The difference between a teaching hospital and others?

talaxandra · Mar 4, 2010

Teaching hospitals provide clinical education and training to student and graduate health care practitioners (medical, nursing, allied health). It most often refers to medical practitioners (resident and registrar experience and hurdles), and generally means an affiliation with at least one university or similar institution.

They're also the kinds of hospitals most often seen on TV - ER, for example, had doctors at every stage from undergraduates rotating through the department to newly-qualified baby docs, to those undertaking specialist training. And in Scrubs we saw JD and Turk transition from interns to qualified practitioners.

As Australian and US practices vary widely, I can't offer any information about what difference this will make to you if you move to a teaching hospital.

Based on my experience (at a quaternery-level trauma hospital), the acuity's higher, the level of support can be higher, and you rarely deal with consultants.

For patients it means they're more likely to be seen by, and treated by, practitioners still undergoing training. This is not to say they're unsupervised or unsafe, but it does mean that Professor Whatsit won't be ordering every test or popping by every day.

Hope that helps :)

silentRN · Mar 4, 2010

1. You work with Residents

2. You get low pay

AllAngelsRN · Mar 4, 2010

You are right about the LOW pay. It is very low comparing to what I am getting now (5.5 dollars less). But I think it will be a good learning experience; or so they say!! Isn't it?

How bad is it working with residents? Is it bad or good?

Elvish, BSN, DNP, RN, NP · Mar 4, 2010

I think you will find that residents are, by and large, just like any other group of people....a few standouts on both ends of the spectrum, with most falling in the middle. They are just people like the rest of us.

I work at a teaching hospital and by and large get along really well with the residents. There are a few with God complexes but they aren't really that common, and I think that's something you'll find no matter where you go (people with overinflated sense of self-worth). Most know that the nurses are there to take good care of the patients, and most appreciate a good catch - whether on a med dose or a subtle change in condition. And most realize that we all have the same goal in mind - to help the patient.

I second the previous poster who says that at a teaching hospital you'll see a lot more high-acuity cases. In my case, I work in OB/mother-baby/nursery. We see a lot more high-risk pregnancies and sicker babies (even in wellbaby nursery) than my friend who works in the community hospital in our town. Both have their place, so I'm not knocking the smaller hospital. I'm just saying in sheer terms of variety, you will probably see more in the teaching hospital, and it might make up for the pay difference.

AlabamaBelle · Mar 4, 2010

I work Peds ICU (combined with Peds CVICU) in a large teaching hospital/Level I Trauma Center for our region. I love it!

As for the pay, there is not any difference in our pay than the private hospital here.

What I like most is the rounding time. Our attendings round with the resident on each child every morning (around 8ish - depends on what's blowing up) and also in the evening around 2100ish with the night attending and resident. The RN is expected, if patient condition permits, to be present. This is a teaching time and I have learned so much from this time.

We get good residents and we get bad ones. The good ones are much appreciated and make our lives really nice. They know we'll look out for them and will make sure the attendings know of how well the resident is performing. The bad ones, you just learn to work around, go up your chain and get what your patient needs.

I just love the opportunities for learning. I'm a geek that way.

RNperdiem, RN · Mar 4, 2010

The pay is comparable for teaching and non-teaching hospitals in my area.

When I started in a previous recession, non-teaching hospitals did not hire new graduate nurses. I worked as a CNA for fours years at one place and was told "we don't have the facilities to train new grads".

Teaching hospitals means never having to call a doctor's answering service after hours. The residents can come see the patient quickly if needed. I like having doctors more easily available.

I work at a level 1 trauma center, so we do see more variety of patients and take care of the sickest patients.

AllAngelsRN · Mar 4, 2010

Same here. I am not in it for the money but for the learning experience; after all I am an RN= Registered Nerd :specs:

It sounds like the teaching hospital will be the better choice for my inquisitive mind and will help me grow professionally faster. Keep your fingers crossed for me. Having said that, I will continue to evaluate both opportunity for my own personal needs. I don't think there is wrong choices. I believe one can learn something form every experience.

Thanks all for your input.

silentRN · Mar 4, 2010

Well, after awhile, the money becomes a factor, especially when you haven't had a raise in 2 years. Working with the Residents is great. I'd rather work with them than some snobby attending. I don't think there is a difference for nurses if you're working in a teaching environment compared to a non-teaching. That is all for the Docs. Actually, the nurses seem to have less say in the matter of things, because the residents are there to learn so more decision goes to the Resident. Oh, and the whole MAGNET status is a bunch of bull too. Just some corporate marketing ideal to lure patients to their hospital. It does nothing for us nurses. So don't get fooled by all the hype.

Nursing only moves laterally, and never progresses upwards. We are in a very limited field. A blue collar job that lives by punching in the time clock.

AllAngelsRN · Mar 4, 2010

Ouch dhammo01!!! I really was hopping your last statement isn't true. My whole goal for making this move is to be able to eventually to move upwards and not laterally. I refuse to make a move if I am not going to be learning anything new and expanding my critical thinking skills. I really hope that it is not true as much as tend to agree with you based on what I have seen from my last couple interviews.

silentRN · Mar 4, 2010

Well, the best way to learn anything new in nursing is to keep moving around to different units. If you stay in one place to long you will never learn anything new. For example, I currently work in the Trauma-Surgical ICU. We also take fresh transplants as well. Well, I'm getting to the point where I don't think I can see too much more, and when I move (if the market allows it), maybe I should get into Cardiac ICU, just to change things up a little bit and see a whole new world that I had never been exposed to while working trauma. Don't stay in one place too long, or you get complacent with your job and bored, and then you start sliding a little. Always stay interested in your job! That is the best advice I can give you. Oh ya...always work critical care and never the floor...I worked the floor for a good year before I went into critical care, and I have to say...it was tough! But your scope is very limited. Floor nurses work damn hard for their pay, while I see many of us ICU nurses sitting on our orifice all shift long...

Nursing really is a good choice though, because of all the time off you get, and the hands on patient care can be really rewarding. It's really how you make it. I will try to stay busy all shift, and it's rewarding to see that your care made a difference. Something as small as mouth care every 2 hours seems trivial, but when you see that the patient hasn't received VAP over the 3 nights you cared for her, it's a great feelings.

Blackheartednurse · Mar 4, 2010

I'm orienting at a large teaching hospital and I really like it except my preceptor gets on my nerves sometimes but overall I consider it a very good learning opportunity...Once I will be on my own I will be working from 3:00 pm to 11 pm (an evening shift) I love the fact that we get the sickest,complex patients,we have an 24 hour access to medical residents (basically you are covered when something goes work) I never wanted to work in a large teaching hospital nevertheless I ended up in one and it is an aswome place to work for.