rapid response team

That's cool! At our hospital the charge nurse and float nurse go to the codes so the rest of us stay on the unit.

I work at a 1,100 bed teaching hospital and I am good friends with a RRT nurse. We have 2-3 RRT RN's on at any given time. They go to codes, get rapid response calls, and a variety of other things. As an ICU nurse I call them to accompany my patients to CAT scan or when traveling, its hit or miss when they have the time, but it helps when they do. The help out a lot on the med surg floors, if a patient goes bad on the floor then 2 RRT's come and take them to where ever they need to go, they are not allowed to leave until the patient is in the hands of another ICU RN. They also responsible to go to every fall occurence in the hospital and take them to head CT ect. They are heavily untilized in my hospital and I really believe the positions are justified and profitable to a health system.

RRT's in my hospital have been ICU RN's for a long time, usually over 10 years. They don't necessarily get paid for what they do, they get paid for what they know.

I work in a 34 bed MICU/SICU and we have two charge nurse's each shift. One is the Code Blue RN and the other is the Rapid Response Team RN (RRT). Neither nurse takes a patient assignment. They assist staff RNs provide help to newer RNs and are in charge of bed management (addmissions, transferrs, etc.) for the unit. They also make staffing assignments for the following shift. The assignments of RRT and Code nurse rotate between the more experienced staff each schedule.

This model works quite well. Hope this helps you.

This sounds like the job I have at the moment - called Critical Care Outreach. In England, Outreach teams have been running, mainly 24/7, for some years - my hospital is somewhat behind the times.

I'm a Band 6 Outreach Sister, with 7 years ICU experience. My team consists of 3 other Sisters and a specialist physiotherapist.
We work independently of the ICU. We see each patient discharged from ICU or HDU to the wards, usually for 3 daily visits. We also carry bleeps and see any patient who scores above a certain level on Modified Early Warning Scores - from the vital signs monitoring.
We include plenty of informal teaching and mentoring for nurses, doctors, students etc on the wards, but also set up formal teaching packages (for the wards and ICU). We also teach on the ALERT course, and one of our team is an Advanced Life Support Instructor. One of our most successful packages was on Sepsis, for the staff on the Medical Assessment Unit.

Every day is different, usually busy. In quiet moments there are always more educational packages to create / update, audits to complete, or we can go to the intensive care unit to offer our services - not to take a patient but maybe to assist with meal breaks, turns, etc.

It's a fantastic job, with variety and a lot of patient care. Can be frustrating at times when you can see that the best care isn't being given, usually due to staff shortages or incredibly busy wards - but then sometimes that's when we can make the most difference.

TulsaTime, hope this helps and the best of luck with your new position. You can find more information by searching for Critical Care Outreach, or check out the National Outreach Forum (NORF). Every NHS Trust will run their outreach slightly differently.

When we first started our rapid response program, it included proactive visits of patients discharged out of the ICU within the last 24 hours. It also included reactive visits-where any nurse could call us for a patient concern. They stopped the proactive visits because of the time involved adn because they no longer budgeted RR nurse out of the count. Now the RR nurse is in charge of a very large ICU or is in the count.

I think the proactive visits prevented a lot of problems. We would round on patients that were discharged from ICU withing the last 24 hours. We would look at the patient and assess if warranted. We reviewed labs, meds, etc. We made sure all restricted medications requiring ICU were off the MAR. We caught a lot of stuff. Sometimes patients were sent out of ICU with labs that should have been replaced. Sometimes we saw potential problems adn fixed them before they became real problems that might have resulted in transfer back to ICU or affected patient outcomes. I believe the proactive visits were almost more beneficial than the reactive visits (less reaction required when you are proactive). It is a shame that they sopped the proactive part

I would agree with Dorimar.
Our 'outreach' visits (proactive) are more of a priority than our 'MEWS' visits.

No offense, but most of that sounds like things that other people are already assigned to do. Checking on patients on the floor that might need to go back? Are the floor nurses or step down nurses not competent enough to determine that and call the doc for orders? For new nurses they usually have a preceptor then a resource person in addition to the shift coordinator and the education department to do their education??? IV insertions and Chest Tubes? This is pretty basic stuff that anyone applying for a critical care position should be very familiar with. I absolutely can see ER transports and being another set of hands if needed. We have positions called Critical Care Cordinators that are different from actual unit coordinators. They take patients if we get in a bind, transport to and from CT and MRI if we are busy and watch patients for lunch and such, but I dont think they would have a job due to annoyed staff if they were doing some of the things you mentioned above. Maybe its just a difference in hospital environments???

Like I said in my original post, those things I described are what I do IN BETWEEN actual calls. Sometimes I am so busy I don't get a chance to do them. If you saw some of the things I have seen from doctors and nurses you wouldn't think it was a waste of time to check on certain patients or situations. Answering questions about a chest tube? No problem--since a floor nurse clamped a chest tube on a thoracotomy patient going down for CT which led to a bad outcome. My hospital really compartmentalizes medicine, ortho/neuro to one floor, CV surg here, post-cath there, gyn surg on that wing. It's because these doctors want things a certain way and want expert nurses for their patients. Which is great, until a total joint who goes into rapid a-fib on a tele floor and the nurse doesn't have a clue how to get the patient out of bed. That's where we come in to help. True, it doesn't fall under the definition of a rapid response and should be assignment to the floor educator. However, things happen on the weekend and at night when educators aren't there or even a decent resource person. TPTB decided to cut back the internships for new grads and the retention rate isn't so good for the preceptors. So my hospital environment needs people to fill that role in the meantime. My director doesn't want us taking a patient load or going on a field trip with an ICU pt or lunch reliefs because it takes away from that educator piece.