Is this common with teaching hospitals? | allnurses

Is this common with teaching hospitals?

  1. 0 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?
  2. Visit  liketheairport profile page

    About liketheairport

    From 'Shorewood, WI, US'; 33 Years Old; Joined Nov '13; Posts: 122; Likes: 163.

    55 Comments so far...

  3. Visit  weirdscience profile page
    11
    I can only tell you some pretty dated info, but it speaks to what you describe. My mom, in 1982-83, was s/p molar pregnancy. It was pretty brutal for her and she basically ended up delivering a dead baby. She was an inpatient in a teaching hospital and was talked to (about?) just the way you describe by an attending to some residents, without her permission or even advance notice. The attending even chastised her for crying when he examined her.

    Her experience there led her to be so suspicious of medicine and hospitals that she ignored her breast cancer and pursued alternative medicine until she had both bleeding open wounds to her breasts and extensive mets, which she ultimately died from shortly after her 58th birthday--6 months after she finally dared to present to an ED, because her SOB was so unbearable she could no longer take a flight of stairs.

    Was she crazy? Sure. She had experienced a childhood of sexual abuse, and was told no one believed her about that, so she didn't really have it in her to advocate for herself.

    One of the saddest moments in my life was in the middle of the night at MD Anderson in Houston, when she was about a month from dying. She held both of my hands and said, "if I had known they'd be so nice, I'd never have waited this long."

    If you're an RN at a teaching hospital, please keep this in mind. As a nurse myself now, I see both sides. I just hope I'm never as callous as that attending my mom described.
  4. Visit  Esme12 profile page
    9
    At a teaching facility you are fair game....when you are admitted it's in the fine print...it is in the consent to treatment.
    Jessy_RN, canoehead, psu_213, and 6 others like this.
  5. Visit  schnookimz profile page
    1
    Yes, I would say that's pretty standard. I loved working at a teaching hospital. I really believe our patients got more competent care more quickly.
    canoehead likes this.
  6. Visit  SquishyRN profile page
    2
    Quote from schnookimz
    Yes, I would say that's pretty standard. I loved working at a teaching hospital. I really believe our patients got more competent care more quickly.
    So at the cost of dehumanizing patients? Just because it is a teaching facility does not mean bedside manner has to be left at the door. The stories the PPs told are pretty sad, and it's a shame that's the standard.
    Not_A_Hat_Person and RetRN77 like this.
  7. Visit  Esme12 profile page
    3
    Quote from SquishyRN
    So at the cost of dehumanizing patients? Just because it is a teaching facility does not mean bedside manner has to be left at the door. The stories the PPs told are pretty sad, and it's a shame that's the standard.
    Not all reaching centers are this way...however some/most of them are. I worked at one prominent center know for it's patient care as they are always on the top 10 list in the country....they we re so oblivious to the patient...most of my patients asked as the pack left the room...."Am I going to be ok?" man that grated on my nerves....I quit a short time later.
    Bklyn_RN, RetRN77, and SillyStudent like this.
  8. Visit  dirtyhippiegirl profile page
    4
    Yes. Although some doctors do it more tactfully than others. (Our surgical services often don't wear their coats and several docs are notorious for not at least introducing themselves as a doctor -- sigh.)

    What happens in the OR after the patient is out is about ten times worse in my opinion.i
    RetRN77, sharpeimom, llg, and 1 other like this.
  9. Visit  ♪♫ in my ♥ profile page
    15
    The problem isn't the teaching hospital; the problem is that some MDs, just like in every other group of people, are jackasses.
    dudette10, brownbook, Carrie RN, and 12 others like this.
  10. Visit  elkpark profile page
    8
    At my facility (a large academic medical center typically ranked in the top ten in the US), the attendings and residents/students are pretty civilized and sensitive, but you (as a client) do have crowds of people you don't know traipsing through your room to discuss your situation and treatment. It's a teaching hospital. As already noted, the consent to have students and residents involved in your care, and to be used as a teaching case, is written into the consent form you signed in order to be admitted. This is the trade-off for getting world-class, cutting edge medical care.
    dudette10, mmc51264, RunnerRN2015, and 5 others like this.
  11. Visit  dirtyhippiegirl profile page
    3
    Quote from ♪♫ in my ♥
    The problem isn't the teaching hospital; the problem is that some MDs, just like in every other group of people, are jackasses.
    Unfortunately, if someone is going to be upset about a parade of residents and medical students crowding into their room, or having to answer the same questions over and over again to different medical students, residents, nurses, and nursing students (a big complaint we get) -- than it kind of *is* the fault of how a teaching institution is set up.

    You can go about it tactfully and some of our docs are great about introducing themselves and explaining the process but. /shrug
  12. Visit  schnookimz profile page
    2
    You can't judge every teaching hospital based on the fact that one doctor was a jerk.
  13. Visit  ♪♫ in my ♥ profile page
    2
    Quote from dirtyhippiegirl
    Unfortunately, if someone is going to be upset about a parade of residents and medical students crowding into their room, or having to answer the same questions over and over again to different medical students, residents, nurses, and nursing students (a big complaint we get) -- than it kind of *is* the fault of how a teaching institution is set up.

    You can go about it tactfully and some of our docs are great about introducing themselves and explaining the process but. /shrug
    Yeah, if you want privacy, a teaching hospital is not the place.

    I guess I was referring more to the attitude and behavior of the attending described in the OP rather than the descending hoards (which is one reason I prefer working nights).

    On the other hand, the patient certainly could ask to speak to only one physician, rather than a room full of people, and many of the attendings and chiefs that I know would comply.
    blueheaven and RetRN77 like this.
  14. Visit  Altra profile page
    7
    At a teaching hospital you are cared for by whatever services, or medical specialties, you need. And yes, it is a team approach. It may have been the first time you encountered that attending and physician residents in person during your stay, but they were consulted by whatever primary service you were admitted to, and so were legitimately involved in your care from the outset.

    And while I am not asking for any further details on your medical history or your reason for that hospitalization ... it does occur to me that your primary problem at that time was a complication of an endocrine disorder ... and excess facial hair in women can be indicative of endocrine issues. I'm guessing that that *endocrinologist* was putting together the larger picture of your medical condition, beyond "waiting to get your blood sugar down".

    BTW ... residents are licensed physicians with prescriptive authority, and outside of certain specialties and subspecialties they provide the bulk of day to day physician care in teaching hospitals, under the supervision of attendings.

    Good luck with your nursing studies.
    psu_213, poppycat, klone, and 4 others like this.


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