Rapid Response Team

Specialties CCU

Published

You are reading page 8 of Rapid Response Team

ZASHAGALKA, RN

3,322 Posts

Specializes in Critical Care.

I posted several comments on this earlier in the thread.

I've now had a chance to be on the RRT team a few times. Mind you, I have my own pts in critical care, so being drawn away for a RRT takes time away from my pts.

But, I've found it helpful. The protocol orders can indeed give more options to a situation. Even nurses from the floor that know what is going on and what interventions to take activate the RRT because those protocols include the standing orders to move the situation forward and maybe seek an outcome prior to a 'code' situation.

I've helped to cut situations off at the pass and fix them before codes and sometimes, before requiring a move to critical care. I had feared that it would be nothing more than an 'expedite to critical care' team, but that isn't the case.

The only problem is that I've found the average RRT intervention takes about an hour - and that is an hour with my critically ill pts being 'watched' by my co-workers. And there is a difference between my pts being actively monitored by me or just troubleshooted for problems by someone else busy with their own assignment.

~faith,

Timothy.

ark-two

47 Posts

Our hospital employs the RRT. We include TCU Charge RN brings defib and reads strips. ICU or CCU push drugs and assist md, respiratory therepist bags and abg's, and a pharmacist makes sure drugs are appropriate, plus house MD runs code with team assist. Lab draws all necessary labs ordered at bedside. It's nice at times since room is not overcrowded. And all input is advised. The RRT also responds to all code blues. It is a good idea to routinely have mock RRT calls and code blue calls so teams skills stay honed. I wish our hospital would do this. I'm relatively new and not sure what my place is. I usually write and run and read strips. Our RRT treats all RR calls as code blues because it can turn quickly.

Cinquefoil

199 Posts

Specializes in Med Surg, Home Health.

This thread has been DC'ed for a while, but just wanted to share another use for RRT's I've heard.

Some RN's I've spoken to say that when the provider isn't giving a patient's increasing acuity the attention it deserves (in their opinion) they can call the RRT which serves two functions:

1) The patient gets immediate attention

2) The provider develops a new and sudden interest, and is suddenly is willing to order or figure out labs and treatments they couldn't have been bothered with before

Anyone else see this?

Specializes in CCU MICU Rapid Response.

I'm am a full time RRT RN and yes, my presence does spark some new interest. If I'm here to see the pt something must be going on. Sometimes, when a staff nurse calls the doc, they request a rapid response assessment. In the event a doc is ignoring the situation, unwilling to transfer or unable to be reached, I will bypass them and get an IMCU or ICU consult myself. More often than not, my suggestions are well received and the pt gets where they need to be. Ivanna

PMFB-RN, RN

5,351 Posts

Specializes in burn ICU, SICU, ER, Trauma Rapid Response.
i'm am a full time rrt rn and yes, my presence does spark some new interest. if i'm here to see the pt something must be going on. sometimes, when a staff nurse calls the doc, they request a rapid response assessment. in the event a doc is ignoring the situation, unwilling to transfer or unable to be reached, i will bypass them and get an imcu or icu consult myself. more often than not, my suggestions are well received and the pt gets where they need to be. ivanna

*** i too am a full time rrt rn. the staff rns love rrt. when a nurse's concernes are being blown off by the physicians they call me. sometimes i assess and am able to reasure the nurse that things are ok. sometimes my assessment indicated the nurse has real concerns and the patient isn't getting the attention they need fromt he physician. a call from the rrt rn certainly gets their attention.

i once heard one of our im attendings tell a group of second year im residents who were about to start rotations as hospital cross cover on nights:

"about the rrt, you guys are going to look like a**holes if you don't address a problem and the rrt rn transfers your patient to icu without orders. i suggest you take their suggestions seriously".

Specializes in CCU MICU Rapid Response.

*** I too am a full time RRT RN. The staff RNs love RRT. When a nurse's concernes are being blown off by the physicians they call me. Sometimes I assess and am able to reasure the nurse that things are OK. Sometimes my assessment indicated the nurse has real concerns and the patient isn't getting the attention they need fromt he physician. A call from the RRT RN certainly gets their attention.

I once heard one of our IM attendings tell a group of second year IM residents who were about to start rotations as hospital cross cover on nights:

"About the RRT, you guys are going to look like a**holes if you don't address a problem and the RRT RN transfers your patient to ICU without orders. I suggest you take their suggestions seriously".

