The hospital staff is composed of highly trained personnel. Many of the positions involve much responsibility and necessarily call for special training and skill. During your hospital stay you may come in contact with a few of the employees, but there are many more whom you will not see, working in support of these few.
The Hospital Administrator
The hospital administrator is a person highly trained for this position, which may be considered a profession in itself. Many hospital directors, or whatever their title may be, are physicians who have gone on to take special training in the field of administration. To be sure, the individual who supervises a hospital must be well trained in business administration, business law, economics, and efficiency, as well as having good insight to all medical problems. Since the primary purpose of the hospital is the care of the sick and disabled, it cannot be compared with any business, where profits are a measure of success. The hospital is a misfit in a capitalistic society, and many hospitals operate at a deficit. Hospitals are often compared to hotels, but their service is much more complex and their expenses many times those of a hotel. The hospital administrator has many more problems than are readily apparent. The hospital director is often governed by a board of trustees. The hospital plays an indispensable role in protecting the life and health of the community, and it is the job of the administrator to direct the hospital toward this goal.
Interns are physicians who recently have been graduated and are serving in the hospital with a dual purpose: they are completing the final step in their training before becoming licensed physicians and they are working with the attending physicians on their cases. If the hospital you enter provides for internship training, an intern will work hand in hand with your doctor on your case. There is usually at least one intern on each service of the hospital all the time. He will answer all professional calls during the absence of the doctor in charge and will order for the treatment of minor complaints. He will summon the attending physician when necessary and will notify him of any change in condition of each patient. An intern will probably assist your surgeon during your operation. Interns rotate through all the hospital services and arc trained by the resident physicians and the attending physicians.
Resident physicians have already completed their internship and are licensed physicians.
They are serving in the hospital to take advanced training in one of the specialties, as well as to help in the care of patients. Various hospitals have residents serving in various specialties, and you as a surgical patient may have a resident surgeon working with your surgeon on your case. The relationship with the attending surgeon is quite similar to that of the intern, except that more responsibility is placed in the resident. A surgical resident or an intern, or both, may assist at your operation. In the final year of training the resident physician may conduct clinics and have hospital cases of his own, in addition to his work and training with the attending staff. These hospital doctors can be of great benefit in making your hospital stay more comfortable and successful.
The dietitian of the hospital supervises the preparation and serving of food. The science of dietetics deals with the application of principles of nutrition to the feeding of individuals or groups. In the hospital it is necessarily composed of the administrative and the therapeutic, or special, diet branches. Administrative dietetics is concerned with planning the daily menu and supervising the preparation of food for all hospital patients on regular diets, and in supervising the operation of the hospital cafeteria for employees. Special dietetics applies the principles of nutrition in designing diets according to the doctor’s diet prescription. The prescription designates the caloric requirements and the amounts of carbohydrates, fats, and proteins to be included, as well as any other special features. The dietitian then plans the special diet accordingly, taking into consideration its pala- tability and the patient’s likes and dislikes. Dietetics is a complex science, and the dietitian spends five years in preparation for this profession; four years of college training and one year of dietetic internship are required. If your doctor orders a special diet for you, the dietitian may call on you. The number of dietitians on the staff may vary in different hospitals. The dietetic department plays an indispensable role in the hospital.
The nursing staff of the hospital works in close harmony with the physician. The main purpose of the nursing profession is to assist the doctor, and the primary duty of the nurse is to see that the doctor’s orders are executed. In the hospital all medications will be administered by a nurse; she is trained in this capacity, and no other employee may assume such responsibility. The nursing staff supervises all other care given patients; anything that pertains directly to patients is the concern of the nurse. In preparation for this field the nurse spends 36 months in training. This training program is usually an affiliation of a large hospital approved for such teaching, but it may be a course given by a university. After completion of training the trained nurse (T.N.) takes state examinations and becomes a registered nurse (R.N.) if she passes them successfully.
Often nurses major in one particular branch of their training to become more expert in a certain field—as, for example, the surgical nurse, who will make operating room preparations and govern the instruments during the operation. This is specialized nursing.
There is also the practical nurse, who has had one year of training under a hospital program. She assumes the same capacity in a hospital as the registered nurse, except that she does not administer medications. She works under the direct supervision of the registered nurse. You will have immediate contact with the nurses during your hospital stay, and some of the nursing students may render part of your care. The special nurse, or private nurse, is one who is not employed by the hospital but is working for one specific patient and assumes all the nursing duties for that case. Naturally, more intimate attention is afforded. Your doctor may ask you to engage a private nurse for your care. Private nurses may also be utilized in the home for the care of a patient, in which case the home becomes a hospital. (The special nurse must be distinguished from the specialized nurse. The former is the nurse who is concerned with the general nursing duties of one specific patient at a time, while the latter is the nurse who has added training or experience in one type of nursing to become an expert in that phase of the nursing profession.)
Nurses’ Aides and Orderlies
Nurses’ aides and orderlies are hospital attendants who do general work under the nurses’ directions. They are trained for routine bedside care and carry out regular duties to maintain order and comfort. They do much of the manual labor necessary for the care of patients. There are training programs in most hospitals for the training of these attendants. There also is, of course, a maid service and a janitorial service.
Laboratory technicians are trained in the examination and analysis of body fluids and other specimens. They work in the laboratories under the supervision of the hospital pathologist. Most of the procedures are intricate and complicated. Laboratory technicians prepare for their highly scientific field by spending three to four years at a university and then taking one year of practical on-the-job training. After passing state examinations, they are qualified. A technician will call on you while you are in the hospital, to obtain specimens for the tests your doctor orders. These technicians also operate the hospital blood banks.
Physiotherapists operate the physical therapy department of the hospital. They arc trained in the administration of such treatments as hydrotherapy, diathermy, electrical nerve stimulation, infrared and ultraviolet lamps, massage, and other electrical and physical procedures. Your doctor may order physiotherapy for you.
X-ray technicians are trained in the technique of taking and developing x-ray films. They are trained in the correct exposures and various techniques of radiograph production, as well as the theories and principles of x-ray, but they do not instigate x-ray therapy nor do they interpret the x-ray films. They work under the supervision of the hospital radiologist.
The hospital pharmacist is a licensed druggist who manages the hospital pharmacy and fills all orders for drugs from each nursing station, as well as all other prescriptions. Needless to say, this is a major function in the hospital and one where error is not allowed.
Clerical workers are found throughout the hospital. To be sure, they play a major role in the operation of the hospital, but a description of each function is not important to your hospital stay.
You can see that the hospital is necessarily composed of a staff of highly trained personnel. There are many more hospital employees working in support of the major purpose of the hospital—comfortable and efficient medical care for you. Suffice it to say, your co-operation with everyone with whom you come in contact during your hospital stay is your own contribution to the success of the institution.