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Who's Who in the Hospital

Having a child in the hospital is a stressful time. And questions about the people who are providing care and their roles can add to the confusion.

Here's a guide to those who take care of 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 hospital and office settings.

Resident: A resident is a doctor who has graduated medical school and is now training in a specific medical area, like pediatrics or internal medicine. Doctors spend from 3 to 7 years in residency training before taking examinations to receive 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 subspecialty.

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.

Subspecialist: A subspecialist is an attending physician who focuses on a particular area of a subspecialty, such as pediatric cardiology (heart and vascular system) or pediatric rheumatology (problems involving the joints, such as arthritis).

Hospitalist: Hospitalists are doctors who usually specialize in internal medicine, family practice, or pediatrics and focus on the care of hospitalized children. A hospitalist caring for your child will be in contact with your family doctor but will manage treatment while your child is hospitalized. Hospitalists usually don't have private practices, so their time is completely or almost completely 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 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 and Subspecialists

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. They also may be consulted to help with pain management in patients with pain problems outside the operating room.

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, pancreas, liver, gallbladder, and intestines.

Hematologist: A hematologist is a doctor who specializes in blood disorders.

Neonatologist: A neonatologist is a pediatrician with specialty training in the care of premature and critically ill newborns.

Nephrologist: A nephrologist is a doctor who diagnoses and treats kidney problems.

Neurologist: This type of doctor specializes in diagnosing and treating brain and nervous system disorders.

Oncologist: An oncologist is a doctor who specializes in diagnosing and treating cancer.

Otolaryngologist: This doctor specializes in treating ear, nose, throat, and neck problems.

Psychiatrist: A psychiatrist is a medical doctor who specializes in treating emotional and behavioral problems through psychotherapy, prescribing medications, and performing some medical procedures.

Psychologist: A psychologist specializes in treating emotional and behavioral problems through psychological consultation, assessment, testing, and therapy. A psychologist is not a medical doctor, but has a doctoral degree (PhD or PsyD). Psychologists at hospitals often help prevent or treat the mental health, behavioral, and emotional problems that patients and families may experience when coping with medical issues.

Pulmonologist: A pulmonologist is a doctor who concentrates on lung problems, such as asthma and cystic fibrosis.

Rheumatologist: A rheumatologist is a doctor who treats problems involving the joints, muscles, and bones, as well as autoimmune diseases. Rheumatologists treat 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 and educating patients about self-care.

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 a state license.
  • Certified nurse midwife (CNM): A certified nurse midwife provides gynecologic care and obstetric 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: Child life specialists work to reduce stress and anxiety while kids are in the hospital. They do this 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 offer comfort and give kids a chance to play or 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.

Dietitian: A dietitian plans meals for patients based on their medical condition and needs. A dietitian also might 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 needed to play, function in school, and perform routine activities (like hand-eye coordination). Kids in occupational therapy may be coping with health issues like birth defects, autism, juvenile rheumatoid arthritis, developmental delays, burns, amputations, or severe injuries.

Pharmacist: A pharmacist provides medicines for patients, checks for any interactions between drugs, and works with the rest of the medical team to choose appropriate treatments.

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 after surgery or as a result of developmental delays, injuries, or long hospitalizations.

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 airways) or inhaled medicines (medicines breathed into the lungs). Others who are critically ill and unable to breathe on their own may be put on ventilators to support 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 help the family meet a child's 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 stress, make patients 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: Steven Dowshen, MD
Date reviewed: August 2014