Abhishek Agrawal and Gavin Britz (eds.)Comprehensive Guide to Neurosurgical Conditions10.1007/978-3-319-06566-3_3

3. The Neurosurgery Healthcare Team

Wenya Linda Bi¹ and E. Antonio Chiocca¹

(1)

Department of Neurosurgery, Brigham and Women’s Hospital, 15 Francis Street, PBB-3, Boston, MA 02115, USA

E. Antonio Chiocca

Introduction

Neurosurgery is comprised of a diverse range of disease conditions involving the brain, spine, peripheral nerves, and blood vessels that supply these vital structures. The care of neurosurgery patients involves an equally complex and mutually integrative group of health care professionals. While each individual serves a slightly different role, effective communication between the team, the patient, and family is crucial to maximizing safe and efficient care.

Team Composition

Your first encounter with the neurosurgery team may be in the emergency room, the clinic, or within the inpatient hospital setting. No matter the location, an integral core of a neurosurgery attending, or the primary physician responsible for the neurosurgical care delivered, occasional residents and fellows, who are physicians undergoing further subspecialty training in neurosurgery, nurses, and ancillary support staff exists. Physician’s assistants (P.A.s) and nurse practioners (N.P.s) augment the neurosurgical team in many institutions, often offering the initial triage and management of a clinical situation as well as reporting any critical situations to the responding surgeon.

Emergency Encounters

Should your initial encounter be in the emergency room, you may interact with a rapidly changing set of personnel as medical needs are triaged and new diagnostic concerns arise. The emergency department clinician solicits the primary symptoms affecting the patient and orders the initial imaging and laboratory tests. Based on their degree of concern for the problem at hand, they may contact the neurosurgery team immediately or after the initial results return. The first neurosurgical team member to assess the patient may be a resident, fellow, or physician’s assistant. This individual will have the clinical experience to make initial recommendations, triage and intervene on emergent situations, and call upon the support of more seasoned neurosurgeons should any questions arise.

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