I can't change your mind and you can't change mine so we might as well agree to disagree. This eICU is coming in about 1 week to my floor whether I want it to or not so I might as well keep an open mind. I have heard mixed reviews; I am excited but that might change once I work with it. Either way it isn't my choice.

One last thing, the people working the cameras are not techs, they are ICU nurses and doctors. Please don't think a tech would be taking your place at the bedside.

Originally Posted by bellehill

I can't change your mind and you can't change mine so we might as well agree to disagree. This eICU is coming in about 1 week to my floor whether I want it to or not so I might as well keep an open mind. I have heard mixed reviews; I am excited but that might change once I work with it. Either way it isn't my choice.

One last thing, the people working the cameras are not techs, they are ICU nurses and doctors. Please don't think a tech would be taking your place at the bedside.

Bellehill, I'd love to hear how the implementation of eICU goes for you and of any experiences, good or bad you might have as this is something that is being considered where I work. Celia

Originally Posted by Celia M

Bellehill, I'd love to hear how the implementation of eICU goes for you and of any experiences, good or bad you might have as this is something that is being considered where I work. Celia

No problem, I will let you know!

Here is another example of how the eICU has worked. Last night while I was in charge a pt. was admitted-SBP 55. The Intensivist that was consulted did not call back after one hour of numerous pages and calls to his home. Called the eICU and received orders for volume and pressors as needed. As RNs we cannot just start a drip...and I really am offended by Diniths post-definately not one open for change. What if you go to computerized charting like we did a few years ago...what negative things will he/she have to say about that, or getting rid of NAs, or pt. to RN ratio changes for productivity? Come on-until you have used it you cannot have anything to say

Originally Posted by CVRNof4

Here is another example of how the eICU has worked. Last night while I was in charge a pt. was admitted-SBP 55. The Intensivist that was consulted did not call back after one hour of numerous pages and calls to his home. Called the eICU and received orders for volume and pressors as needed. As RNs we cannot just start a drip...and I really am offended by Diniths post-definately not one open for change. What if you go to computerized charting like we did a few years ago...what negative things will he/she have to say about that, or getting rid of NAs, or pt. to RN ratio changes for productivity? Come on-until you have used it you cannot have anything to say

Please dont be offended by my posts...i'm mostly just voicing my opinion.

However, eICU is still stupid...and now both of your examples are bad...

...if i had a patient crashing, you can rest assured i'be be hanging dopa, or giving a bolus ...in fact IT would be excpected of me...i wouldnt walk away from a crashing patient like that to call a doctor...

If, as you say, you let the patient lay there for one hour hypotensive, in need of volume and pressors...(one HOUR?)...your eICU failed you, your 'on-call intensivist' failed you (and should be written up for this!) and you may have failed your patient...you should know better. If that guys kidneys are fried (among other things) it'd be on your shoulders. If your hands are really that tied...something's wrong... (An HOUR? and admitted w/SBP55???)

In that 'scenario', the eICU was merely an alternative 'on call' doc...whose role could've been filled by any doctor with a beeper. NO need at all to spend a ga-zillion dollars on that technolegy(sp?)...(and ongoing salaries to 'eICU nurses (who sit on their bums and stare at screens...)...and intensivists who probably nap..???) Money much better spent on additional bedside staff...tech. upgrades (BEDSIDE-tech ) ...inservicing...etc. ad nauseum

Originally Posted by Dinith88

Please dont be offended by my posts...i'm mostly just voicing my opinion.

However, eICU is still stupid...and now both of your examples are bad...

...if i had a patient crashing, you can rest assured i'be be hanging dopa, or giving a bolus ...in fact IT would be excpected of me...i wouldnt walk away from a crashing patient like that to call a doctor...

If, as you say, you let the patient lay there for one hour hypotensive, in need of volume and pressors...(one HOUR?)...your eICU failed you, your 'on-call intensivist' failed you (and should be written up for this!) and you may have failed your patient...you should know better. If that guys kidneys are fried (among other things) it'd be on your shoulders. If your hands are really that tied...something's wrong... (An HOUR? and admitted w/SBP55???)

