Rapid Response Team and Families

  1. Our Rapid Response Team (RRT) is about one year old. It has been a success. The nurses on the med surg units have appreciated the assist.

    Part of the JACHO requirements for the Rapid Response Team is to involve the pt/families, allowing them to call the RRT themselves. Has anyone started this aspect of the team function?

    I don't want this to be a taddling on their nurse or underminding the pt's nurse. I want it to be part of the pt's orientation to the room/unit. Given positively and part of encouraging the pt's participation in their care. Ex: do your I.S. DB/C and call the RRT if you feel like you are in a crisis and your nurse hasn't been able to help. Talk with your nurse first.
    We have the Joint Commission "Speak Up" posters everywhere and it would play into that theme.

    Do you have a family handout?

    Who receives the call from the pt/family? The team itself? A "screener" like the nursing supervisor - to screen out irritation calls? (no one is answering the call bell fast enough).
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  2. 51 Comments

  3. by   Dinith88
    Quote from Grumpy's Girl

    [B]Part of the JACHO requirements for the Rapid Response Team is to involve the pt/families, allowing them to call the RRT themselves. ).
    Are you serious? Your hospital is allowing FAMILIES to call RRT? That's (for lack of a better term) stupid. S.T.U.P.I.D.

    I almost didnt want to respond to this...and i hope you're not serious.
  4. by   NRSKarenRN
    Last edit by NRSKarenRN on Nov 15, '07
  5. by   Dinith88
    whatever. call it a 'successful program'....i call it a well intentioned but misguided over-kill knee-jerk response to a tragic event.

    i doubt this will ever take hold in the vast majority of hospitals...at least the ones that trust in their floor-nurses and are confident in their abilities.

    ...get the code team all lathered-up and sprinting to a room...just because a patient/family wants more narcotics...(for example). a waste of resources and time...

    and s.t.u.p.i.d.

    in my opinion.
  6. by   traumaRUs
    It is actually well-publicized in the area where I live. I am on staff at five hospitals and all of them have it and the patients love it. Most of the pts I see are in the ICU and even those families talk about it.
  7. by   missionary
    Being a nurse and also being a family member at times, I would think it would be great. I know while I am working, I can't be everywhere at once. And call lights do not elicit emergency help. Better the RRT than having them pull the Code light, right?

    If family member err much, it may be that they don't ask for help soon enough -- d/t denial, fear, ignorance. And if they call prematurely and patient is stable, there's no harm done.
  8. by   eamon66
    Quote from Dinith88
    Are you serious? Your hospital is allowing FAMILIES to call RRT? That's (for lack of a better term) stupid. S.T.U.P.I.D.

    I almost didnt want to respond to this...and i hope you're not serious.
    Heh well said! Without undermining the patient, the reality of the situation is that patients often do have unfounded concerns. If you can't identify a potentially adverse situation or help to alleviate their concerns or liase directly with the RRT then maybe nursing isn't for you. The RRT must be getting called every 5 seconds which would be a waste of their time. I'm sorry but the initiative needs to be taken by the nurse NOT the patient/family. I didn't do 4 yrs training for nothing!
  9. by   traumaRUs
    If you think that the families don't know what's going on, then you must work in a wonderful hospital with wonderful nurse/pt ratios. My grandson has been in the hospital (two different ones) in the last year. At the first (small) hospital,(he was 6 weeks old with RSV) the nurses giggled over him. Said how quiet he was, how little, etc.. I got there, realized he was pale and listless from hypoxia and asked for some oxygen! These nurses were clueless. They didn't want to put an IV in him "because he's so little." Four months later, he was in a large hospital with rotovirus. The nurses didn't want to come in because "he's in isolation."

    The frustrations felt by family members is huge. It is important to remember they KNOW the patient better than us. It has nothing to do with being a good or bad nurse. It is the ability to be in all your rooms at the same time, seeing everything.
  10. by   Dinith88
    Quote from eamon66
    Heh well said! Without undermining the patient, the reality of the situation is that patients often do have unfounded concerns. If you can't identify a potentially adverse situation or help to alleviate their concerns or liase directly with the RRT then maybe nursing isn't for you. The RRT must be getting called every 5 seconds which would be a waste of their time. I'm sorry but the initiative needs to be taken by the nurse NOT the patient/family. I didn't do 4 yrs training for nothing!
    eamon66, Thank you for agreeing! (though i wager you'll soon be showered with cyber pies-in-the-face for agreeing with me)
    I think the link provided was an interesting article in that it showed a system-wide (in that particular facility) mis-trust or lack-of-faith of the nursing-staff's judgement and/or ability. If a family has a serious concern they should approach the nurse...not have access to some 'panic button' that mobilizes a team of critical-care practicioners...which takes them a away from their patients...and.

