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