Who’s Who in the Hospital?

 

With so many different medical specialties it’s easy to feel confused by the number of people who come into your hospital room to check on you. Sometimes your doctor may show up along with a whole bunch of medical students. Other times you may not recognize the person leaning over your hospital bed.

Don’t hesitate to ask questions if you ever find yourself looking at someone and thinking, “Well, she has a badge, but who is she?” It could he the person is a specialist and your regular doctor sent her (or him) to check on you. Or it may be that the person is the doctor on call who is covering for the doctor you usually see.

Here’s a guide to some of the experts who care for patients in the hospital.

Doctors

Attending Physician

This is the name given to the doctor who has completed training and is in charge of your care. An attending physician might supervise a team of medical students, residents, and fellows — which means that he or she may bring other people on rounds to visit patients.

Hospitalist

Hospitalists are attending physicians who only care for patients who are in the hospital. These doctors don’t have offices where they see patients. Sometimes pediatricians and family doctors have hospitalists care for their patients while they are in the hospital. A hospitalist will stay in contact with your regular doctor but will manage your treatment while you’re in the hospital.

Doctor On Call

Your doctor can’t work all the time. The doctor on call is a physician who covers weekends, evenings, and other shifts when your doctor can’t he there. Doctors on call are there to answer questions and cover emergencies.

Fellow

A fellow has completed medical school and residency training, and is getting additional training in a particular specialty, such as heart surgery or kidney problems.

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 can care for patients in a teaching hospital, but they arc supervised by attending physicians who must approve their decisions.

Medical Student

Medical students (who are training to be doctors) usually spend the first 2 years of medical school in the classroom and the last 2 years seeing patients in a hospital setting.

Physician Assistant (PA)

A physician assistant works under the supervision of a doctor. He or she examines patients, diagnoses and treats simple illnesses, orders tests, looks at test results, provides health care counseling, assists in surgery, and writes prescriptions. Most PAs have a college degree and have completed a special 2- to 3- year training program.

Nurses

There are several types of Nurses who help care for you in the hospital, like doctors, each have their own specialities.

Licensed Practical Nurse LPN

This is the name given to the doctor who has completed training and is in charge of your care. An attending physician might supervise a team of medical students, residents, and fellows — which means that he or she may bring other people on rounds to visit patients.

Registered Nurse (RN)

A registered nurse gives medication, performs small procedures such as drawing blood, and closely follows a person’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 taken additional 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 a person’s 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 and board certification in their specialty. They are licensed by the state in which they work.

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 additional training in this area.

Other Medical Staff

In addition to getting care from doctors and nurses during a hospital stay, you may also see specialists with training in different fields.

Child Life Specialist

Child life specialists offer comfort and the chance to talk about feelings. They’re great resources for helping you manage any emotions, like stress and anxiety, while you’re in the hospital. A child life specialist can help you deal with everything from getting blood drawn to missing school. They also help patients cope with a diagnosis of a serious illness. Child life specialists may also have 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 (also called a dietitian) 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 people to improve coordination and motor skills. These can be skills needed to play sports, function in school, or perform routine activities, like hand-eye coordination. People in occupational therapy may be coping with conditions such as 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 don’t usually have contact with the pharmacists like you would if you were going to the drugstore.

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. People may need physical therapy as a result of developmental delays, injuries, long hospitalizations, or after surgery.

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. Social workers also help with any 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 patients in hospitals. 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

Some hospitals use pet therapy, also called animal-assisted therapy. Research shows that pet therapy can help patients cope both emotionally and physically. In pet therapy volunteers and pets who have completed training programs are brought to the patient’s bedside. The volunteer will always ask before bringing the pet near you. They will only approach if you feel comfortable around the pet and want it to be there.

The hospital can seem like a busy place. But if you’re not sure who a doctor is or what role a person plays in your care, don’t hesitate to ask a nurse or someone else you know.

Reviewed by: Latissa Hirsch, MD Date reviewed: June 2008

This information was provided by Kids-Health, one of the largest resources online for medically reviewed health information written for parents, kids, and teens. For more articles like this one, visit KidsHealth. org or TeensHealth. org.

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  • Laya

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  • You, or your webmaster, made a couple mistakes. The definition of attending physician was also included under licensed practical nurse for one.