In that 'scenario', the eICU was merely an alternative 'on call' doc...whose role could've been filled by any doctor with a beeper. NO need at all to spend a ga-zillion dollars on that technolegy(sp?)...(and ongoing salaries to 'eICU nurses (who sit on their bums and stare at screens...)...and intensivists who probably nap..???) Money much better spent on additional bedside staff...tech. upgrades (BEDSIDE-tech ) ...inservicing...etc. ad nauseum

First off it was not my pt.-I was in charge of the unit and had other nurses to help out...Believe it or not the pt. was not symptomatic (bilateral amps to the groin, ESRD, spends most of the time in the hospital...). As RNs I do not remember learning or being licensed to hang pressors without an order. The eICU MDs can only give orders on certain pt.s in our CVICU-they are catergorized. This was not a category III pt. where they could freely give orders. They went above and beyond when I called them-not the RN at the bedside. The so called intensivist who did not answer his pages was fine with the orders. Later that night he did not return a call on a pt. that was admitted for over three hours. You can have your opinion, but obviously the Magnet hospital I work at finds a need for it...and yes we are one of the number one heart centers in the Midwest, unfortunately some of the overflow pt's we receive have to have incompetent intensivist (and not the eICU MDs-they are only allowed to do so much in the unit I work in). Best of luck to you in your nursing career.

Originally Posted by CVRNof4

First off it was not my pt.-I was in charge of the unit and had other nurses to help out...Believe it or not the pt. was not symptomatic (bilateral amps to the groin, ESRD, spends most of the time in the hospital...). As RNs I do not remember learning or being licensed to hang pressors without an order. The eICU MDs can only give orders on certain pt.s in our CVICU-they are catergorized. This was not a category III pt. where they could freely give orders. They went above and beyond when I called them-not the RN at the bedside. The so called intensivist who did not answer his pages was fine with the orders. Later that night he did not return a call on a pt. that was admitted for over three hours. You can have your opinion, but obviously the Magnet hospital I work at finds a need for it...and yes we are one of the number one heart centers in the Midwest, unfortunately some of the overflow pt's we receive have to have incompetent intensivist (and not the eICU MDs-they are only allowed to do so much in the unit I work in). Best of luck to you in your nursing career.

So...this frequent-flying asymptomatic patient...required pressors and volume to correct his hypotension when the doc finally called???

Regardless.... The eICU's purpose is to 'monitor' these people..and if the eICU
failed to notice or failed to 'phone in' for an entire HOUR while the patient layed there for 60minutes (because your nurses are unable to correct this without a doctor telling you to) then in my estimation the eICU failed.

Luckily @ most places (including my non-magnet hospital), the ICU nurses have more freedom and are expected to know how to handle things and are covered/protected by standing protocols and orders (for pt's admitted to icu).

Originally Posted by CVRNof4

Here is another example of how the eICU has worked. Last night while I was in charge a pt. was admitted-SBP 55. The Intensivist that was consulted did not call back after one hour of numerous pages and calls to his home. Called the eICU and received orders for volume and pressors as needed. As RNs we cannot just start a drip...and I really am offended by Diniths post-definately not one open for change. What if you go to computerized charting like we did a few years ago...what negative things will he/she have to say about that, or getting rid of NAs, or pt. to RN ratio changes for productivity? Come on-until you have used it you cannot have anything to say

That is one of the reasons we are looking forward to the eICU. We had that same situation the other night, SBP in the 50's, boluses started, no MD call back for 30 minutes. Unfortunately in this state as, well as yours, RNs are not allowed to write med orders or initiate medications without a doctors order. Were we geting ready to hang Dopamine without an order? Yes. Did we already send an order to pharmacy for Levo? Yes. The nurse put her head on the block hoping that the meds she "ordered" would be okay with the MD when they called back. This is not effective nursing, we are not doctors nor do I want to be. I'm glad to hear the eICU worked so well for your unit, now I am even more excited.

Re: eICU

Here is an eICU update for those of you who were interested. We have been "live" for one week, of course the acuity on the unit dropped as soon as we went live. The main problem is our attendings not allowing eICU to write orders on non-emergent issues (K+ replacement, temps, low hgb...) but they also don't want to be called in the middle of the night. We are working on that issue. I have not been bothered by the eICU at all. I was floated to ICU the other night and saw eICU in action in a code, it was awesome. The resident needed a cool, level-headed person backing him up and that is what he got. I'm still waiting for the shift it helps me, but like I said, our acuity is very low right now.

Re: eICU

Originally Posted by bellehill

Here is an eICU update for those of you who were interested. We have been "live" for one week, of course the acuity on the unit dropped as soon as we went live. The main problem is our attendings not allowing eICU to write orders on non-emergent issues (K+ replacement, temps, low hgb...) but they also don't want to be called in the middle of the night. We are working on that issue. I have not been bothered by the eICU at all. I was floated to ICU the other night and saw eICU in action in a code, it was awesome. The resident needed a cool, level-headed person backing him up and that is what he got. I'm still waiting for the shift it helps me, but like I said, our acuity is very low right now.

I still think eICU's are stupid