Totally true... It never ends well when I get ignored. I am the proverbial squeaky wheel! I'm all about getting these pts the treatment they need and the level of care they deserve!! Ivanna

eCCU

215 Posts

Specializes in CCU, CVICU, Cath Lab, MICU, Endoscopy..

Well, my hospital has RRT in place they are specifically scheduled for this role. Consists of 1 medical ICU nurse, 1 Cardiac ICU nurse, 1 Surgical ICU nurse, 1RRT, 1 upper level resident. These people also rotate with other trained ICU nurses tasty way they do not lose their ICu skills. When they are not being called for RRT they rotate in the ICU and assess n change central line dressings and vent tubings. They have a log and also document in EPIC which has a template for their duties specifically. They will also assist an ICU or shock room nurse who is getting over whelmed. The nurses seem to enjoy their presence!....and we have documented numbers on the decrease of codes on the floor, plus decrease in central line infections and VAP. So the hospital had no problem continuing to keep this team!

PMFB-RN, RN

5,351 Posts

Specializes in burn ICU, SICU, ER, Trauma Rapid Response.
Well, my hospital has RRT in place they are specifically scheduled for this role. Consists of 1 medical ICU nurse, 1 Cardiac ICU nurse, 1 Surgical ICU nurse, 1RRT, 1 upper level resident. These people also rotate with other trained ICU nurses tasty way they do not lose their ICu skills. When they are not being called for RRT they rotate in the ICU and assess n change central line dressings and vent tubings. They have a log and also document in EPIC which has a template for their duties specifically. They will also assist an ICU or shock room nurse who is getting over whelmed. The nurses seem to enjoy their presence!....and we have documented numbers on the decrease of codes on the floor, plus decrease in central line infections and VAP. So the hospital had no problem continuing to keep this team!

*** Our RRT also will help out in the ICU, ER, Trauma bay (we respond to all trauma team activations anyway) as needed. The critical care and ER nurses love it. If they are super busy and just need somebody to draw their labs or place an art or PICC line, or help them get a critical patient setteled in we are there.

Your hospital's team sound very comprehensive. The only concern I would have with such a team is that nurses, families, interns and residents might hesitate to call your team as it seems like an RRT call is sort of a big deal with all those people showing up. Sounds like a great pre-code team though.

One of the advantages of our system is that, being dedicated RRT RNs who round in the hospital all the time we get to know all the nurses and develop a repore with them. I get ton's and tons of calls for "hey I just wanted to run something by you". Sometimes these turn into real RRT activations, more often the nurse, or family member just needs a little reasurance.

As for maintaining critical care skills. I have found that RRT has it's own set of skills. Certainly a very strong background in critical care is required, but also parmedic skills, internal medicin, and interpersonal skills are required.

I came to my RRT job with extensive SICU, ER and critical care transport experience, as well as having been a paramedic in the past. For me the bigges learning curve is the internal medicin skills like managing COPD exacerbation and respiratory managment in patients with extensive pulmonary diseases.

Specializes in Emergency Dept, ICU.

I think RRT is in the majority of major hospitals now. Our team gets along with the MDs just fine. We do not use NPs though, we just use the MICU RN Charge nurse with protocols.

machaix

44 Posts

Hi,

I haven't read the whole thread of this, but just want to share what we have in the 1,000+ bed capacity hospital I am working in in Saudi Arabia .

We have what we call RRT and it started I think 2 years ago. It's consists of ICU nurses, RT's and Mobile ICU doctors. ICU nurses assigned to it are by rotation (We get to be rotated in General ICU, Surgical ICU, Respiratory ICU and RRT every 3-6 months).

I haven't been rotated in RRT but as what I know of is that their role is to:

1. Attend to cardiac calls.

2. Cover the critical patients in the wards and Emergency rooms who have been referred to Mobile ICU. What I mean by "cover" is that they follow up the status of these patients and relay it to the ICU doctors. They also inform the ward nurses sometimes on what to do especially with high alert medications/ drips that are just usually used in a critical unit. (I don't think ward nurses are being looked down upon when ICU nurses give them advice/ instruction on what to do. ICU is a special unit, just like the theatre, and there are some things that other units may know that others may not be familiar of and vice versa).

3. Attend to MEDIVAC's.

One of the Charge Nurses I have spoken to told me that RRT has been very helpful in the hospital. Before a Charge Nurse had to run to a cardiac call and leave the ICU, and it was difficult for them especially if the unit was really busy. But now, they really have assigned nurses to it and so it was more convenient most especially when there's a MEDEVAC patient.

+ Add a Comment