Published Sep 3, 2004
Hello. I am a graduating nurse looking into employment at various hospitals. I wanted to know if anyone could tell me what is the difference between a teaching hospital and one that is not. Both the pro's and cons. My understanding is that a non-teaching hospital is not as advanced technologically. But, the place I interviewed today, I also had my clinicals at, and they seem very up on technology. In fact out of all the hospitals I had clinicals at their computer system was the best and easiest to use. The doctor's also use PDA's for pt info and sync it to the main hospital database etc..They are also working on getting Magnet status.
Any feedback would be much appreciated!!
Gompers, BSN, RN
I think what they mean by "advanced technology" isn't about their computer systems but about their actual medical treatments. Teaching hospitals often have studies and research going on using new medications and equipment, so you might see things there years before you would at private community hospitals.
Teaching hospitals have residents, of all levels, (intern, 2nd year and so on) so that there will always be a physician overseeing a 'teaching case'. That doesn't mean every pt is a teaching case; many of your very complex and medium complex patients will be teaching cases. Your noncomplicated cases may not be so. Example: in the ED where I work, there are residents and attendings. I had a patient who had a very severe laceration of his left hand secondary to an argument with a table saw (you know who won!) This patient, while badly injured, required straightforward care: X-rays, IV for fluids, pain medication, tetanus shot, ABX, and about 50 stitches, as well as good wrapping to compress the sutured areas. The reason this was not a teaching case is because this is not the guy to practice sutures on. The attendings need to be on top of what their residents/medical students are doing.
I enjoy teaching hospitals: the residents are really willing to explain and work with you; you will learn immense amounts and you will practice with them on a level that is different from the attendings. You will see them more; I always used first names w/residents and with attendings who introduce themselves by first names. (I think it's silly to work cheek to elbow with someone and not use first names, but I'm weird that way) The downside is that sometimes residents forget to treat the patient and not the chart: elderly patient comes in with CP, slap some nitro on her, never mind that she's got classic symptoms of aspiration pneumonia. So sometimes you have to remind them that they must first see the patient. They aren't stupid, they aren't being a--holes, it's just that the focus is different for medicine and nursing. The more professionalism you bring to the relationship will be your reward in the long run: you will find that the residents will treat you with the respect you show them.
One thing to be careful of: July. It's when med students become physicians, so it's just like your first nursing job: SCARY. Also, I do not take orders from med students. I will initiate treatment (IV's, blood, fluid, etc) on my own and tell the attending what I did, and ask what comes next, but for me the MS is a non-entity.Not because of his status, but because he isn't licensed to practice medicine and therefore no orders are valid. Medical students bring a ton of enthusiasm and energy to the ER, they just can't give orders. I know it's frustrating for them, but it's like signing "RN" before you've passed your NCLEX
I second everything Stitchie said. Another plus is that there is lots of continuing education going on for the residents/students (Grand Rounds in all the specialties, Ethics Grand Rounds, that sort of thing) and nurses can often attend those, if they choose. Not only are they free, but they often include lunch! :chuckle
I've worked in all kinds of hospitals in all kinds of settings, and always have a soft spot for big teaching hospitals.
Years ago, though, I saw a nursing humor article in some journal that was about how to translate the "code" used in nursing employment advertisements -- you know, statements like, "convenient to both the beach and the mountains" really means "in the middle of nowhere." The article noted that, in nursing employment advertisements, "teaching hospital" is code for "part of your job will be to make sure that the residents don't kill anyone." (Too true!! :rotfl: )
purplemania, BSN, RN
Teaching hospitals have residents around so you can get a doctor any time of the day or night. That was helpful to me as a new grad as I got to see things get done, not just get ordered. As for technology---depends on finances. I am in a community hospital now, but we have the best of everything. Teaching hospitals also are "labs" for people doing research, so the newest info is usually being discussed and tried.
A community hospital in a wealthy, affluent area is going to be very different from one that is not so situated. The community hospitals in wealthy areas are going to have more $$ to spend on technology, pumps, new equipment, building new wings/rooms, updating. That doesn't necessarily mean they will pay more per hour for the nursing staff, though.
Interview at lots of places and get a feel for what you're looking for. You'll see the difference between the places and have an idea of what to ask along the way: culture w/physicians (if someone says to you "Well, you know how surgeons are" ask them to clarify that, because a statement along those lines makes me think that abusive behavior is tolerated) culture w/in the nursing organization, career steps/ladder, continuing Ed, etc.
A teaching hospital is ANY hospital where some or all of the care provided to a patient or patients is done by a student of ANY field. There are not just medical school residents - there are physical therapy students, occupational therapy students, and most important of all - NURSING STUDENTS. If you are going to work at a teaching hospital, check with the hospital policy and most importantly your board of nursing. Here, a nurse must have two years of experience before she/he can oversee a nursing student.
While this may be true of Canadian hospitals, IL/US hospitals are designated as 'teaching hospitals' when they have a residency program for graduate medical physicians, MD or DO.
Any hospital in IL can have allied health students rotating thru for clinicals, but that does not designate them as a formal 'teaching hospital' affiliated with a large academic medical school or university program. Many of these hospitals, community or otherwise, offer their own schools of radiology, paramedic programs, ultrasound tech, physical therapy or respiratory therapy, but that alone does not make them a teaching hospital. They may support students (who are free labor, after all) but it doesn't or shouldn't imply that that institution is affiliated with academic centers or medical schools.
Thank you so much for everyone's feedback. Much appreciated!! I am in the mist of interviewing, and so far with two hospitals in the burbs, one non-teaching and one teaching, I see a world of difference. The teaching hosp. I interviewed today has so much to offer as far as education: Master's, certifications, ACLS etc.. And they are all paid for. I was impressed. Plus, I like teaching and wouldn't mind a student nurse under my wing- and they have preceptor programs etc.. All interesting stuff. They also seem to be up to date with advances in medical technology and procedures. It's a transplant unit and they are going to add cardiac transplants to their repetoir soon. Anyway, thanks for the help!
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