Rapid Response

[francoml, ASN, RN]

I work at a level one medical center in Texas in the Medical ICU. This week I have an interview with the director of Rapid Response for a position on their team. I have been a nurse for almost a year all in the ICU and I work ~110 hours a paycheck so I have significantly more experience than other people with only a "year" of experience.

My question is, what types of questions do you think they will ask. There is the obvious, ACLS, PICC lines, EJ lines, ultrasound competency, and making decisions under pressure but beyond that I am unsure what they will expect out of me. Any thoughts??? THANKS!

[thenightnurse456]

Even though your new to nursing, I think your hours and experience I'm a level 1 unit will mean you could be an asset to the RR team.

a hot asset.

[Cook26]

Congrats on your interview. Where I work (large university level 1 center) we require 5 years of ICU experience before you can apply for Rapid Response.

[traumasurgRN]

I work in a level 2 Trauma ICU, though we more often function as a level 1. Our hospitals RR system is based out of my unit. To be eligible to serve as the RR nurse, you one must have 2 years of ICU experience and be ready to train for the position of Charge Nurse in the unit. I have recently started serving on the RR team, and I have 2 years of trauma experience. I feel that I am competent enough to perform the job, however, when compared to the more senior members of the team, I still see areas in which I am lacking. There is no way I would have been ready to serve on the team with only a years experience, and I too put in many hours my first year. There is no substitution for years experience. When you respond to a RR call, you never know the severity of the situation that you are walking into, and unlike being in the unit, you often do not have other critical care nurses to back you up and be a resource; you are the resource and the expert opinion. I am not saying you are not ready for the job, I just feel that a system that allows nurses with only a year of experience to serve as that expert opinion, is not a safe system.

[PMFB-RN, RN]

I work in a level 2 Trauma ICU, though we more often function as a level 1. Our hospitals RR system is based out of my unit. To be eligible to serve as the RR nurse, you one must have 2 years of ICU experience and be ready to train for the position of Charge Nurse in the unit. I have recently started serving on the RR team, and I have 2 years of trauma experience. I feel that I am competent enough to perform the job, however, when compared to the more senior members of the team, I still see areas in which I am lacking. There is no way I would have been ready to serve on the team with only a years experience, and I too put in many hours my first year. There is no substitution for years experience. When you respond to a RR call, you never know the severity of the situation that you are walking into, and unlike being in the unit, you often do not have other critical care nurses to back you up and be a resource; you are the resource and the expert opinion. I am not saying you are not ready for the job, I just feel that a system that allows nurses with only a year of experience to serve as that expert opinion, is not a safe system.

I agree. Our RRT team prefers 6,000 hours in adult SICU (more if MICU), 2,000 in PICU, and 2,000 in ER or transport. It has happend that people where hired without required experience, usually PICU. They were sent to work as a staff RN in PICU and go through their orientation for a while before being moved over to RRT.

Exceptions are made depending on the individual and their experience. We dont' try to train RRT nurses but recruit them with the experience we want so thre is some flexabiliety.

We are expected to respond to any situation in any patient population.

[francoml, ASN, RN]

Does your facility have dedicated RRT nurses or are they staff nurses who have one or 2 RRT shifts a week? At our facility I work staff in MICU and then once a week I am a rapid response nurse with no patient assignment just my rapid duties.

[PMFB-RN, RN]

Does your facility have dedicated RRT nurses or are they staff nurses who have one or 2 RRT shifts a week? At our facility I work staff in MICU and then once a week I am a rapid response nurse with no patient assignment just my rapid duties.

Our RRT nurses are dedicated to RRT. It's the only thing we do. Several of us have other jobs at other hospitals as well.

So what happens on the days you are not doing RRT? Are other MICU RNs doing RRT on those days?

We have found that RRT requires a unique skill set and that to achieve the goals the administration has for RRT we really need to be dedicated RRT nurses and concentrate. Critical care skills are a big part of what we do, but only part.

[francoml, ASN, RN]

In my facility there are Rapid nurses from all the critical care areas although the vast majority come from SICU and MICU. To answer your question, there is always as dedicated RRT nurse available and when they are rapid response they are dedicated to doing only RRT we just work full time as ICU nurses when it is not our day to do RRT.

[OneDuckyRN]

Our RRT nurses all come from critical care. I don't know what the experience requirement is but I'm thinking it's somewhere in the 5-year ballpark. The RRT nurses work some shifts in ICU/CCU as staff nurses and some as RRT with no assignment. I have found them to be VERY helpful to me, especially on nights. We are encouraged to call them to assess a pt, even if we are not calling them on a formal rapid response. Last week, the RRT RN helped me advocate for a pt who we both agreed needed to be transferred to critical care, but the doctor wasn't buying it. The nurse helped me out for the better part of 2 hours until we were able to convince the physician that he needed to be transferred. I'm pretty sure that if we hadn't been successful, the day shift would have either been coding or rapid responding this guy.

Good luck to you, francoml! I hope you get the position.

[francoml, ASN, RN]

I got the position, thank you!

[PMFB-RN, RN]

Our RRT nurses all come from critical care. I don't know what the experience requirement is but I'm thinking it's somewhere in the 5-year ballpark. The RRT nurses work some shifts in ICU/CCU as staff nurses and some as RRT with no assignment. I have found them to be VERY helpful to me, especially on nights. We are encouraged to call them to assess a pt, even if we are not calling them on a formal rapid response. Last week, the RRT RN helped me advocate for a pt who we both agreed needed to be transferred to critical care, but the doctor wasn't buying it. The nurse helped me out for the better part of 2 hours until we were able to convince the physician that he needed to be transferred. I'm pretty sure that if we hadn't been successful, the day shift would have either been coding or rapid responding this guy.

Good luck to you, francoml! I hope you get the position.

Our RRT can transfer patients to ICU without the physicians order. However we are supposed to work with the docs and not transfer on our own except in dire circumstances.

I usually say something like:

"Look doc I don't need your order to transfer this patient, but just think about what a moron you are going to look like in the morning when he is intubated and on pressors and you DIDN"T write the orders"

Congrats francom! Keep us up to date.