Understanding the key players on your team
Key Takeaways
Clinical teams consist of multiple members with different, yet complementary tasks.
Nurses often have extensive experience and can offer insight on best patient care practices that they have seen throughout their career.
It is important to understand both your own role in the team, and the role of the other members—you should know what to expect of them, and they should know what to expect of you.
In medicine, team-based care is often needed to provide optimal care to patients. Most teams will have a core composed of clinicians, nurses and medical assistants, with an expanded care team composed of pharmacists, social workers, therapists and others.
Using a team-based care system allows for the delivery of better quality care, allows work to be finished within the time allotted, and gives patients ready access to prompt treatment.
For team-based care to work most effectively, it is important to know who the members of the team are, and what their role on the team is meant to be.
Clinicians
In residency, your team will consist of several doctors. Attending physicians supervise and, ultimately, serve as the responsible party for the medical decisions being made.
Some teams will include fellows who have completed their residency and are pursuing advanced training in a sub-speciality; they typically oversee residents (along with the attending) as you provide care. The residents in your program are key members of the team.
Some teams also include medical students who may be under your direct supervision. This will provide you with the crucial experience of acting as a mentor.
Related: Residents as mentors: Should you take the opportunity?Nurses
Most nurses work closely with patients, although their duties will depend on their education and area of specialty.
Licensed practical nurses (LPNs) train for approximately 1 year at a community college or a vocational school. They are licensed by the state, and they will typically perform basic patient care like checking blood pressure and vitals, as well as helping patients with eating and dressing.
Registered nurses (RNs)—nurses who have completed a diploma program, an associate’s degree, or a bachelor’s degree—tend to be the backbone of the healthcare system, performing a range of duties and interacting with patients and the entire healthcare team.
RNs prepare patients for exams or treatments, monitor and record symptoms, administer medicines and treatments, operate and monitor medical equipment, and teach patients and their families how to manage post-treatment care.
It is important to partner with the nurses on your team, as they will be seeing your patients at different times and may be able to offer unique insights. Oftentimes, RNs will have extensive experience and can offer good advice on best patient care practices that they have seen throughout their career.
Advanced practice nurses have more education and experience than RNs. They act as clinical nurse specialists, nurse anesthetists, nurse midwives, and nurse practitioners.
Pharmacists
Pharmacists have earned a PharmD degree, which typically takes 5 to 6 years to complete. They are also required to be licensed by the state. Some pharmacists also go on to complete a 1 to 2 year residency, which can make them true experts on the medications you prescribe.
The role of the pharmacist in the hospital is to advise patients on how to use the medications prescribed and answer questions about side effects.
Pharmacists are often helpful in selecting medications in certain situations, or advising you when a patient has been prescribed a combination of medicines that may cause harmful interactions.
Pharmacists are often helpful in selecting medications in certain situations, or advising you when a patient has been prescribed a combination of medicines that may cause harmful interactions.It is important to listen to any advice your pharmacist has regarding your prescriptions.
Social workers
Social workers are crucial members for most medical teams. They can be found in many hospital settings, from pediatric wings to hospice facilities, and the work they perform will vary based on the setting.
In the hospital, social workers are often tasked with patient discharge, where they will work one-on-one with patients and their families to plan for what will happen after the hospital stay is complete.
Therapists/rehabilitation specialists
There are many types of therapy and rehabilitation specialists, including:
Occupational therapists who help patients perform tasks for everyday living and working
Physical therapists who help patients recover from injuries, disabilities, or medical conditions that limit their ability to function
Respiratory therapists who treat and care for those patients with breathing issues
Speech therapists who work with patients who have problems related to communication or swallowing.
As a resident, you may not interact with these specialists often, but understanding their function and what they can and cannot do for your patients is important.
Support providers
For many patients, key members of their healthcare team are the people who are there to provide emotional or spiritual support.
This can include mental health professionals (psychiatrists or psychologists), social workers, and clergy members.
Some hospital systems employ patient navigators. These team members work closely with patients to reduce barriers that can keep them from accessing optimal healthcare, such as difficulties with finances, transportation, language, childcare, or education.
The actual duties of patient navigators vary from patient to patient, and you should ask about the system employed where you are training so that you can understand what is available to your patients.
What this means for you
As a resident, understanding the members of your team and the roles they are expected to play is a vital part of facilitating patient care. Each team will be slightly different, but all will consist of specialized members with unique roles to play.
Understand those roles, and respect the people who hold them. You are all working together to provide the best possible care for your patients.