    Secondly, a clinical nurse specialist, such as a certified emergency department nurse, uses the titlle RN-C. It means they have passed a secialty exam. They do not need a master’s degree. Nurse practitioners by and large do, and the trend is to require them to hold a doctor of nursing practice degree, a professional degree, not designed to replace the Ph.D. for nurses who want to do clinical research.

    Also, fellows sometimes moonlight as attendings. A fellow in cardiology, for example, may already have passed the general internal medicine specialty board and may fill in as an attending in general internal medicine, while at the same time studying to be a cardiologist.

  • Carol

    Rev. Daniel is partially correct. No wonder our patients are confused! I am an RN in critical care for 30+ yrs and also a patient with Lupus and NMO.

    Yes, most NP, nurse practitioners do have an MS degree but I don’t know of any who have a Phd. I live in IN so it may vary from state to state. Most nurse practitioners have prescription writing capability and must work under the auspices of an MD altho they work very independently.

    You are also correct about the Clinical Nurse Specialist altho I know of many who have attained their MSN, also. In critical care many opt to take the Critical Care Reg. Nurse exam. iI they pass they are a able to have CCRN after their signatures. This is true for many specialty areas such as OR, ER, Chemo, Hospice, Pediatrics and Oncology for example. These are extra tests that they have studied and passed to prove their expertise in that particular area. It is not a state licensing designation.

    In Indiana even interns “moonlight” as ER physicians, for instance, but must pass their MD boards before they can do so. Most have passed them prior to their admission into an Internship at a hospital. I think of an attending as your regular physician, such as an internal med. doc. However, if you are admitted to a cardiac care unit the doc managing your care will most likely be a cardiologist. You are in luck if a cardiology fellow is moonlighting in a small county hospital and you go to that ER with chest pain. You have almost received a specialists care!

    A fellow in cardiology will always have passed his gen med boards (MD) before his internship as he would not qualify for entrance in a fellowship if he had not.
    In Indiana after med school, one takes general med boards to become an M.D. To be accepted into an Internship/Residency one has to pass the M.D. boards. After an internship/residency they take an internal med. board test.After this they enter a specialty area such as cardiology and have a certain amt of time practicing in a cardiology group to pass cardiology specialty boards.

    An exception to this is a surgical residency and one would enter this specialty area for 2-6 yrs depending on the surgical area such as general surgery, neurosurgery, cardiac surgery etc.

    To further confuse the issue. It is very important that if you need a specialist, make certain that the physician is board certified in the specialty area. It is not as common but a med school grad could pass his M.D. boards and open up a practice limited to pediatrics, for instance, without the board certification. One can open a practice right out of med school without the benefit of an internship/residency and additional training. I believe that it is frowned upon but is entirely legal in Indiana and many other states.

    In the town I was from, a general surgeon did vascular surgery for about 25 yrs without the specialty training in vascular surgery and until the hospital decided that it was detrimental to their accreditation, did they suspend his privileges to do surgery. I tend to think that these kinds of things happen in smaller communities than in the larger teaching hospitals.

    I also want to comment on the RN issue. An RN is an individual who has completed an accredited program. This can be a 2 yr. associates degree that is usually obtained at a community college, a 3 yr. diploma (rare now, but usually affiliated with a hospital, usually of some religious order) and the 4 yr. Bachelors Degree program, usually offered only at a university that offers many other BS, BA programs. All of these are able to sit for the state registry exam. RN is a state designation stating that you have met minimum requirements to practice nursing in your state.

    LPNs usually study for 1-2 yrs , do not have a degree and sit for a state exam just for LPNs or LVNs.

    I hope this is all clear as mud.

    As stated the best thing to do is ask questions. No one should ever feel offended by this!!

  • The Rev. Msgr. Daniel Beegan

    You, or your webmaster, made a couple mistakes. The definition of attending physician was also included under licensed practical nurse for one.

    Secondly, a clinical nurse specialist, such as a certified emergency department nurse, uses the titlle RN-C. It means they have passed a secialty exam. They do not need a master’s degree. Nurse practitioners by and large do, and the trend is to require them to hold a doctor of nursing practice degree, a professional degree, not designed to replace the Ph.D. for nurses who want to do clinical research.

    Also, fellows sometimes moonlight as attendings. A fellow in cardiology, for example, may already have passed the general internal medicine specialty board and may fill in as an attending in general internal medicine, while at the same time studying to be a cardiologist.