Re: eICU

No, eICU is not stupid at all.
We are getting soooo much better nouw that we have night coverage on most of the nights.
You have to make pressure so you docs can order electrolytes replacement, give you orders for cultures and Tylenol, Haldol...
Keep on calling them, have your manager work with you to have eICU work with you, this is what's it's all about.
Last night, for ex. the nurse at eICU called to ask if we noticed that bed #3 K was 2.4. I told the nurse in ICU the message and asked her if she wanted an order for K runs. She, herself said:"Do you think they'll give me one?"
Sure, they did. We have to get used to have them to support us.
It is so great not to have to awaked the "Grumpy ones"!:hatparty:

Re: eICU

Originally Posted by connyrn

No, eICU is not stupid at all.
We are getting soooo much better nouw that we have night coverage on most of the nights.
You have to make pressure so you docs can order electrolytes replacement, give you orders for cultures and Tylenol, Haldol...
Keep on calling them, have your manager work with you to have eICU work with you, this is what's it's all about.
Last night, for ex. the nurse at eICU called to ask if we noticed that bed #3 K was 2.4. I told the nurse in ICU the message and asked her if she wanted an order for K runs. She, herself said:"Do you think they'll give me one?"
Sure, they did. We have to get used to have them to support us.
It is so great not to have to awaked the "Grumpy ones"!:hatparty:

So umm.. the eicu nurse knew about the hypokalemia before the floor nurse??? scarey.

And i'll never be convinced...eicu's are a misuse of resources. Maybe (in best case scenario) it makes your night nurses more comfortable because they're scared to call the doc regarding a dangerous k level when it's late.

Spend bazillions of dollars...so skittish nurses wont get their feelings hurt when a jerk doc. gets grumpy when you wake him up for a potentially lethal lab result. Hmmm. MOney well spent.

I'm well aware of my inability to convince 'eicu advocates' of it not being all it's cracked-up to be (and not worth the bazillions$$$). HOwever...the truth remains that the eicu is little more than a prying monitor tech that lets doctors sleep in the middle of the night...sure it can give an occaisional order (if intensivist is at the eicu desk) but it can never replace bedside care-givers.

Sure it can 'supplement' things...but at a ridiculous cost...with very little REAL ability that the bedside care-givers need (tell the eicu nurses to come over and clean blood, puke, or wipe a butt...then it may be a little more worth the money)

And how about during the day...do you call the patients doc re: your pt's labs...what if they're napping? or eating? or on a strole??
You know, those guys are on call for a reason...if your scared of 'grumpy one'...you need more confidence...or something...

and please explain why getting an order from an eicu doc is better than obtaining it from on-call doc???

something is wrong here....

Re: eICU

Thanks to Bellehill for keeping us up to date on the progress of her adventure . Health care quality and associated expenditures are the #1 business issue currently affecting the American economy (and possibly worldwide.) It's interesting to read what efforts are being made to try and increase efficiency without sacrificing patient outcomes. It may or may not be successful long term, but we sure need to do something before the system completely tanks.

Re: eICU

Thank you for that comment, Nurse Ratched. Yes, the eICU has been proven to be most beneficial especially in our rural areas. I know there are some issues surrounding its presence for some, but, for the most part, we are very fortunate to have this. I know many are reaping the benefits of this elsewhere as well.

Re: eICU

We have used EICU for over a year where I am currently working. I must say there are certainly times when I could do without them, i.e. one time I got an admission, had the pt. fully admitted to both their system and ours. pt brady'd down to like 25, sustained, although asymptomatic. I happened to be in the room w/ the pt. the entire time and I guarentee the camera never initiated and I NEVER got any calls saying " umm did you know so-n-so's HR is in the 20's". It was onlt after I called the attending, Medical CCS, HO, Critical care admitting resident ad never got call backs from anyone that they intervened. Pt was a Lvl IV. Which means that EICU could write for ANYTHING from tylenol to levphed for the pt. They could have interveined at any point, yet they werewaiting to see if this pt's MD's called back, which they clearly weren't doing. So i ask... what good were they?? I've noticed some out MD's tend to make the EICU the on call MD for the night so that they don't get 0300 "tylenol calls"which is very nice, unless you have RN's who are unable to properly assess a pt, since the RN's and MD's rely on the bedside RN for about 90% of their knowledge of the pt.

ok
sorry for the tirade.
a

Re: eICU

I've read all your arguments for/against eICU. I guess my observation is this: It seems the eICU works well in high volume facilities like an extra pair of eyes for the nurse (who hasn't had a patient fall out of bed even tho the nurse was right next door?). Also works well for those rural facilites who need the expertise in certain situations. I can also envision eICU on the tele units--after all, the hospitals are becoming one great big ICU now that patients are being sent home so early, or not admitted at all. The only patients in the hospital nowadays are the ones who didn't survive 20 years ago.

JustMy observations.

Re: eICU

Originally Posted by CVRNof4

Does anyone work in one of these new parts of the ICU care? Was wondering...looking for opinions of this. Thanks

Hi, I work in a CVICU that has eICU. There are a team of MDs and Rns at an off site. they can view our pts with a camera on the wall and they can read the chart because it is digitalized. they a can view the pt so close that they can see the size of the pupil..they are extremly helpful especially at noc. We just push a button on the wall and they are right in the room with us so to speak.. they can walk us through a code blue or help us with just about anything...the nurses like them. some of the docs dont trust it yet...joanie in McHenry.

Re: eICU

If used as intended, not a bad resource, I would think--I will have the opportunity to find out beginning of the month--however from ideas coming from our manager like having us walk into the room to do an IV check with these people on the other end of the camera. My concern is how freaking stupid will I look to my patient. They want to use it like big brother watching our every move. We are a unit of experienced ICU RN's and only have two people on the unit with less than 5 years experience. I find it insulting to think that I or any of my colleages can't tell the difference between NS or D5W, give me a break. And yes they can keep an eye on one pt for you if you have another that is not doing well, however they do not take any responsibility for the pt that they are watching so guess what if the pt climbs out of bed and hits the floor it is still my responsibility all they do is tell the pt to "lay back down and don't get out of bed", then call me and if I'm wrapped up with someone unstable and doing multiple interventions I can just see myself telling my crashing pt "just a minute while I take this call". That will work real great. Instead of saving us any time they have come up with multiple "real time" charting that has to be done at the bedside. It takes me longer to do my job running back and forth between my rooms logging on to the computer, flipping through multiple screens to get to the one I need. If our IT dept. made it more user friendly that would be nice, however there are currently no plans to do that.
So it sounds like labor intensive, instead of labor saving.
I will try to keep an open mind, however the planning for all this is in the hands of only two of the nurses on our unit, no one else has been asked for ideas on how to make this a smooth change. I have a problem with that.