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 role is will help you to survive and thrive.
As quickly as possible, find out who the key healthcare professionals are on the hospital unit where your loved one is receiving care.
Find out who the nurse who runs the unit on a day-to-day basis: The name is different in just about every hospital and every unit (examples: 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 are often a key-player in planning for discharge or transfer to other units, services, and home.
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 (OT): They help with assessment of how a patient can do their activities of daily living (eating, bathing, dressing, toileting, and self-care). The OT will be re- sponsible 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 (who are general practitioners or internal medicine specialists) are assigned to be the lead in 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 of who the doctors are and try to get an understanding of their rotations and availability.
Most Responsible Physician/Practitioner (MRP): This is 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, and the role is often assigned according to the primary reason the patient was admitted to 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 to make sure they continue to oversee the patient’s care.
