Working in a Teaching Hospital?

erica2117 · Feb 16, 2015

I'm hoping to be offered a job in a teaching hospital sometime this week... I'm pretty excited about it. Yet I can't help but be nervous at the same time. I keep hearing the first job be described as nursing school part 2

NicuGal, MSN, RN · Feb 16, 2015

Actually, I will help you help the intern to not do something stupid...you have to

learn too!

I have worked in a teaching hospital for almost 30 years. I can't imagine working anywhere else. I love always having a resident, NP or fellow around for those bad nights. I love helping those first year residents figure out things and help them procedures. I really love watching some of them grow into fellows and then great attendings. Yes some come in with a holier than thou attitude or a cultural thing against women's telling them what to do, but they learn pretty quickly after we let them flounder in rounds a time or two.

We do have a lot of great learning opportunities and we see some really interesting things that smaller community hospitals don't see or ship out. We still have a lot of autonomy in our hospital even with all the docs.

HouTx, BSN, MSN, EdD · Feb 16, 2015

I've often been amused by the "teaching hospital" label. To me, it indicates that a facility is 100% physician-centric, everything revolves around the wishes of the medical school which is being heavily subsidized by the hospital. Srsly, have been involved in the inner-workings of 3 such organizations, I have experienced some very odd and peculiar arrangements. You wouldn't believe how much money it takes to keep them afloat - salaries of med school fat cats are astonishing, particularly when you consider that they don't usually do anything even remotely reimbursable.

To me (having seen both sides of the fence) academia and healthcare are not even remotely on the same page - in terms of mission, operations or external stressors. This is really horrible in some well known teaching hospitals where the academic poobahs / professors are automatically the hospital department heads. Believe me, "tenure" is not a concept that is easily transplanted to (or can be supported by) any sane environment. Completely different 'work ethic' and motivational mindset - LOL.

roser13, ASN, RN · Feb 16, 2015

Teaching hospital: You will never be able to take time off in the month of July because that's when the new crop of interns shows up and is most likely to kill someone. All experienced hands stay on deck during that month.

NicuGal, MSN, RN · Feb 16, 2015

July is when we all fight to take vacation lol

Ruby Vee, BSN · Feb 16, 2015

According to the chart, "teaching hospital" is code for "part of your job will be to make sure the residents don't kill anybody," and thinking of that always makes me smile when people ask about teaching hospitals (because it's so true :)).
Having said that, though, ditto to what mmc said, and I really like working in big, busy teaching hospitals. :)

When you work in a teaching hospital, part of your job will be to educate the residents. Making sure they don't kill anyone is part of their education. We learned to be quite subtle. "Are you sure you really want to do that DOCTOR?" is code for "Stop what you're doing, you moron, before you kill someone." Most of them listened, and the ones that didn't heard about it from up the ladder.

There are plusses and minuses to teaching hospitals, just like everything else. One of the minuses is that nurses aren't quite as autonomous. But on the flip side, you get to influence how the residents interact with nurses, and their attitude toward nurses for the rest of their careers. You get to see unusual diseases and very sick patients that the community hospitals won't touch. Sometimes you work with world famous physicians or take care of celebrity patients.

sistrmoon, BSN, RN · Feb 17, 2015

I've worked in both. I actually quite like the teaching hospital because I am mostly dealing with interns and residents(both of which have been very respectful for the most part and often asked for my suggestions/expertise) rather than attendings. I work night shift and at my first job at a non teaching facility, I was only calling attendings and surgeons and they were almost all surly. I feel like the teaching hospital has a more collaborative feel. It also has far better ratios and support staff but that could just be a coincidence.

Here.I.Stand, BSN, RN · Feb 17, 2015

Loved your statement about "part of your job will be to make sure the residents don't kill anybody". That sounds frightening, especially for a new grad!

I still remember the interview for my first ICU job. I was a newer RN, about 18 months on a floor of that same U-affiliated hospital. My then-future NM said, "I need you to understand that independent critical thinking is very important on this unit. Sometimes the nurses have to protect our patients from these residents." :yes:

Now the vast majority of my interactions w/ residents have been positive. Here and there though, I have had a resident order something that was not appropriate (e.g. D5W for the IV fluid, for bad TBI. Big no-no!) In the ICU I haven't had to deal with PGY-1's, so I can't speak to that. Otherwise, I've worked in two teaching hospitals and pretty much agree w/ the PPs.

License2Heal · Feb 17, 2015

I'm hoping to be offered a job in a teaching hospital sometime this week... I'm pretty excited about it. Yet I can't help but be nervous at the same time. I keep hearing the first job be described as nursing school part 2

Good luck!!!

allnurses Guide · Feb 17, 2015

I've worked at two teaching hospitals. I really enjoy the academic atmosphere. I preferred the residents to the attendings who usually swooped through without realizing anybody else was a living being. To be fair, their career record often made the lack of social niceties a complete non-issue. I'm a huge people-watcher, so I found it interesting to speculate to myself about what kind of physician they would eventually make, who I would want as a provider and who I thought would probably crash and burn due to the stress. A couple of the jerks are now "TV Doctors" which makes me think "if they only knew....."

If you are young, be careful of the social atmosphere these places have. It's loads of fun sometimes but it can sink you just as fast, and it's amazing how much time all these busy people find to gossip!

MunoRN, RN · Feb 17, 2015

I actually found that a non-teaching hospital was a better learning environment for a nurse (keep in mind that "teaching" refers to teaching physicians, not nurses). There's much less autonomy for nurses at least in the teaching hospitals I've worked at, which sort of stunts the learning progression of the nursing staff. There are more interesting and complex patients, although part of that is because they seemed less likely to advise avoiding a surgery or treatment when it's not really appropriate for the patient. I started out at teaching hospitals in part because I figured it would be the best way to learn, it wasn't until I got out of teaching hospitals that I realized I would have learned far more if I had just skipped teaching hospitals from the very beginning.

PMFB-RN, RN · Feb 17, 2015

Loved your statement about "part of your job will be to make sure the residents don't kill anybody". That sounds frightening, especially for a new grad!

There is some trueth to that. Residents will kill a few without watchful nurses. However what I find WAY more often is more of a case of the nurses keep the residents from letting patients die. Not very often does a resident's actions have a potential for patient harm, however their INACTION very often does. In my experience not much happens for a patient unless some RN is bothering some resident about it.