Parents are likely to be stressed when a child is hospitalized,
and questions about the people providing medical care and what
roles they play can add to the confusion.
Here's a guide to those who care for kids in the
hospital:
Medical student:
Medical students usually spend the first 2 years of medical school
in the classroom and the last 2 years seeing patients in a hospital
setting.
Resident:
A resident is a doctor who has graduated medical school and is now
training in a specific field. Doctors spend from 3 to 7 years in
residency training before receiving board certification in their
specialty. Residents providing care are supervised by attending
physicians who must approve their decisions.
Fellow:
A fellow has completed medical school and residency training, and
is getting additional clinical training in a specialty.
Attending physician:
An attending physician has completed medical training and has
primary responsibility for the care of the patient. While
overseeing care, the attending may supervise a team of medical
students, residents, and fellows.
Specialist:
A specialist is an attending physician who focuses on a particular
area of medicine, such as cardiology (heart and vascular system) or
rheumatology (problems involving the joints, such as
arthritis).
Hospitalist:
Hospitalists are doctors who usually specialize in internal
medicine, family practice, or pediatrics. A hospitalist caring for
your child will be in contact with your family doctor but will
manage treatment while your child is hospitalized. Hospitalists
don't have private practices, so their time is devoted to
caring for hospitalized patients.
Physician assistant (PA):
A physician assistant, under the supervision of a trained doctor,
examines patients, diagnoses and treats simple illnesses, orders
tests and interprets results, provides preventative health care
counseling, assists in surgery, and writes prescriptions. Most PAs
have a college degree and have completed a 2- to 3-year training
program.
Doctor on-call:
The "doctor on-call" is a physician working on weekends,
evenings, and other shifts to answer questions or cover
emergencies.
Specialists
Anesthesiologist.
An anesthesiologist administers medicine during surgery to help
patients relax and fall asleep. The anesthesiologist is present
during an operation to watch over patients and make sure they have
no pain.
Endocrinologist.
An endocrinologist is a doctor who specializes in diagnosing and
treating diseases and conditions caused by hormone problems, such
as diabetes and growth problems.
Cardiologist.
A cardiologist is a doctor who specializes in diagnosing and
treating heart or blood vessel problems.
Gastroenterologist.
This type of doctor specializes in problems with digestion and
diseases of the esophagus, stomach, liver, gallbladder, and
intestines.
Hematologist.
A hematologist is a doctor who specializes in blood disorders.
Nephrologist.
A nephrologist is a doctor who diagnoses and treats kidney
problems.
Neurologist.
This type of doctor specializes in brain and nervous system
disorders.
Oncologist.
An oncologist is a doctor who specializes in treating cancer.
Otolaryngologist.
This doctor specializes in treating ear, nose, throat, head, and
neck problems.
Pulmonologist.
A pulmonologist is a doctor who concentrates on lung problems, such
as asthma or cystic fibrosis.
Rheumatologist.
A rheumatologist is a doctor who treats problems involving the
joints, muscles, and bones, as well as auto-immune diseases. A
rheumatologist treats conditions such as arthritis and lupus.
Surgeon.
A surgeon is a doctor who can operate on patients if needed. A
general surgeon does many different types of procedures, such as
taking out an appendix or fixing a hernia. Specialized types of
surgeons include neurosurgeons who operate on the brain and nervous
system, urologists who operate on the urinary system, and
orthopedists who operate on bones and joints.
Nurses
Nurses provide much of the day-to-day care in hospitals, closely
monitoring a patient's condition and performing vital jobs like
giving medicine.
Many kinds of nurses provide varying levels of care:
Licensed practical nurse (LPN):
LPNs provide basic care and assistance to patients with tasks like
bathing, changing wound dressings, and taking vital signs. An LPN
has at least 1 year of training in this kind of care.
Registered nurse (RN):
A registered nurse gives medication, performs small procedures such
as drawing blood, and closely follows a child's condition. RNs
have graduated from a nursing program and have a state license.
Advanced practice nurses (APN):
An advanced practice nurse is an RN who has received advanced
training beyond nursing school. At minimum, APNs have a college
degree and a master's degree in nursing. Different kinds of
APNs include:
-
Nurse practitioner (NP):
A nurse practitioner has additional training in a particular
area, such as family practice or pediatrics. NPs often take the
medical history, do the initial physical exam, perform some tests
and procedures, write prescriptions, and treat minor illnesses
and injuries. NPs have a master's degree, board certification
in their specialty, and and a state license.
