Is this common with teaching hospitals?

Nurses General Nursing

Published

This was several years ago, so bear with me while I remember some details.

I had been admitted to one of the larger hospitals in my area. I was in DKA, recently found out I was pregnant, and was basically just waiting to get my blood glucose down. So, there I am, feeling crappy anyway, when a teaching doctor comes in with a bunch of residents without asking and tells them about my conditions. He then proceeds to ask me about another condition, which has nothing to do with the diabetes or the fact that I was pregnant.

I have mild excess facial hair, something a lot of women do. Normally, if I am at home, I groom it away and generally no one knows about it. This doctor pointed it out, asked me "has it been like that since puberty?", and then talked about me as if I wasn't there.

Is this standard practice at a teaching hospital? It made me very uncomfortable, and as a potential nursing student, I would hate for any patient to feel weird or like a sideshow. This was not my doctor. These were not people I knew. It wasn't the nurses who had been taking care of me a couple of days now. I, as a patient, was already feeling pretty crappy to begin with. This certainly didn't help me rest better or add to my getting better. What should I have done?

I have worked at teaching and non teaching hospitals. My questions is which is worse: Being talked about like that (which isnt right, but hey, at least you know they know what's going on with you) or have the primary doctor run in for two minutes, say "How are you?", not even assess you, and you don't see them again for 24 hours... the complaint I get the most at the non-teaching hospital.

I do understand that they're learning while in a hospital environment. I'm not trying to sound whiny, I just think that any patient who is able to understand is TOLD that residents will be learning on the floor today, that's all.

They're not "learning on the floor today;" it's all day, every day. It's the basic organization and structure of the hospital. That's how a teaching hospital works. Telling people that would be like going from room to room informing everyone that they are going to get meal trays and clean linen today.

I do agree that there is no excuse for the attending or residents being rude or unpleasant. That's not something I've observed at any of the teaching hospitals I've worked at over the years. In my own experience, I would say I've run into more rude and dismissive physicians at community (non-teaching) hospitals.

They're not "learning on the floor today;" it's all day, every day. It's the basic organization and structure of the hospital. That's how a teaching hospital works. Telling people that would be like going from room to room informing everyone that they are going to get meal trays and clean linen today.

IMHO, this is really the biggest issue patients have with teaching hospitals. Lack of communication, and when you do have the temerity to ask a question of those on high being treated like you are a fool/mere mortal b/c you wondered about something that is SOP to them but maybe not to you.

Unfortunately for me, I know how teaching hospitals work. . .which is why I avoid them.

They're not "learning on the floor today;" it's all day, every day. It's the basic organization and structure of the hospital. That's how a teaching hospital works. Telling people that would be like going from room to room informing everyone that they are going to get meal trays and clean linen today.

I didn't get clean linens everyday. I feel that's not the best attitude. They were learning on the floor I and other people were on THAT day. I don't see how mentioning it should be such a big problem. Patients are people, and they may not be as aware that's SOP.

If I think there's any chance that someone may not know that, basic communication is simple. It is a skill that essentially everyone should have, especially in very, very people-oriented fields. I don't see what's so wrong with mentioning it when you're checking my blood glucose every hour. You shouldn't have to go out of your way.

Specializes in Emergency & Trauma/Adult ICU.
They were learning on the floor I and other people were on THAT day. I don't see how mentioning it should be such a big problem.

When you are admitted to a hospital, do you not expect to see the physician(s) taking care of you? Well -- that's exactly what happened there. Your "learning on the floor" statement just is not an accurate description -- it makes it sound like coming to your room was some assigned learning exercise. It was simply rounding -- the way that physicians make contact with their patients. I get that you were startled by what appeared to be a large number of people, as well as the attending belaboring a point regarding a particular symptom of your disorder that you are sensitive about.

I'll try again to use the analogy I posted earlier in this thread -- you make it sound like these were uninvited guests at your party -- when in fact they were the physicians taking care of you -- the very reason for your admission.

Unfortunately, this is common at most hospitals period. Sorry you had this experience. Next, time if you can. Speak up for yourself.

Specializes in NICU, PICU, PACU.

In a teaching hospital, it is the residents that are on the floors every single day. It is NOT like nursing students whom are on the floor "that day", this is their job and they round every day with the attending and fellow. There is no going to each patient and telling them they have a resident that day..you have a resident every day you are in the hospital. Now, if you would have asked the nurse, she should have explained the chain of command...med student, resident, fellow, attending. And that they do travel in a pack and they are learning along the way. I totally agree that some things should be discussed away from the family, but TJC now wants the family to be involved in rounds so they mostly stay in the room to avoid getting the ombudsman called.

I think you, as a patient, are definitely owed a sense of respect and dignity, even at a so-called teaching hospital, and even if you signed up for it when you signed whatever consent that they put in front of you. But we're all learners, and we need patients to help us learn. I'm always grateful for the patients when I am in clinicals - I know they have every authority to ask me to leave their room at any time, and never has anyone done that (knock on wood). That's why I always make sure to thank them at the end of my clinical day for allowing me to learn from them.

*redacted*

Specializes in Medsurg, Homecare, Infusion, Psych/Detox.

I am assuming that this is your first pregnancy and you have yet to experience the inhumanity of giving birth in a hospital? Well if I am in fact correct, brace yourself. If you think that made you feel weird and like a sideshow. And that it was not your doctor and you didn't know those people. Then you should look into a home birth. I just had a baby at a well renowned hospital. And even though my MD was there in charge of things. There were things she delegated to others whom I was not familiar with. Like inserting my foley etc. Also there were several essential ancillary staff members present. I am the kind of gal who would not go to a male OB/GYN MD if you paid me. Yet there I was. The control freak in me was uncomfortable and wanted to protest my foley being placed by the male MD assisting my MD (at least she had introduced him). But the professional in me overruled the control freak. I thought of all my patients who had to shed their pride (and or dignity) and have total strangers examine and attend to them.

Specializes in Med/Surg, Academics.

I work in a teaching hospital, and I feel it's my responsibility to educate my patients who are flummoxed by the teaching routine. The statement, "There are so many doctors," will usually elicit an explanation of the hierarchy and specialties to them, with a reassurance that the primary doc they are used to seeing is consulted regularly along with having a full MD specialist in charge of the others. I can't change the residents, but I can let them know if a patient has an issue with their care and help the patient cope with it. That said, did you mention how you felt to the primary RN? He/she is often the one who can smooth things over between you and the residents through education and talking to the residents about the patients' perception.

Specializes in Emergency, Telemetry, Transplant.

It is a bit of a catch 22. On one hand, no one should feel like a sideshow, and it can be intimidating with the "herd" of docs coming into the room.

On the other hand, the residents/med students are there to learn and they have to be involved and in the room to take care of you. While they should make you more comfortable, some discussions/procedures/exams are unpleasant and will seem like intrusions. They really should explain things like that better before they start, but that is the reality of the situation.

As for bedside manner--we always complain about the bedside manner of some attending physicians. Some are just rude and dismissive. Part of the residents' learning experience is to learn the proper bedside manner. Tell whomever will listen if you feel you were treated rudely--tell the attending, tell the nurse, tell the next nurse. They (residents) need the feedback.

+ Add a Comment