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Advice for Patients
May 2013

If Your Child Is Hospitalized: The Hospital Health Care Team

JAMA Pediatr. 2013;167(5):496. doi:10.1001/jamapediatrics.2013.2318

If your child needs to be in the hospital, it can be a stressful and confusing experience. In many hospitals, there are multiple people involved in the care of each pediatric patient, and it can be challenging for parents to keep track of who is who. I outline the typical medical and nursing team members, and suggest ways to interact with your child's hospital health care team.

The physician team

Physician (also called “ attending ” or “ attending physician ”): These terms mean the main physician who is overseeing, or attending to, your child's care.

  • A common question that parents may have is whether or not their children's usual physician will be caring for them while they are in the hospital. Many hospitals use specially trained physicians called hospitalists, who are employed by the hospital to care for children when they are hospitalized. Many physicians' offices choose to use the service of hospitalists for their patients and then continue providing care once their patients are out of the hospital. During the hospitalization, hospitalists work closely with your child's regular physician to make the best medical decisions for you and your child.

Fellow: Some physicians decide to become subspecialists, such as a cardiologist or allergist, and focus their medical care on a particular set of medical conditions. During this stage of training, which takes place after a residency, the physician is called a fellow.

Resident: After medical school, new physicians complete a residency in their medical field of choice. Different residencies include primary care residencies, such as pediatrics, or more specialized residencies, such as anesthesia. In the hospital, your child may meet 2 types of pediatric residents:

  • Interns: “Intern” is a traditional name for the first year of residency. If an intern is assigned to help care for your child, typically he or she will be closely involved in your child's day-to-day progress. Interns are supervised by more senior residents, as well as by physicians.

  • Senior residents: Senior pediatric residents are typically in their second or third year of residency. These residents often supervise a team of interns and medical students, and help coordinate care for multiple patients rather than providing one-to-one care for a single patient.

Medical student: Medical school lasts 4 years, and the first 2 years are typically focused on classroom learning. The last 2 years are spent learning in hospitals and clinics. Your child may have a medical student assigned to help in his or her care; these students are supervised by residents and attendings.

The nursing team

Shift nurse: Nurses often work in shifts, which may be 8 or 12 hours long. Your child may have 2 or 3 nurses each day. Whenever possible, many hospitals will try to consistently match patients with a particular nurse.

Charge nurse: The charge nurse is typically the supervising nurse for that particular shift. Often the charge nurse will assign patients and handle admissions and discharges of patients.

Nurse practitioner: A nurse practitioner is a nurse with advanced training; these nurses can often provide advanced care for patients (such as wound care after surgery).

How to interact with your hospital health care team

Each morning, your medical care team will do “rounds.” During this time, the medical team will walk around the hospital ward and discuss each patient's care. In this way, the whole medical team gets to know your child and is involved in discussing what the best decisions are to help your child get better.

Many hospitals now have “family-centered rounds” in which family members, and even your child, are present during the discussions and are able to share their views and experiences.

Rounds are a good time to interact with your child's health care team. If the hospital does not have family-centered rounds, let your team of doctors or nurses know that you want to be part of rounds.

To prepare for rounds, you can write down any information that you think is important about your child's condition or about any changes in your child's condition. You can also bring a list of questions that you want to ask during rounds.

For more information

Department of Psychiatry, Children's Hospital Boston, Massachusetts
http://childrenshospital.org/az/Site 1705/Documents/parent_guide2.pdf

Inform yourself

To find this and other Advice for Patients articles, go to the Advice for Patients link on the JAMA Pediatrics website at http://www.jamapeds.com.

Source: American Academy of Pediatrics

The Advice for Patients feature is a public service of JAMA Pediatrics. The information and recommendations appearing on this page are appropriate in most instances, but they are not a substitute for medical diagnosis. For specific information concerning your child's medical condition, JAMA Pediatrics suggests that you consult your child's physician. This page may be photocopied noncommercially by physicians and other health care professionals to share with patients. To purchase bulk reprints, call 312/464-0776.