How to Understand the Hierarchy in PICU (Pediatric Intensive Care Unit)

Pediatric critical care provides a multidisciplinary approach to care for children who have progressive and rapidly changing complex surgical, medical and traumatic issues. PICUs or (Pediatric Intensive Care Units) assist and provide for the special needs of injured or critically ill children and their families. However, understanding the staff in the PICU can be confusing.

Instructions

Difficulty: Moderately Easy

1. Talk to the the staff to learn how to differentiate them. Depending on the hospital, different color scrubs may mean a different job in the PICU. Janitors, nurses and doctors may all wear scrubs. Nurses, doctors and pharmacists may wear lab coats. Residents, specialists and even med students may dress similarly or wear different lengths of jackets.
2. Look at ID badges. Some hospitals delineate jobs by colors of or on ID badges. Anyone at the hospital should be happy to show you their ID badge. This will also help you to learn the names of the staff taking care of your child.
3. Differentiate the different levels of nurses. Some nurses will have specialties in the PICU, while others will have general duties for your child. There are charge nurses who oversee the nurses on the shift and primary nurses whose job is to care for your child. There also may be nurse students who are learning about the PICU. The charge nurse probably supervises the nurses during that shift and so ranks highest in the hierarchy. If you have any problems with the nursing staff, ask to speak to the charge nurse.
4. Learn about the doctors, including the pediatric intensivist, general pediatricians, specialists of pediatrics, medical students and residents. Medical students are usually the lowest in the hierarchy, specialists and general pediatricians may trade back and forth, depending on what's going on with your child and the hospital's policies. However, the pediatric intensivist is in charge of the PICU, in charge of all doctors, nurses and other specialists.
5. Note the other specialists who may in the PICU. These will be pharmacists, nutritionists, lab technicians, and physical therapists. These people are beneath the pediatric intensivist. There also may be clergy members, social workers and volunteers who have no medical training, and who are out of the heirchary ladder.

Tips & Warnings

• The PICU has a higher patient to nurse ration that other areas of the hospital, which allows them to have more time to spend with your child.
• Ask questions that help you to understand your child's illness and treatment plan. Become involved in the care plan so that you can support your child emotionally and physically.