what are they for?

Darlene K. · Sep 28, 2005

what are those attending physicians, housestaff, residences are for?
Lets say one of my patient complain of pain and there was no order for pain med. who am i going to call first? if the blood culture final report turned out positive, or let say patient got confused and restraint is emergent? please help

Hi,

You will find Residents and Attendings in teaching hospitals. As to who you call, it all depends on who their doctor is, what they are in for and who ordered the test. Let's say Mr. Jones PMD is Dr. Smith and his GI doctor is Dr. Doe. - Pt glucose is 500, you would start with the PMD. If he is vomiting blood and in the hospital for GI issues, you might call the GI doctor. Don't worry, if you happen to call the wrong doctor, they have no problems letting you know. Usually, they will tell you who is the correct person to contact. Don't be afraid to ask and document.

I work in a teaching hospital, so I look to see who their doctor is and then I check the list to see if they have a resident or a NP or PA. If so, I start with them. Private Physicians, might have a NP or PA but not a resident.

Don't worry, it will all come to you. You will have regulars on your speciality floor.

Good luck!

caroladybelle, BSN, RN · Sep 28, 2005

It depends on the facility. They should have protocols to follow in regards to this. This varies from place to place, but here is how I have seen it work.

In Teaching hospitals:

There are med students. We cannot take orders from them and they are not referred to as Dr. In some places, they put orders in, but they must be cosigned before being legal. In the summer between graduating med school and starting internship, there are SubIs.

There are interns. They are referred to as Dr. and in some cases can write orders. Some more critical orders must be cosigned by a senior resident, in some facilities and/or for some drugs.

There are residents which are more senior and oversee interns. They also write orders.

There are fellows, that are more senior and working in a specialty. Frequently chemo orders or BMT management may come from a fellow in some facility, because of the high risk of those issues.

There are attendings, that oversee the care given by interns/residents. As a general rule, they do not give orders as that is what interns/residents are learning to do and is their job. Though in some facilities , they must cosign high risk meds like chemo.

House officers vary from place to place, but generally includes interns and residents for that facility.

In most cases, the intern for that patient is the one you first call for patient issues. And if you cannot contact them, the resident takes the call. Some issues like BMT or chemo may go to a fellow or attending.

This does vary from place to place, though. Check with your facility.