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We don't have a true med/psych unit (though we are trying to open one in the near future), but as we are connected to a major academic medical center by tunnel, we have a fair amount of medical acuity in our inpatients. Definitely have people with with PICCs, on dialysis, getting IV abx, hospital beds, with trachs, and up to 8L O2 by NC. We have our own (small) dedicated medicine service in the building and all interns spend a month with the doing the medical stuff for our inpatients, which I think is possibly the most relevant possible training. We have a small army of PAs doing most routine primary care stuff on our floors so the MDs handle things that are trickier (Type 1 DM), minor procedures (I&D's and the like). Our major limitation is our nurses can't start IVs (we can call the hospital IV team to do this) and can't do IV push meds due to regulations. There are some former CC nurses who behind closed doors are willing to "assist" an MD in placing an IV but they are not supposed to do this. We have a dedicated wound care nurse as well so are fine with vacs and what not. There is also an eating disorder inpatient unit, so many of our residents end up being called in the middle of the night to replace or troubleshoot NG tubes.
We have a geriatric floor with 40 beds, so I can't imagine how that could even work if we couldn't take care of basic inpatient medical stuff. Obviously we also do consult various specialists as appropriate but it is not like we have endocrine managing everyone with diabetes.
It sounds like at facilities with less intensive supports outpatient medicine might be more relevant, although I wonder if emergency medicine would be better to some extent (practice triaging into sick who need to go to the medical side and not-sick who don't).
We have a geriatric floor with 40 beds, so I can't imagine how that could even work if we couldn't take care of basic inpatient medical stuff. Obviously we also do consult various specialists as appropriate but it is not like we have endocrine managing everyone with diabetes.
It sounds like at facilities with less intensive supports outpatient medicine might be more relevant, although I wonder if emergency medicine would be better to some extent (practice triaging into sick who need to go to the medical side and not-sick who don't).