CNAs and RRT (Rapid Response Team)

Nurses General Nursing

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Specializes in ICU. Med/Surg: Ortho, Neuro, & Cardiac.

I've been reading through some threads on the members of the rapid response team at different facilities. Quite a few people have mentioned that their rapid response teams include a BLS certified CNA (usually from a Med Surg unit). IMHO, this seems like a good idea. Currently, our RRT is the RN house supervisor, an ICU nurse, a respiratory therapist, and the RRT physician, if nursing staff deems it necessary to page him.

I could see why a BLS certified CNA would be a good addition to the team. Every time there has been a rapid response on my floor when I am working, they have always needed the extra set of hands. Whether I'm running back and forth between the pt's room and the supply room, or whether it turns into cardiac arrest and they need someone to do compressions. It never fails that I get called in there, which I don't mind at all.

For instance, last night when I working (of course, the only aide on a 30-bed m/s unit with four nurses including charge) a rapid response was called. The primary was relaying info to the charge nurse who was constantly on the phone with different doctors (primary physician, surgeon, anesthesiologist, etc.) The ICU nurse was pressure bagging a bolus, the physician was placing a central line, and the RT was busy managing the airway and drawing ABGs. The physician needed someone to assist with placing the central line...which ended up being me.

Well then, we had to take the pt to CT. Massive retroperitoneal bleed. Straigh to OR. (For some reason, the rapid response team didn't follow us to CT, so of course the nurse needed help brining the pt down there because the doctor was watching the cardiac monitor.) Long story short, we were gone about an hour and 30 minutes.

I think a CNA on the RRT would be a good addition. I know things get crowded with everyone in the room, but I always find a corner or stand off to the side.

Thoughts? Do any of you have a CNA on your rapid response team? If so, what are the positives and negatives? I'm going to have the supervisor suggest it at the next nurse council meeting and she wants to know many advantages and disadvantages.

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Our Code Blue team is made up of ICU staff. They just arrive on unit with the big crash cart to supplement the unit cart.

At my hospital, the NA's are all CPR certified. First to find the patient down calls and starts the code.

The Team has never kicked anyone out of the room that was doing the job. Whether you are the scribe or the runner for supplies, everyone's job is vital.

The only people I've ever seen kicked out of a code are the new residents and interns who race to every code.

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Specializes in ICU. Med/Surg: Ortho, Neuro, & Cardiac.

Right. All the CNAs at our facility are BLS certified also, but I have heard of some facilities that aren't, which is why I added the clarification. As a CNA, I have walked into a few rooms (don't worry, I can count them on one hand) to found a patient in full cardiac arrest. I pulled the code switch, and started compressions/bagged to precede the arrival of the code team.

We all know that while ACLS is wonderful, it wouldn't be nearly as effective without BLS (good, effective chest compressions.)

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Specializes in EMS, ER, GI, PCU/Telemetry.

i think CNA's are a great asset to an RRT. its always good to have an extra set of hands. a good CNA is worth their weight in gold, especially one that isnt afraid to jump in and help out in during a RR or a code blue. we had one on our RRT and if i didnt know she was a CNA i would have guessed she was an RN, she was just excellent and always willing to help me out with anything i needed.

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Specializes in ICU. Med/Surg: Ortho, Neuro, & Cardiac.

I totally understand. See, I ended up in med/surg because I took my CNA classes at a local community college; the hospital paid min. wage while I was in class, and then we were all given jobs at the hospital. I ended up on m/s, not really because I wanted to be. I'm all about trauma and critical care, and I love the adrenaline rush.

When there are bells and alarms going off, I become super calm and just do whatever I can. I'm not afraid to jump in there at all. Before we went to unifroms, a lot of people thought that I was an RN (of course, I corrected them. I can't stand it when people don't.) Anytime there is a code, I bring the cart and if compressions haven't started I just walk right up there and do them. I used to think a lot of nurses would be offended or think that I'm cocky, but I've come to find that they appreciate my initiative and willingness to help.

Last night during the rapid response the doc was like, what are you? When I told him I was a CNA he did this great "deer in the headlights" look. Then he said, "Well, I don't give a damn. Your coming with us in case the patient codes on the way there." That made me feel really pretty damn awesome for some reason.

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Specializes in Ortho, Neuro, Detox, Tele.

See, for our hospital, unless the patient is OBVIOUSLY coded, then us CNAs have to wait for a RN to say "go ahead and start compressions."....also have to wait for a CPR backboard to be put under patient....then once doctor arrives, get the heck out of the room....Personally, I feel that my set of hands could start compressions quicker by whipping the matress out of there and starting with the bedframe.

Our "almost code" team is our RRT and the CNAs job is to get the heck out of the way and clear a path for everyone who's going to show up.

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Specializes in ICU. Med/Surg: Ortho, Neuro, & Cardiac.

My facility figures that if you are BLS certified through the American Heart Assoc, then you know to check for S/Sx of cardiac arrest. A lot of aides/techs will refuse to initiate CPR without an RN/LVN present and if you have absolutely no doubt in your mind that the patient is dead and you didn't witness the arrest, then I don't see how it is supposed to improve the survival rate by having to wait on someone to come down there and telling you to start CPR.

That is why all nursing staff are at least trained BCLS. It teaches you what to do as first responder, second responder, and so on. And the first responder should initiate CPR until someone more highly trained has arrived.

I cannot believe they would make you wait, especially since that first 3-4 minutes is critical.

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Specializes in ICU. Med/Surg: Ortho, Neuro, & Cardiac.

The only people I've ever seen kicked out of a code are the new residents and interns who race to every code.

I've seen this before. The ER physician attending the code will get ****** and tell them to get out.

Anyone else have thoughts?

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