Is your hospital like this???

[bustbones26]

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This is what I have learned at William Beaumont Army Medical Center's Internal Medicine Program.

The program is fairly solid, interns/residents get to do many procedures, attendings seem fairly nice. But there is one thing that scares me about this place-----

The nurses on the general medical floor are just dangerous!!!! They just plain ignore orders, residents have to worry about their orders being carried out all day long!!!

Examples of bad things I have seen.

1) Patient admitted from ER ordered to be telemetry, patient gets to floor, 12 hours later intern realizes patient was never on telemetry, the nurses never hooked the patient up

2) Nurses ordered to take patient to the ICU stat. Patient lies there and BP drops and O2 sats drop to numbers so low, its ridiculous!

3) H. pylori stool test ordered. Patient poops, nurse flushes to sample. Nurse adamant test was never ordered, resident shows the order to them, ooops!

4) Radiology calls and says "Hey, we are not waiting all day for X to come down here for their CT scan, where are they?"

5) Resident orders stat CBC on patient. Nurse claims blood draw occurred, computer showing the Stat CBC pending. Five hours later, resident begins to wonder why his STAT CBC is still pending, calls the lab, lab says, we never got the blood sample!!!

6) Attending at rounds: "Did you look at the patients ins & outs"
Residents/Interns: Roaring in laughter
Senior Resident: "The nurses on this floor haven't recorded ins and outs in three years, even though the orders state so!"

And I can go on and on here. Now I am almost convinced that these minor frustrations really do go on at teaching hospitals and should be expected. So I am asking you all, am I right, or wrong, does this stuff happen frequently at say Brooke, Walter Reed, etc etc?

 

[R-Me-Doc]

That kind of stuff happened rarely during my residency. Seems to happen more often at the smaller MTF I'm now at.

I'm curious how you developed your opinion of the training at Beaumont. Did you do a rotation there or is this second hand info? We'll see how many people I piss off with this, but I've always gottent the sense that Beaumont has a rep in the Army as being the place you go to do your residency if you don't get picked up by Reed, Madigan, Tripler or Brooke. Kinda the lowest rung on the Army GME residency ladder.

 

[bustbones26]

well you have to remember that in the army, since ppl move soo much, things change. In the past, this place may have been second rate, but here is what is going on right now------

Right now, Beaumont is picking up attendings that trained at Brooke, Madigan, etc etc. Now this ppl all had great training, love to teach, and are now beefing up the medical education and didactics of beaumont.

Of course, its still a small hospital compared to the "big three", but he good news is that here there is no fellowships so I have seen interns and residents here do tons and tons of procedures, you name it, they've done it many times over!!!

My opinion, and this may cause controversay, is this.

In army medicine, ppl tend to view Walter Reed and San Antonio as the Army's version of "the Cleveland Clinic or Mayo Clinic" and everybody wants to go there! EVerybody competes for these places. But the really, in the end it doesn't matter.

So no, Beaumont is not Brooke, its not Walter Reed, but the training here is solid and is improving thanks to the fact that the incoming attendings are very well trained and love medical education of the residents.

However, as I was asking originally, from being here I have noticed that being an intern or resident on the floor can be immensely frustratating due to nurses not carrying out orders, nurses ignoring orders, things getting lost, and the list goes on and on. And I just wanted to know that if this was simply because it was a teaching hospital?

But put those frustrating things aside, the education is fairly ok