teaching hospitals

medsurgrn · Aug 25, 2004

I found it compromising for the patient. on one hand (in surgery) you can learn so much as the Dr/teacher teaches the med students...but the flip side is there were so many students observing, sterile technique was constantly being compromised. Also the "technique" in general..watching a med student perform a procedure on your unconscious patient can be stressful as you owe it to your patient to be their eyes and mouth. There are many strong "personalities" you will be dealing with too. Most of the med students who come to the teaching hospitals are the cream of the crop from schools such as Harvard, Stamford etc. They bring to their practice a false sense of confidence tht you will have to deal with everyday. You will constantly be checking their orders (mistakes) as the Md/prof will more than likely be off in his office while the students are seeing his patients.

Just wondering everyones opinions of working at teaching hospitals... pros cons
I've never worked at a teaching hospital and am thinking of taking a position at a local teaching hospital

Katnip, RN · Aug 25, 2004

I worked in a teaching hospital and actually liked the residents.

Not all residents come from Ivy League schools. Med students don't perform surgery...residents do. And at least where I was they were started out very slowly. At the end of their first year they considered themselves really lucky if they got to place a chest tube. And that was done either in the OR under the direct supervision of the attending surgeon or once in a while at the bedside under supervision of a chief resident.

Yes, there were a few with attitude. Most though were very pleasant to work with, had a lot of respect for the nurses and were will to learn from us. Sometimes there were debates, but rarely did they get out of hand, and all it took was a call to the chief to straighten things out, whether it was a surgical or medical resident.

dazzle256 · Aug 25, 2004

Thanks to both of you. I really don't want to be a baby sitter which is kind of what I'm getting from some nurses that have worked in teaching hospitals...on the other hand I'm getting kind of tired of the "God" attitude I'm getting from some of these doctors at the community hospitals I've worked at.

Nurseboy1 · Aug 26, 2004

The only thing I truly dislike about working in a teaching hospital is that the interns change services every month. Just when we get used to the docs, or they get comfortable with our patient population (Renal & Pulmonary), they move to another floor.

One good thing about teaching hospitals is that medical and nursing students alike are always on the floors. They are usually more willing to help you out with patient care if needed.

directcare4me · Aug 30, 2004

I started my new nursing career at a teaching hospital and stayed for several years. Then went to the private hospital closer to my home. There was a marked difference in atmosphere. I hadn't realized just how much of a "team" effort and spirit there was at the teaching hospital; at the private hospital early on I tried to discuss something about one of my patients with the surgeon while he was there doing his rounds; he never made eye contact with me, and barely acknowledged that I had spoken. I've never experienced that at the teaching hospital; needless to say, I ended up back at the University hospital.

Just remember that it is a teaching hospital and don't get mad at the residents for not knowing everything. Some of my co-workers are pretty impatient with them; most of the new docs know that they are there to learn, and most also don't mind learning from nurses, as well as from their attending and upper level residents. You will also keep learning too; I heartily recommend it.

DNRme · Aug 30, 2004

Having worked at both, I think care is much more progressive at a teaching hospital. In a private facility, it is much easier for everyone (MDs and nurses) to get stuck doing things "the way we always have" You don't have a chance to do that in a teaching facility.

We always have the most up to date info and equipment and I have only rarely (twice in 18 yrs) had to really put a resident in their place. I would never go back to a nonteaching hosp.

RN4NICU, LPN, LVN · Aug 30, 2004

Hmm...I don't notice much difference in the docs, but then again we never see med students or interns and only the peds residents are usually in and out at the speed of light. For the most part, we just deal with the neonatal fellowship participants, who have already completed the pediatric residency - so they already have a pretty good idea of what they are doing by the time they get into the unit. The only actual students we get are nursing students, who are only allowed to observe - they don't handle the babies, and NNP students, who by the requirements of the program are NICU nurses with at least 2 years of experience.

There are other "particulars" to our teaching hospital - some good, some not so good. I've noticed that the University hospital is the least flexible with scheduling. Definite black mark against them, for me. Another is that they always have an ample supply of new grad nurses from the affiliated university, so salaries are the lowest in town. Benefits are pretty comparable to other places. Ratios and acuity levels can be horrendous, however. All the ICU patients (neonatal, pediatric, and adult) are much sicker than in other hospitals. This is mainly due to demand for bed space. Only the sickest patients are in the units there - the stepdown units there are like the ICU's in many other places. Yet, instead of having 2 moderately sick to very sick patients in another hospital, you might have 3 patients who are at death's door! Combine the stress, horrible ratios, lower pay, and inflexible scheduling and you do not have something that I am willing to put up with any longer. When I was an excited new grad and wanted to see everything and do everything, I didn't mind working myself almost to death, not getting paid as much, never being able to take a vacation because I didn't have any seniority, or risky ratios. I didn't really know any better. Now, I'm into "cruise" mode. Work is what pays my bills, so I can enjoy my life. I am no longer willing to make work the focus of my life. Apparently, many nurses feel the same, because staffing at the university hospital is about 85% with under 3 years experience, and the remaining 15% have been there forever (they were probably there tending to patients when somebody decided to build a hospital up around them, LOL), there are very few working there that are in-between those two extremes.

Audreyfay · Aug 30, 2004

Pros of a teaching hospital:

1. Doctors are there because they like to teach (?) There are opportunities for nurses to learn too.

2. Since there are residents, there is almost always a doctor available.

3. I agree with the technology

4. Student nurses around. Might decrease your load (at times?)

Cons

1. New residents every year. You have to break new ones in yearly.

2. Don't have to put up with the residents you don't like as long.

3. Might have med students trying to sign orders and then you have to find the MD for the official order.

4. Sometimes get asked a lot of questions that take time.

I like teaching hospitals and would opt for one over a non-teaching hospital.

BeenThereDoneThat74, MSN, RN · Aug 30, 2004

I have only worked at teaching hospitals, so I can't imagine what it is like otherwise (esp. the God-like attitudes in community hospitals). Believe me, there are some residents like that, but I assume the Gods in the community setting know what they are doing. One thing I can't imagine is having to wake one up in the middle of the night (is that what you have to do?)

From a patient perspective, it must be pretty annoying, to constantly have all these people assessing you, and figuring out who the 'real doctor' is.

Ruby Vee, BSN · Aug 30, 2004

I've worked in both teaching hospitals and community hospitals and VASTLY prefer teaching hospitals. Here's why:

1) I actually like teaching. I get to teach medical students, interns, and because our turnover is so great, lots of new nurses.

2) We get a chance to influence the way the next generation of MDs will practice.

3) Interesting patients -- when the community hospital runs out of ideas, they send them to us.

4) New and interesting technology. Never saw a VAD in a community hospital!

5) The pay is the best in town

dot54 · Mar 28, 2006

I started in teaching hospitals,,and found one thing is for certain...as other hospitals,,there are no cushions,,lots of experience...sometimes stretched to the limit..but also gives opportunity to really stress importance of being good and ethical in your work...challenging..and if want a change..give a try..just watch for the pitfalls,,as anything else,,politics in everything...even teaching hospitals..but good experiences with so many types of illness:smiley_ab es..good luck...