Quote from HouTx
I would advise you to focus your energies on avoiding codes by triggering your Rapid Response team whenever needed. That is a much better goal for your patient population. In order to become really competent/confident in managing codes, you have to work in an environment where they happen regularly enough to give you the experience needed to gain proficiency. This is just should never happen in a MedSurg unit.
Most hospitals have a code team approach, because it is not realistic to have proficient code leaders in all areas (for reasons stated above). Instead, make sure you know what to do first - in order to prepare for the arrival of the code team. This should be spelled out in a policy somewhere. Generally, it involves triggering the alarm, beginning BLS & preparing for the team's arrival (e.g., flat bed, remove headboard, bring cart to bedside, clear traffic, start documentation, etc.) One of the bedside nurse's primary responsiblities is making sure the code team has an fast & accurate H&P on the patient. This process should be covered in a mock code exercise. If there are no mock codes scheduled, talk to your manager to arrange them.
The highlighted is the most crucial in bedside nursing. Open up your policy and procedure manual and look at the examples of appropriate times to call a rapid response. Your hypoglycemia protocol should also have an option, under given circumstances, to call a rapid response. Become familiar with the code cart. Know how to call a code or rapid response.
As the PP stated, you, as the bedside nurse, are responsible for providing patient information to the RRT and code team. This includes code status (and exceptions), current vital signs and trends, reason why the code is called, primary diagnosis and significant co-morbidities, etc. Your co-workers will drop everything (if they can at that moment) and help you. One of them will most likely grab the code cart. The code cart, IV access supplies, bedside FSBS machine, and the chart should be bedside. If not, ask one of your co-workers to retrieve the missing supplies/info.
The rapid response team is not going to ask you any "trick" questions and have confidence that you will know the answers if you have been precepted appropriately. Report gave you all the background and current status as of last rounds. Start of shift vitals should be compared to previous vitals for trends, if possible. Know the abnormal vitals associated with the primary diagnosis and significant co-morbidities. (On my unit, half the patients have "abnormal" BPs, so you're really looking for abnormally abnormal, if that makes any sense!) Know the code status.
I had my first rapid response the second week off orientation, and I had just received report on the patient and was doing my initial shift assessments. To top it off, she was an admit for the previous shift, so we didn't have a whole heck of a lot to go on, trend-wise. The patient was A/O x 4, so she actually helped me with her "normal" s/s of her chronic diagnosis and her vitals. This was definitely an exacerbation of her symptoms and abnormal vitals, and that's the reason the RRT was called. Remember, an alert and oriented patient knows when something is wrong and don't be afraid of asking them questions about what is going on with them, especially
if the patient is new to your unit.
And, I can't agree more with what others are saying: YOU ARE NEVER ALONE. Looking back, I'm very glad I had the RRT so early off orientation. I was dreading my first, but the experience made me less fearful of future RRTs (which are bound to happen). BTW, my patient was transferred to a higher level of care, so it also gave me confidence that my gut was right in calling the RRT.