Families can now call the code team

[rn-jane]

Yesterday we had a staff meeting and the new thing at my hospital is the family can call the rat team(rapid assessment team, code team) if they feel their family member has a change or are not getting proper care. My manager said this is actually one of jacho's rules for 2009 for standard of care and beg my pardon "ARE THEY CRAZY!!!!!" I told my manager this is so not going to work and they better get more than one team because while some poor patient is actually having a true code, some family is going to monopolizing their time because their family member feelswe are not getting their bedpan, bath or popsicle in an orderly fashion.

Here is a for instance. I got out of the meeting to attend to one of my patients coming back from the cath lab got her all tucked in. A family member for another patient grabs my arm and says I'm so worried about my mother. "Her heart rate has gone up to 100!" Keep in mind it has been in the 90's all day, she was not my patient but I took her pressure, assessed her and said I would keep an eye on the monitor. They ended up caling the operator and had the head case manager come up to basically yell at me for not doing anything. I ended up calling the nurse out of the meeting to see their patient. Does anyone do this at their hospital and if so how does it work?

[rn-jane]

When I worked in the large metro city family members were well... normal. I found that living in a rural community now they act... lets just say nutty. We all have the crazy family members but out here it seems they all live around here. What constitutes as normal nice country folk, these people go crazy when their loved one is in the hospital. The hospital I work at is a very progressive hospital, we do cardiovascular surgery and keep up with the metro area. We do have rat codes on a daily basis(rapid assessment team). These patients may not be in a full blue code but they are close and we in icu get called maybe several in a shift.

Most of what jacho does with patient safty I agree with, but wish they would worry more on my acuity of patients and patient load versus putting the code button in the families hands.

[southernbeegirl, BSN, RN]

I am sooooooooooo sick of Joint Commission I'm almost ready to quit nursing. They are coming to my facility soon, and our manager says if we don't "hand off" our patients, even when we go to the bathroom it's a JC violation.

I'm sick sick sick sick of Joint Commission. I hate hate hate them!

Whew...that felt good. Carry on. LOL

In the time it takes to hand off a patient while you make the pee..you could have allready made the pee!

i think im going to work in a yarn store.

[nursecass]

Thank you very much for the post rn-jane! I have to say that I am relieved to hear so many people saying that in their hospitals it has not been abused, but I share your concerns.

Our RRT is a critical care charge nurse that is available to anyone in the hospital-but I can see how this would be abused in our ICU at least, and I fear all over the hospital. We've had families come RUNNING out (sometimes even yelling for help) to the desk because a heart rate went from 72 to 68 on the monitor. Or because the O2 sat went from 100% to 96%. Or because the white line (respirations) looks too flat...you get the idea.

Or like last night, we had a gentleman brought in by the RRT for low BP for which we had him trandelenburged, were bolusing fluids and running blood, and the family came rushing out to the desk demanding to speak with his nurse (who was about 10 ft away talking to the doc). When asked what they needed (because it seemed really urgent), I was told that his blood pressure was WAY lower than the last one. So I go into the room, and SBP is 5 less than the last one. MAP is about the same. I think it is exactly things like that where some families may abuse the RRT option, not knowing that it is just going to be someone from our unit answering anyway.

Oh well....I guess we will see when it is implemented for us!