Who is Who in the Hospital Zoo?
When you or a loved one is seriously ill or injured, you will find yourself pushed into the deep end of the healthcare system. Knowing who is who in the zoo and what their roles are will help you survive and thrive.
Find out as quickly as possible who the key healthcare professionals are on the hospital unit where your loved one is receiving care.
Find out who the nurse is who runs the unit on a day-to-day basis. The name is different in just about every hospital and every unit (e.g., head nurse, patient care coordinator, nurse manager). This nurse is usually there for several shifts in a row and has ongoing knowledge of all the patients and what the nurses, doctors, physiotherapists, and occupational therapists are saying and doing. Introduce yourself and ask for an introduction as to the layout of the unit, phone numbers, best times to call, and when doctors are most likely to make rounds.
Write all of this in your notebook.
Who is who?
Registered Nurses (RN): They are often key allies in getting information and keeping you in the loop. Write down their names and the dates and times of the shifts they worked (in case something goes wrong — but, also, if you later want to send a thank you).
Unit social worker (SW): Can be a key resource for all things non-medical, such as emergency financial resources, psychological supports, and is often a key player in planning for discharge or transfer to other units, services, and home. They are the most knowledgeable professionals about Advance Care Planning and Medical Assistance in Dying (MAiD).
Physiotherapists (PT): The key persons in getting patients physically activated, transferring from bed to chair and toilet, walking, and strong enough to get home. Ask to be taught how to help with physical exercises.
Occupational Therapists (OTs) help assess how a patient performs their activities of daily living (eating, bathing, dressing, toileting, and self-care). The OT will be responsible for assessments for where your loved one will go next: rehabilitation, residential care, or home. They are key players in discharge planning and any equipment that will be needed if the patient is going home.
Physicians: These are the key players you are likely to see the least. Who the doctors are depends on the unit the patient is on and the size of the hospital. If the patient is in a smaller hospital, the family physician will likely remain involved and be the lead physician.
In larger hospitals, on general nursing units, hospitalists (general practitioners or internal medicine specialists) are assigned as the lead on patient teams. They usually will have rotations of a week or two, so there is consistent medical care.
In critical care and intensive care units, specialists will likely lead the teams and are on duty or available 24 hours a day. In large teaching hospitals, you may never see the lead physicians and specialists, as all care will be overseen by Residents.
Wherever possible, ask questions about the doctors and try to understand their rotations and availability.
Most Responsible Physician/Practitioner (MRP): The physician or nurse practitioner who is ultimately responsible for the patient’s care. This role is most often used in larger hospitals, and when multiple specialists are involved in care, it is assigned according to the primary reason the patient was admitted to the hospital (cardiology, neurology, orthopedics, internal medicine).
Sometimes, the MRP gets lost in the shuffle, especially when the patient is moved from a critical care unit to a nursing unit. This can result in a lack of oversight and planning. It is vital to know who your MRP is and ensure they continue to oversee the patient’s care.
