[CYBERNURSE2000]

I work in a 9 bed SICU. We now have a policy that when a patient meets certain criteria, an RN must accompany the patient to the procedure, and remain with them if the procedure takes longer than 15min. This complicates things when you have other patients to care for as well. Are there any other institution around the country that have this? If so how are you managing with it? I would like to see a copy of your policy. Is it working for you or against you?
Thanks in advance for any replies. :-*.

[justanurse]

In our ICU/CCU units the RN always transports with a patient and stays with them through tests. The only time the RN leaves the patient, is if there is an RN in the testing department that is there to monitor the patient. Usually the patient is in the unit because they are critical and need monitoring, and should be monitored by the RN. Also, all our RN's are ACLS and can initiate care if the patient codes while they are in transport. Our CCU CN used to transport a patient, thereby leaving the patient's nurse free to care for the other patient(s). But, now the CN is covering CCU/PCU and can't leave the floor for extended periods.

It does put a kink in things when the patient has to be accompanied everywhere. But, look at the other side: If that critical patient went without an RN and coded who would be responsible? There are a couple of things that we do to help each other out: Night shift in CCU gets the baths done on all those patients who are going to be leaving the unit for procedures/tests (ICU does their's on nites anyway), so you don't have that bath to do on top of everything else. Also, we try to get all the departments to help us out so that we don't have more than one nurse gone from the unit at a time, if at all possible.

Good luck!!!

[ParRN]

It seems were traveling to scan more and more often. In our 17 bed unit the RN always has to go and stay with the pt.If the pt is on the vent a RT also has to go.It doesn't matter if they have chest tubes,3 pumps one with levophed maxed and are vented if the MD wants a scan off we go! Ofcourse when we get there an emergency has tied up all the c-scan tables and we're left to wait in the hall while the portable moniter goes dead.
I hate to go to scan something always goes wrong.

[CYBERNURSE2000]

Hello ParRN, Though we have not yet expirenced any emergencies during transport at this time, I do fear that there are some of our junior staff that can fall into a bad situation during a trasport. I must say, that you as the nurse responsible for that paitent, should never allow any waiting time between you, your patient and the test IE: ct-scan,special procedure or otherwise. What we have done is that CT will call for the Patient, so that when we get there the test is done right away. we also would never transport a patient to a test who is unstable,( MAX Or High dose Levo ect.)I appreciate your response but, do you have a written approved policy that dictates to you who goes with what pts, and when??? I'm more intersted in the actual policy than the obvious ongoings and possible problems with transport. -- Does anyone out there have an actual POLICY?
Thanks, CYBERNURSE2000.

[ParRN]

Cybernurse2000
Sorry you missed my note of sarcasm ie:maxed levophed,3 pumps, dead monitor. I used exaggeration to express my frustration at more and more frequent trips to scan.

I'm working in a med-surg ICU whereby we do get alot of CT head scans for our neuro-surg pts. Our unit policy is that 1 SN & 1 MD has got to go with the pt to the scan room or for any procedures outside the unit. However, if the pt is on spinal nursing, then I can bring along an AN to go along with me. Besides the portable transport monitor & the oxylog with we bring along, we also have along a standard intubation bag & an air-viva. As for e-drugs, the MD will have to prepare it himself (no standardised types & quantity). We are also told to call the unit for help if pt collaspe in the scan room. In the event whereby I'm taking care of two pts, then I'll pass the other case to another SN for the time being. I personally enjoy going for scans etc as it provides me to "see the world outside the unit" & catch some "fresh air". However, I really hate it when a good I/A line with perfect waveform seems to always goes dampened during these trips, & having to wait in the corridors for appointments that are not arranged properly by scan room staffs with fear that my transport monitor battery goes flat or my 02 supplies runs low - too risky for my pts!

[Maggie LI]

Hi! I work in 22 beds ICU. I always transport with a patient and stay with them through test or CT scan. In our unit, The ICU's DR. must go to with the patient to the lab. room.
When the RN accompay the patient to the procedurce, other RN in ICU will overlook for the other patients until she back.

[nursekremer]

We have an "ICU resourse nurse". The resourse nurse does all the transports unless unavailable with another transport. This frees the nurse to care for their other patient(s). This seems to work well most of the time and most transports go smoothly since the nurse is used to travelling. I'm not sure if a policy exists. The general guidelines are: if a nurse has only one patient they take them, if the patient is very unstable the resource nurse may stay on the unit and watch their other patient, and patients who don't need continuous monitoring don't need a nurse. I do this about 25% of my shifts. I've only had one arrest (not a good outcome). The downside of a "resourse nurse" is that they never know as much about the patient as the nurse assigned and have to trust that the report they get is adequate. The plus side is that the nurses who do it are used to dealing with the logistics and the limited resources away from the unit.

[This message has been edited by nursekremer (edited June 15, 2000).]

[This message has been edited by nursekremer (edited June 15, 2000).]

[gpip]

Hi all...
I work in a 12 bed med/surg icu in michigan.On our unit if the patient is unstable and needs to go off the unit for tests it is st the discretion of the Intensivist. If we do have to go usually 2 nurses plus respitory travel with the patient.If a code is called in that area the 2 nurses run the code until the docs arrive and then we fal into our normal roles. The thing that scares me all the time is that our travel monitors do not have defibrillators. If the pt codes enroute we are supposed to sstop right there and start cpr and wait for the docs and a crash cart. Wealway travel with 1 each of atropine,epi, and lidocaine o2 ambu bag with mask regardless of if the pt is intubated or not and the monitor,o this

[LBauer007]

I work in a busy Neuro/SICU unit and the RN always transports their patient to Ct, MRI, Angio ect., once I had 9 pumps running with Q 15 min V/S and Neuro checks. The charge nurse takes over for our other patient while we are away and a Nurse attended and RT if patient is on the vent help get us down there. ive also been in angio with a patient for over 3 hours before because there is only one RN and she has to assist with the procedure. it has worked well so far but there are those days after my 3rd trip to CT that I wish we had a transport team