day running of each discipline. I shadowed the nurses and was trained to work alongside them, and to support them and the team during their day. Without the internship, coming from first opinion to the ICU I wouldn’t have gained the skills that every nurse from each department taught me. I use the skills I have learnt from each department nurse every day. We can learn from each other. During the internship I became part of each team for a short period of time and I feel it has created a good working relationship with each department, they know my abilities and I try my best to support my colleagues and the patients that are in my care. I want to say thank you to the nurses at The Ralph for taking the time to teach me, you have made me the nurse I am today.

What advice would you give to someone currently working in primary care practice, who may want to explore referral nursing?

Katie: My advice to anyone thinking about a referral internship would be: just go for it! You never know what may happen and you could unlock a new love for a particular type of nursing. I still have moments where I’m doing something like placing a nasoesophageal feeding tube or nursing a ventilated patient and I’m caught off guard because it makes me appreciate just how far I’ve come in a relatively short period of time. It’s the best feeling, and that could be you too!

Heather: If you are curious about referral or want to see if there is an area that you would be interested in, this internship will give you the taster you need in an appropriate time frame.

Louise: I would say go for it! It was not the easiest of journeys but when I look at where I am now in my nursing career compared to where I was before I joined The Ralph, the challenges are absolutely worth it! I learn new things every day at The Ralph and get to work with some genuinely kind and compassionate people. Now that I am a permanent member of staff I can see just how helpful the interns are which is something I worried about a lot when I was in that position myself!

Evie: If you are interested in referral nursing, the nurse internship is a good opportunity to learn with support and to find out what discipline you would like to specialise in.

Thank you for reading Katie, Heather, Louise and Evie’s insights. If you have any questions or would like to know more about our nurse internships, contact [email protected].

Take care,

Team Ralph 🐾

P.S. Katie recently featured in Bo’s story video, giving an ECC nurse perspective on Bo’s miraculous recovery from tetanus. Check it out for a more in-depth view of Emergency and Critical Care nursing. You may also like this separate video about Katie’s bond with Bo 💙