Saturday, November 26, 2011

Tip #6: Know the Role That Each Person Plays In The Hospital Team (quick cheat sheet) ~ Insider Tips on How to Get the BEST Medical Care in the Hospital ~

Who are all those people working in the hospital & what do they do?? 
Continuing our journey into the foreign land of the hospital, lets meet the team...
  • Nurse:  Your tour guide.  Responsible for your day to day care. Manages meds, personal care, intake & output & executes doctors orders.  Eases patient's anxiety and deals with overwhelmed (and often emotional, highly stressed) families. Have the most comprehensive view of the patient's condition & can usually make or break a patient's progress.  Their insights are extremely valuable.  Most are very intelligent, highly educated or experienced and have the patient's best interests at heart. Some are not and do not (but I've found these folks to be few & far between).  There are a lot of different kinds of nurses:  RN, LPN (LVN), APN(NP)) and I'll devote a guest post to my husband (THE HAPPY NURSE) to explain all of these sub-types and specialties but on the floor you will usually see either RN's or LPNs/LVNs. A good medical team always takes nurses' assessments into account with great weight when making any patient care decisions.  I do not recommend being rude to your nurse.  Please treat them with the respect they deserve.  Frequently understaffed.
  • Tech:  Your helping hand.  Responsible for a long laundry list of tasks including: recording vitals, running EKG's, assisting nurses in complex tasks (i.e. wound care, etc), helping you to the restroom, helping with your grooming/bathing/dressing & managing your transfers (moving from the chair to the bed, etc) so you won't fall.  Also many times get stuck running patient's errands.  Be very nice to them.  They are not your servants. Also frequently understaffed.
  • Social Worker:  Your tour management company.  Responsible for coordinating your admission and discharge.  Arranges home services, equipment, transportation and plugs you into community, government resources.  Tracks down absent family members to assist with your care upon discharge & obtain data on your advanced directives, insurance, etc if you are unable to do so.  Manages the majority of communications with your family as a whole.  Directs "family meetings" about end-of-life issues & your care plan.  Overworked, underpaid and usually extremely nice people.
  • Physical Therapist (PT):  Your Coach.  The key to your physical independence.  Their job is to help you walk again, get you strong, and push you to become as independent as possible. They are experts in the appropriate exercises for each specific surgery, illness or injury.  They generally tailor your program to return to or exceed your pre-hospital activity level upon discharge or after home/outpatient care.  They focus primarily on training the lower body and OT usually focusses on the upper body, but there is overlap. These people are extremely nice and motivated.  I have yet to meet a PT (or OT for that matter) that I don't like.
  • Occupational Therapist (OT): Your ADL guru.  In rehab, the term "ADLs" refers to "Activities of Daily Living" and OT's are the experts in these.  Eating, bathing, dressing and toileting are the basics, but their skills range to helping physically replicate your daily routine (i.e. cooking, laundry, etc) to allow you to function as independently as possible at home.  They are extremely innovative in providing you with adaptive devices that can allow you to function independently--from splints to "reachers."  Once again, nicest people ever!
  • Speech-Language Pathologists: Your Translator. Most of you will not meet these therapists but if you have trouble swallowing, speaking or processing language (like after a stroke), these people will be your best friend.  They are exceptionally well-trained and patient.  They do things ranging from the extremely technical (modified barium swallows and FEES to determine the quality of your ability to swallow) to the physical (speech & swallow exercises).  They also do cognitive assessments in patients with suspected dementia or brain injury.  Once again, like all the other therapists--I have found them to be VERY kind.
  • Nurse Pracitioners & Physician's Assistants:  Your Doctor's Point Person.  Depending on what state you are in, responsibilities & level of independence of NP's and PA's varies.  Detailing the differences between each & their training is going to have to be a future independent post as it is very complicated to describe each one's scope of practice.  For your purpose's know that they are the DIRECT line to your doctor.  They often have more experience than the doctor they work with and can offer you very important information.  They will manage your day to day care in the hospital if the doc doesn't have any residents (and sometimes even when the doc does!). If they are a surgeon's PA or NP they are often in the OR with the Doc assisting in the surgery as well.
  • Doctors: Your Team Leader:  I'm going to devote a whole post this week to doctors.  For now know that the different categories of doctors include:
    • Attendings
    • Fellows
    • Residents
    • Interns
    • Medical Students
    • Dietician:  Your secret weapon. Obviously I'm a huge fan of anyone whose job revolves around helping my patients become nutritionally healthy.  The dietician does nutritional assessments, makes recommendations to the team on how to nutritionally optimize your ability to heal and can intercede on your behalf to improve your meal choices & content.  Once again, very nice, very smart people.
    Other people you will see who are not involved in DIRECT clinical patient care include:
    • Administrative Assistant for the Unit (also known as the Unit Secretary depending on the hospital):  This person has a crazy intense job.  They answer phones & patient call lights & communicate needs to nursing staff.  They organize all the massive paperwork in everyone's charts.  In hospitals without electronic medical records, they enter all the orders.  They administratively admit & discharge patients--serving as a hub for coordinating all the services on the floor--from housekeeping to transport to maintenance.  I'm sure I've missed a bunch of stuff but you get the gist.    
    • Housekeepers:  Big job, small time frame.  These folks have to clean and sanitize rooms between patients (very time-pressured turn around) AND make sure patient rooms are kept hygienic.  They deal with contaminated trash & are responsible for managing all that laundry you see everywhere! A key role in minimizing hospital infectious diseases. Without them, all those MRSA and VRE patient rooms would spread disease from one patient to another. A lot of work, very underappreciated.
    • Dietary Staff:  manage your food--from ordering to delivering.  You see these folks three times a day and often their sunny moods (or lack thereof) really sets the tone for the day.  They have to keep food hot through long distances and make sure that each patient gets the right food (key--we don't want the kosher patient eating pork, etc!).  A busy job!
    {NOTE:  I know the above descriptions do not NEARLY capture the full extent of the responsibilities in each position!  I just tried to hit the highlights!!}

    Next Time on Medical System Tuesdays (new feature on the blog):

    • Tip #7:  Know Your Doctors: A Short Guide to Hierarchy! ~ More Insider Tips on How to Get the BEST Medical Care in the Hospital ~

    Coming Up THIS Week!

    • SuperImmunity Foods for KIDS (Calling All PARENTS!)
    • RECIPES & Ideas: Snacks!  YUMMY & Portable Plant-Based Snack Food--all sugar-free, gluten-free & without adding oil or fat!!
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