Admission Process in ICU

William2 · Aug 16, 2016

No specific roles really needed. If you are the receiving nurse of the patient you are usually outside of the room after the patient arrives getting report in person via the transferring nurse. When finished that nurse steps back in and assumes care and does the dual skin assessment with someone else. If drips are being hung usually someone else is getting you pump tubing setting up the pumps and or getting supplies ready for a central line while you are doing a basic first assessment and charting minimal data. Maybe at this time the intensivist needs to be called. That be your job.

We all just dive in and help with no roles clearly defined roles. Usually though I will be the one to hook the patient up to the monitors and hang drips. Its just a role i gravitate to. We know what must be done and we anticipate needs pretty well and follow through. I also believe that if you are working with a strong group people can just read on what to do next.

Okami_CCRN, BSN, RN · Aug 18, 2016

We do not have roles assigned. If a flex nurse is schedule, he or she would complete paperwork (advanced directive form, flu/pneumonia vaccine screen, contact information, initial assessment, etc). Another nurse documents on the flowsheet, one will be helping the primary nurse bath the patient with CHG and do a skin check while simultaneously connecting the patient to the central monitoring system. Another nurse would then be setting up fluids/IV's. We all find a role and stick to it depending on what needs to be done. This is great as it allows the admission to be done in little to no time.

MYSTICOOKIEBEAR · Aug 30, 2016

In my Cardiac/Transplant ICU we call it "Dream Teaming" a patient (usually when they come straight from the OR). In any admission, and for the most part, you will have the same things that you will need to accomplish. So basically when we know that a transfer is imminent, it is all hands on deck. One person is on the computer putting in orders and timing meds, primary nurse hooks up the tram/spot checks drips/gets report from the fellow and anesthesia, another person is putting on the vamp and drawing labs, another person is hooking up the SWAN, another person throws restraints and puts chest tubes to suction, and then the RT throws the patient on the vent.

If it is just a free for all and it is like a bunch of chickens with their heads cut off, that doesn't do you any good. I would recommend that the primary nurse assigns duties to whoever is in the room to help. Once you work with nurses for long enough, you don't even need to talk and just do things as needed. If someone is already doing something else, you continue down the line in order of importance.

My ICU is a very well oiled machine :yes: and I find it very funny when Unit nurses floating to us come in to help and see us descend upon a fresh one from the OR like a scourge of locusts or school of piranha and knock all the busy work out in 10 minutes. They are always shocked, dumbfounded, and impressed at our efficiency and effectiveness as a team :laugh:

delphine22 · Dec 1, 2016

We don't get telephone report from the ED, they wait until they are bedside (the floors get phone report). So when the pt arrives everyone else descends, does the skin assessment, cleaning and turning, hooking up, etc. etc. I hate this when I'm the primary nurse because I'm not present for the initial skin assessment (and depending on stability, it's not feasible to turn the pt again right away). I wish we had telephone report so I can focus fully on my pt when they arrive and not on the ED nurse.