Hospital Care Team Members

The attending physician is the leader of the team and has responsibility for all decisions that affect a person's care, including diagnosis, treatments, and supervision of the remainder of the team.

Based on the problem that brought the person to the hospital, the attending physician may be a hospitalist (a doctor who is trained in internal medicine and works only with people who are hospitalized), a surgeon, or another specialist physician. In smaller communities, the person's primary care doctor may act as the attending physician.

Some hospitals are designated as teaching hospitals. That is, the hospital team includes medical students who are at various stages of education and who are supervised by the attending physician.

A resident or intern is a fully licensed doctor who is engaged in further training after graduating from medical school.

Although these team members are not attending physicians, they are often active members of the team.

When people have complex or serious medical problems, the attending physician sometimes requests that specialists evaluate the person and recommend how to best diagnose and treat the problems. For example, the specialist may be a doctor who is extensively trained in the diagnosis and treatment of disorders of the heart (cardiologist), kidneys (nephrologist), or cancer (oncologist). In other cases, the specialist may be a surgeon who has particular expertise in one area, such as the brain, spine, and nerves (neurosurgeon) or muscles, bones, and joints (orthopedic surgeon).

People usually have more contact with the registered nurses (RNs) assigned to their care than any other member of the team. RNs give medications to people and monitor and evaluate their physical and emotional needs. When a person's condition suddenly changes, RNs are often the first to detect the change. RNs then report the change to the attending physician or house staff. RNs may be charge nurses or nurse supervisors, organizing and monitoring overall nursing care in a hospital unit.

Licensed practical nurses (LPNs) are supervised by RNs and provide basic medical and nursing care. For example, LPNs check blood pressure, insert catheters, and help people bathe and dress. LPNs also talk to people about their health care, answer their questions, and report how they are doing to RNs and doctors.

Nurse practitioners and physician’s assistants (PAs) work closely with the attending physician to coordinate a person's daily care. They also help with doing physical examinations and ordering medications and treatments when people have more common or routine medical or surgical problems. Although nurse practitioners and PAs are not doctors, they have advanced training in diagnosis and treatment. Nurse practitioners and PAs are supervised by doctors.

Patient advocates are non-medical administrators employed by the hospital to assist patients receiving care there. In general, they handle complaints that people have about their treatment or health care professionals. People can meet with a patient advocate if they feel uncomfortable discussing concerns directly with their health care professionals or they feel that their concerns have not been addressed.

Traditionally called nurse’s aides, patient care technicians help nurses with people's care. Their duties may include

• Obtaining vital signs (such as measuring blood pressure and temperature)

• Moving people to and from a bed or wheelchair

• Helping people with walking

• Providing items for people's comfort (such as pillows and blankets)

• Sometimes, helping feed people who cannot feed themselves

Physical therapists evaluate and treat people who have difficulty functioning—for example, difficulty walking, changing positions, or transferring from a bed to a chair. These problems may develop or worsen in the hospital because people have to stay in bed a long time (bed rest), as may occur after surgery, or because their disorder worsens.

Physical therapists assess people's strength, endurance, and coordination and design brief in-hospital exercise programs to help people function better physically and become more independent. Often, physical therapists help doctors determine whether people are likely to be able to function on their own at home after they are discharged from the hospital or whether they may need help at home or need to stay at a skilled nursing facility for additional physical therapy.

Occupational therapists assess people's ability to do their daily activities. These activities include eating, dressing, grooming, bathing, using the toilet, cooking, and cleaning.

Occupational therapists can recommend strategies and devices to help people function more independently.

Speech pathologists work closely with people who have had a stroke or who have another disorder that interferes with swallowing or communication. For example, if a stroke causes problems with swallowing, speech pathologists recommend that the person eat foods with certain textures. They can suggest ways to swallow that can prevent food from going into the lungs instead of the stomach. They also evaluate the thought processes involved in communication.

Pharmacists specialize in how medications work and interact with each other. Hospitals have pharmacists on their staff who supervise the use of medications in the hospital. If needed, hospital pharmacists teach people how to safely and effectively take the medications prescribed for them. For example, pharmacists may advise people to avoid specific foods that interact with their prescribed medications or teach people how to inject medications (such as insulin) at home. Hospital pharmacists also provide information to doctors and answer questions about specific medication actions and interactions.

Social workers provide support, information, and education. They help people prepare for discharge from the hospital by identifying and arranging helpful services that can be provided in the home and community. For example, they may refer people to a skilled nursing facility if people are not well enough to return home and need ongoing care and therapy after discharge from the hospital. Social workers also coordinate certain home health care needs, including a visiting nurse or physical therapist and medical equipment such as wheelchairs and hospital beds.

Registered dietitians have specialized nutritional and medical training that helps them determine a person's dietary needs and plan the person's meals in and out of the hospital, as requested by the attending physician. When planning meals, dietitians consider the person's personal, cultural, and religious food preferences.

Certain medical conditions have very specific dietary requirements. For example, people with diabetes need a low-sugar diet, and some people with kidney problems need a low-potassium diet. Dietitians can advise people about which foods satisfy these requirements and which foods they should avoid.

For people who are deaf or hard-of-hearing and for people whose first language is a foreign language, hospitals provide an interpreter who has special skills in medical terminology. Sometimes the interpreter is present in person, and sometimes, the interpreter is available by telephone or video conference in the person's hospital room.

Rapid response teams are groups of designated hospital staff (often a doctor, nurse, and respiratory therapist) who quickly come to a person's hospital room if there is any indication that their condition is deteriorating, such as abnormal vital signs, trouble breathing, chest pain, or signs of a stroke. After ordering tests or starting treatments to stabilize a person's condition, the team contacts the attending physician and may move the person to another area of the hospital for specialized monitoring or treatment.

Other staff members may be involved in a person's hospital care. They may include a radiologist and radiology technician, a respiratory therapist for people with breathing problems, staff members to help transport people within the hospital, clergy, and hospital volunteers.