-
Certified nurse midwife (CNM):
A certified nurse midwife provides gynecological care and
obstetrics care for low-risk pregnancies. CNMs attend births in
hospitals, birth centers, and homes.
-
Clinical nurse specialist (CNS):
A clinical nurse specialist provides a wide range of care in
hospitals, clinics, nursing homes, private offices, and community
health centers. A CNS has been licensed in nursing, has a
master's degree, and often works in administration,
education, or research.
-
Certified registered nurse anesthetist (CRNA):
CRNAs specialize in giving and monitoring anesthesia. They
prepare patients before procedures, administer anesthesia, and
oversee recovery from anesthesia. CRNAs receive 2 to 3 years of
training in this area.
Other Medical Staff
In addition to care from doctors and nurses during a hospital
stay, kids may also see therapists with special training in
different fields.
Child life specialist:
A child life specialist works to reduce stress and anxiety while
kids are in the hospital. A child life specialist can help in a
variety of ways, helping kids deal with everything from getting
blood drawn to missing home and coping with a diagnosis of a
serious illness. They give kids an opportunity to play, and offer
comfort and the chance to talk about feelings. A child life
specialist often has training in social work.
Health educator.
This specialist works as part of a medical team, teaching patients
about a particular health condition and how to manage it. Health
educators are trained and certified. They often specialize in a
particular field, such as diabetes or asthma.
Nutritionist:
A nutritionist plans meals for patients based on their medical
condition and needs. A nutritionist might also provide dietary
guidance for kids to help them after they leave the hospital.
Occupational therapist:
An
occupational therapist
works with kids to improve coordination, motor skills, and skills
to play, function in school, and perform routine activities, like
hand-eye coordination. Kids in occupational therapy may be coping
with birth defects, autism, juvenile rheumatoid arthritis,
developmental delays, burns, amputations, or severe injuries.
Pharmacist:
A
pharmacist
provides medications for patients, checks for any interactions
between drugs, and works with the rest of the medical team to
choose appropriate treatments. In hospitals, patients typically
don't interact with the pharmacists on staff.
Physical therapist:
A
physical therapist
uses exercises, stretches, and other techniques to improve
mobility, decrease pain, and reduce any disability related to
illness or injury. Kids may need physical therapy as a result of
developmental delays, injuries, long hospitalizations, or after
surgery.
Respiratory therapist:
A respiratory therapist evaluates, treats, and cares for kids with
breathing problems and heart problems that also affect the lungs.
Kids with obstructed airway passages may receive chest
physiotherapy (exercises that move mucus out of the lungs to open
airway passages) or inhaler medications that are breathed into the
lungs. Others who are critically ill and unable to breathe on their
own may be put on ventilators to improve breathing.
Social worker:
A social worker at a hospital focuses on improving the emotional
well-being of kids and their families, and helps coordinate health
care. In addition to offering emotional support, a social worker
can also help facilitate improvements a child needs at school or at
home.
Speech-language therapist:
A
speech-language therapist
can work with patients who have problems speaking or swallowing,
such as kids with developmental delays, hearing problems,
neurological issues, or birth defects like cleft palates.
Volunteer:
Volunteers of all ages, from high school students to retirees,
donate their time to help enhance patient care. The tasks
volunteers do vary from hospital to hospital, but might include
bringing games and books to patients or taking them for a walk
around the hospital.
Pet therapy volunteer:
Hospitals sometimes use pet therapy, also called animal-assisted
therapy, to help reduce patient stress, make them feel more
comfortable, and improve mood. Research has shown that pet therapy
can improve emotional well-being in patients coping with a variety
of conditions, and may even improve mobility, motor skills, and
independence of those with disabilities. In pet therapy, volunteers
and their pets who have completed training programs are brought to
the patient's bedside, with the patient's consent.
The hospital can be a busy place, but if you're uncertain
about who someone is or what role a person plays in your
child's care, don't hesitate to ask someone on staff.
Understanding this will help you and your child feel more
comfortable during a hospital stay.
Reviewed by:
Larissa Hirsch, MD
Date reviewed: January 2008
Note: All information is for educational purposes only. For specific medical advice,
diagnoses, and treatment, consult your doctor.
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