The Pediatric In-Hospital Care Team

Who might be involved in your child’s care?

Your child will meet many care team members in the hospital. Aside from their doctors and nurses, they will meet several other experts who will coordinate their care and help plan their transition from the hospital to their home or rehabilitation facility.

Hospitals have various groups with unique expertise and roles to play in your child’s care and recovery. Their care team may consist of doctors, nurses, medical trainees, respiratory therapists, social workers, care managers, rehabilitation experts, child life, pharmacist, clinical nutritionists, and chaplains. Different team members will see your child, or “round,” at different times of the day. The core medical care team will engage the pediatric survivor and their family to communicate daily care plans and goals.

Here is a brief description of who you and your child might meet and what their role might be during their hospital stay. The primary contact among all the family members should keep a log of questions for the care team and feel empowered to ask for clarification when needed.

Doctor

The main doctor may be a critical care doctor or “attending physician,” cardiologist, or internal medicine doctor. Your child may need consults from other doctors, such as those who specialize in the brain (neurologists, psychologists, or neuropsychologists), kidney (nephrologists), stomach and intestines (gastroenterologists), lung (pulmonologists), rehabilitation (physical medicine and rehabilitation doctors), or others. They may also need to have procedures performed by surgeons or interventional radiologists.

Nurse

There will likely be a primary bedside nurse assigned to your child and family, as well as potentially 2-3 different nurses in a day, depending on how long their shifts last. There will be a “charge nurse” who can also be a resource for additional questions. Patient care technicians or health aides may assist with checking your child’s vitals or drawing blood.

Physical therapist

A physical therapist may be asked to evaluate and treat your child for various physical impairments, such as the ability to walk, rise from a chair, etc. They may recommend assistive devices such as a cane, crutches, or a walker. They may suggest adaptations to improve your child’s ability to get dressed, walk, or use the stairs in order to be independent with these activities.

Occupational therapist

An occupational therapist may be asked to evaluate and treat your child for various fine motor impairments, such as the ability to use their hands, coordinate their fingers, sense objects they touch, etc. Assistive devices such as a grab device (“reacher”) or utensils with modified handles or textures may be recommended. The occupational therapist may also suggest adaptations to improve your child’s ability to get dressed or eat in order to independently do these activities. They may focus on strategies to improve your child’s memory or ability to multitask.

Speech-language pathologist

A speech-language pathologist may be asked to evaluate and treat your child (depending on age) for difficulties with language (e.g., finding words they want to say, enunciating words clearly), communication, or ability to swallow. They may recommend assistive devices such as communication boards. They may suggest adaptations to improve your child’s ability to express themselves (e.g., wants, needs, safety), organize, plan, and multitask.

Child Life Specialist

A child life specialist is someone who is certified to help support children and families cope with illness, injury, and medical treatments in a hospital setting. Their role can look like promoting effective coping through age-appropriate play, preparation, education, and self-expression activities. They are also available for other siblings who may need help navigating this new-normal, and can advocate on behalf of the family to the medical team.

Pharmacist

Pharmacists are specialists in medications. They help decide which medications might be best for your child, provide information about these, and give guidance regarding how medications might interact. They are vital aspects of the care team, and will be involved during your hospital stay and outside of the hospital.

Case manager

A case manager is often someone with nursing training who helps to navigate discharge plans recommended by doctors, checks on insurance coverage, and facilitates transfers to rehabilitation, skilled nursing, or long-term acute care facilities. Case managers also help apply for durable medical equipment and home health services for your child.

Social worker

A social worker is someone with specialized training in social and community resources. Sometimes, social workers do many of the same tasks as the care managers too.

Unit coordinator or assistant

A unit coordinator answers phone calls, coordinates consults, and files or faxes paperwork. There is often one at the main desk in the patient’s unit. They may have various other responsibilities, depending on the level of care for the unit or the hospital.

Administrator on duty or patient care services

There is often an administrator on duty for the hospital. This individual can be a resource if you or your child feels that their care team is not addressing their needs or if they have an urgent safety concern.

Clinical nutritionist

They are highly qualified professionals who create diets for patients based on how food can affect the body. They may consider digestive problems, metabolic issues, immune function, and the brain’s response to certain chemicals and how by-products can harm a patient’s health. They will work with your child when structuring a diet.

Chaplain or clergy

A chaplain is a certified clergy member who provides spiritual care for nurses, doctors, and administrators, as well as patients and their families. Chaplains lead non-denominational religious services that can benefit patients and families from a variety of religious or spiritual backgrounds.

Thank you to our contributors

Kelly Sawyer, Jasmine Wylie, & Isabella Tincher