    It's a good (but misguided) idea. But for any hospital to assume that families are potentially better at assessing patients is ...well...stupid. Unless of course the nursing staff in these hospitals really IS really bad. ...ummm...
  11. by   blueheaven
    Quote from missionary
    Being a nurse and also being a family member at times, I would think it would be great. I know while I am working, I can't be everywhere at once. And call lights do not elicit emergency help. Better the RRT than having them pull the Code light, right?

    If family member err much, it may be that they don't ask for help soon enough -- d/t denial, fear, ignorance. And if they call prematurely and patient is stable, there's no harm done.
    I know of too many times that if a family could have called the RRT in, code situations may have been avoided. On a personal note, a friend of mine (who is a nurse) was staying with his father in the hospital post cardiac bypass surgery. His dad wasn't acting right and complaining of abd. and flank pain. After being nice and notifying the nurse twice, and being told "It's OK, it's normal" nothing was done...anyway finally he had to get very verbal, threaten to call the attending himself (which he did) and found that his dad had a large retroperitoneal bleed. If a RRT was available, much anxiety and hassle would have been avoided. I shudder to think what would have happened if he hadn't stayed with his dad.
  12. by   blueheaven
    Quote from traumaRUs
    If you think that the families don't know what's going on, then you must work in a wonderful hospital with wonderful nurse/pt ratios. My grandson has been in the hospital (two different ones) in the last year. At the first (small) hospital,(he was 6 weeks old with RSV) the nurses giggled over him. Said how quiet he was, how little, etc.. I got there, realized he was pale and listless from hypoxia and asked for some oxygen! These nurses were clueless. They didn't want to put an IV in him "because he's so little." Four months later, he was in a large hospital with rotovirus. The nurses didn't want to come in because "he's in isolation."

    The frustrations felt by family members is huge. It is important to remember they KNOW the patient better than us. It has nothing to do with being a good or bad nurse. It is the ability to be in all your rooms at the same time, seeing everything.
    What you say is true. Then there is the idiot family who screamed "We need some help in here" and I was 8 months pregnant and fell on my stomach trying to get to a patient who needed a bedpan!!! One of the doctors I worked with was there (not this patients doc) and immediately went back and tore them a new one for doing that. Fortunately nothing happened with my daughter.
  13. by   eamon66
    Quote from traumaRUs
    If you think that the families don't know what's going on, then you must work in a wonderful hospital with wonderful nurse/pt ratios. My grandson has been in the hospital (two different ones) in the last year. At the first (small) hospital,(he was 6 weeks old with RSV) the nurses giggled over him. Said how quiet he was, how little, etc.. I got there, realized he was pale and listless from hypoxia and asked for some oxygen! These nurses were clueless. They didn't want to put an IV in him "because he's so little." Four months later, he was in a large hospital with rotovirus. The nurses didn't want to come in because "he's in isolation."

    The frustrations felt by family members is huge. It is important to remember they KNOW the patient better than us. It has nothing to do with being a good or bad nurse. It is the ability to be in all your rooms at the same time, seeing everything.

    Listen really sorry abt your personal situation but the failing their is with your son's nurse. Still think that was an unbelievably ridiculous post & I stand by that. What gives patients/families the right to call the RRT? I'm lost on that! If wards feel they need to give pts/families the go ahead to contact the RRT then they shouldn't be nursing. Can't they assess their own patients and make decisions? sorry but this post makes my blood boil....I'm a realist....NOT a fantasist!
  14. by   JaredCNA
    At our hospital, RRT has "decreased the number of Code Blues by 70% in the past year." It sounds great to a patient or family member, but 9/10 rapid responses I've been in (aides take the roll of runner, do compressions) turned into cardiac arrest...there's just no need to call it overhead due to the fact that when you call a rapid response at my facility, you get two ICU RNs trained in ACLS, an RRT physician, Respiratory, and the house supervisor.

    AKA, the code team. Well, we have standing orders that the nurses carry out without a physician present for rapid responses, but we still don't have to page code blue...if we have to shock the patient we just call ER and have them send a doc.

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