I posted a few months ago about my interest in pursuing medicine (I’m graduating this June with a bachelor’s in nursing) and I’ve come quite a ways in as far as thinking about the future in all of that.
This last quarter has been especially different for me because I’m precepting at a hospital on the same unit (a NICU-neonatal) and I’ve got a much better sense for the role of the RN and the MD/DO.
I am coming to you to ask if you could discuss your role a little bit in the hospital. From what I can tell (and perhaps I’m seeing this completely wrong), the physicians come in to round on the patients for about 2 hours, write orders, ask the RNs how the babies are doing, and then we don’t see them again unless we call them for some issues with the baby. Is that really all a physician does? What do you do the rest of the day? Just paperwork and research on the patient’s condition to better treat it? I say this with someone who is probably still very naive, so my apologies. This is not at all meant to belittle the role of a physician, who, afterall, saves our babies if shit really does hit the ceiling.
But is that all that there is? Our NNPs pretty much do everything that our MDs do as well (writing orders, intubations, sharing overnight call, etc.). Are there any real differences in this?
The role of the physician outside the hospital is going to vary by specialty. In my experience in a VERY large hospital with one of the busiest OB services in the US, neonatologists (who’d be rounding on NICU babies) are hospital-based. In addition to their responsibilities for the NICU babies, they also examine the well babies whose own doctors don’t come to that hospital, and they attend deliveries if needed. They also give lectures to medical students and pediatrics residents.
I believe (but could be wrong) that they also have an office-based practice where they provide follow-up care for some of their NICU graduates.
Most physicians doing rounds in the hospital go from the hospital to their offices where they see patients all day. When they get hospital calls, they must interrupt office appointments to take those calls. They end up doing rounds before and after a full day of office work. And this is why fewer and fewer community-based physicians are also seeing patients in the hospital: it extends the work day and, by the way, doesn’t reimburse very well.
I really liked hospital work, but I am working SO hard in the office that the idea of also seeing patients at the hospital is enough to make me cry. It’s really too bad, because the continuity of seeing your office patients in the hospital is really ideal, but it is not practical from a business point of view.
I echo what Mary said. If your hospital was like my training hospital, there was always a NICU/OB/trauma attending in house (in the hospital) on call. They have many responsibilties, some of which Mary has addressed. Others include teaching the residents, staff, patient conferences,…Just because you don’t see them doesn’t mean that they are not working.
This is all from a person who does shift work in acommunity ED and wish everyone was in house. I had to deliver a baby last week…not something I want to do, but thankfully no problems. What a wonderful feeling (that I do not need to do again for a long time.
Rachel Yealy, DO
I work in a NICU as a health care coordinate and we have a neonatologist 24/7. Maybe for about 5 hours at night they will go to their sleep room, but if we need them they can be here pretty quickly.
For the most part, there seems to be a good relationship between the doctors and nurses, with the doctors realizing how important the nurses are since they are at the bedside. We’ve a sign that shows that among all the nurses, there is over 1,000 years of experience.