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PT inpatient
OT inpatient

You made it into the hospital floor.   There are more people here then in the ER it seems.  Who are these new people?

Do not fear, many of the people you met in the ER are also working up on the wards.

But wait a minute here - where is my Family Doctor?

In smaller hospitals your family doctor still may be the one taking care of you in the Hospital. They may also be assisting your obstetrician (OB) with your child birth or the surgeon in the OR.  However, this traditional way of practicing medicine has lead to burn out of those doctors.  Also, with medical knowledge and treatments advancing so much over the past few years, there is a lot more to know about taking care of acute inpatient illnesses then ever before.  This is also know as keeping up the the standard of care. 

So was invented The Hospitalist. 

The Hospitalist - This is a relatively new role in the hospital over the past 20 years.  This physician is an Internal Medicine or pediatric doctor who specializes on acute inpatient diseases.  They know what to work up and fix now to get you home and what is safe to leave for your family physician.   

Usually they work in shifts for a week at a time.  Some only work at night and are called Nocturnists. 

They are generally on the younger side, newer doctors.  But some are older physicians scaling back and taking part time jobs.  

Some are great at doing procedures such as putting in central lines or a thoracentesis.  Others are not. 

Some are great at managing many conditions on their own. Some are not.  

They all have different styles of practice and they are all doing their best to make you better.

I was a Hospitalist once.  😊

According to the statistics there are more doctors graduating from internal medicine residency going straight into being hospitalist then going into general internal medicine practice.  This is the largest group of growing physicians at the current time.

More of Your Care Team

Let me introduce you to the new players on your Care Team below. 

Ward clerk or ward secretary - This is the person sitting on the floor at the main desk that you have been admitted.  They take care of a lot of the paperwork and charts.  They fax orders, keep track of patients coming and going off floor, answer phones, can contact all the nurses.  They often get your discharge package ready to go.

Echo tech - A person trained in doing echocardiogram.  Echocardiogram is an ultrasound of your heart to see what the function of the muscle and the valves is like.  It tells us how strong your heart is pumping.  They can come to room to do this at the bedside.

Physical therapist (PT) - They help you get moving after you have been sick.  They often help after operations such as hip replacements.  They help with gross motor movement required to move her body and manage pain.  They help strengthen your muscles and show you exercises to do.  They help you with mobility and transferring to the bedside commode or to a wheelchair safely.  They make sure you can walk up the stairs when you are ready to go home.  They do assessments and recommend a plan of care for discharge such as inpatient acute rehabilitation or outpatient rehabilitation.

Occupational therapist (OT) - They help out with fine motor movement after you have been sick or have had a stroke, for example.  They help you to be able to comb your hair and use utensils to feed yourself.  There is a group of activities called ADLs - activities of daily life.  They help you get back to functioning on your own.  They work with Physical therapy to come up with a plan to help you get back home, and be safe.

Speech and Swallow Therapist – This person can assess you for speech disorders problems with communication.  Often they also do swallow therapy as well.  When we become ill often times the ability to coordinate all the muscles in the back of your throat to swallow gets very weak.  It requires a lot of coordination to send that food into the esophagus and then into the stomach and not into your lungs.  The swallow therapist can recommend thickened liquids so you do not get food into your lungs.  That is called aspiration.  They can also do a test called a modified barium swallow to look to see if there is any fluid going into the lungs when it should not be.  This is called silent aspiration.

Nutrition Services/ Dietary -  These people help you order your meals, if you are lucky enough to choose. They deliver your meals and pick up your trays as well.

There are also Nutritionists that can visit your room to give advice on your diet. They have an average of 4 years of training. 

Housekeeping - They visit your room daily to clean.  They are highly trained and do extensive cleaning between patients.  They have to know which chemicals to use to properly disinfect your room. 

Infection Preventionist (IP) – You usually will not see this specially trained Registered Nurse (RN) but they are part of a team overseen by a physician trained in Infectious Diseases.  They monitor the hospital for any signs of outbreaks.  The assure that our hand hygiene is top notch.  There are many reportable issues that they must gather data on and report to the credentialing system of the hospital.  If there is an outbreak, they start a formal investigation. If you are on “Isolation”, the IP team likely knows about you.

Transporter – The transporter will take you in a wheelchair or on a bed through the hospital to where you need to go.  They can take you to your CT scan or MRI.  They can take you from the ER up to the wards.

Pharmacist – Some hospitals have a pharmacist to sit on the wards and review all the medications that you are on at home and here in hospital.  They make sure the dosing is correct.  They make sure there is no dangerous interactions.  They often help in something called “medication reconciliation” when you are admitted.  They have access to your outpatient pharmacy to see what you have been taking.

There are several different types of Pharmacists.

  • Pharmacy assistants: These roles require a high school diploma or GED. Some pharmacies might also hire high school students to work part-time in a pharmacy assistant role.

  • Pharmacy technician: These roles require a high school diploma, certificate, or associate’s degree. Having formal training from a certificate or associate’s program is possible.  Pharmacy technicians can also pursue specialty training certifications in areas such as IV medications.

  • Pharmacists: These roles require a Doctor of Pharmacy (PharmD) degree. All aspiring pharmacists need to complete an accredited PharmD program in order to become licensed.  This requires a 4 year undergraduate bachelors degree followed by a 3-4 year PharmD degree.  

  • For further reading you can go to American Society of Health-System Pharmacists

Speech and Swallow Therapist
Infection Preventionist (IP)
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