Does anyone work as Rapid Response?

ckh23, BSN, RN · Jul 6, 2012

At my facility we do not have a dedicated rapid response team. The ICU's rotate the rapid response and code pager. Quite frankly it sucks when you have an assignment and have to go to a rapid response when you have a crap ton of work to do with your other 2 sick patients.

nrsang97, BSN, RN · Jul 6, 2012

At my facility we do not have a dedicated rapid response team. The ICU's rotate the rapid response and code pager. Quite frankly it sucks when you have an assignment and have to go to a rapid response when you have a crap ton of work to do with your other 2 sick patients.

That is how it used to be at the hospital I applied at. At my current facility we have a dedicated rapid response team. I think it is BS that you have to take 2 patients and have to do rapid response.

PMFB-RN, RN · Jul 6, 2012

I have a potential interview for a position as a Rapid Response nurse. Anyone here work for a Rapid Response team? Do you like it?

*** I am a full time rapid response RN. I LOVE IT, LOVE IT, LOVE IT! I have a vast number of standing orders and protocals that allow me to intervene in nearly any situation. I have privlages to write for any diagnosic tests such a labs, x-rays, doppler studies, CTs. Can order lots of medications like Lopressor IV, Amioderone, nebs, NTG and lot of others on specific protocols. Can order many interventions like bi-pap or intubate (CRNA actually preforms intubation) I don't really know why it is called RRT, it really should be called RRN since there isn't a team, just the RRT RN.

I am also allowed to transfer patient to step down or ICU without an order from the resident. I am supposed to work with the residents but in cases where the resident refuses to do the right thing, or doesn't know and isn't taking "suggestions" I can transfer on my own, and do occasionaly. Our hospital has E-ICU and they give me orders for transfer after I get the patient to ICU.

The other job we do is to assess each patient that transfered out of any of the ICUs every 4 hours for 24 hours. This has greatly decreased the number of bounce back patients who come back to ICU as a crash.

The hospital has policies that RRT MUST be called in certain situation. Our "triggers" for RRT call are:

SBP

HR 130

RR 25

SPO2 ,90% on any amount of O2 (unless different parameters are ordered, like for COPDers)

Visibly labored breathing or respiratory distress

New neurological change or deficit

Suspected CVA

Chest pain

other:

I get a huge variety of calls. Everything from post surgical or trauma patient bleeding, chest pain, respiratory distress, unresponsive patients and anything you can imagine that makes the primary nurse nervous. In addition we are the code "administrators" means we lead codes until the physician gets there (if they do) and monitor the code for qualiety, offering suggestions as needed. We have gained a good reputation and have started getting calls from physicians to "keep an eye on" certain of their patients, or they may request one of us stand by for a cardio version or other procedure if done on the floors.We are a smaller hospital, 275 beds and a teaching hospital. We (the RRT RNs) have as much autonomy as I can imagine any hospital RN having. The only time I had more autonomy was doing transport. The job is very much a customer service job. I get many really silly calls but I don't ever want to have a nurse NOT call me cause I was rude to her when she called me for something silly. There is tons and tons of coaching and teaching in this job and that's fun for me too.

If you have good customer service skills and enjoy variety, and have confidence in your assessment and critical care skills, and are a strong patient advocate you will enjoy it.

That Guy, BSN, RN, EMT-B · Jul 6, 2012

^^^^ Thats what I want to do eventually. It sounds like a lot of fun to me. I know I am nowhere close to ready for it so I have to get some years under my belt. That kind of independence sounds too good to be true ha ha.

Caffeine_IV · Jul 10, 2012

Sounds very interesting to me. Our hospital is not large enough to warrant such a position though.

HouTx, BSN, MSN, EdD · Jul 10, 2012

I think that 'hardwired' RR teams are going to become a lot more common as more hospitals see what a difference they make in patient outcomes... and therefore, the bottom line.

We have begun automating MEWS indicators via our electronic documentation systems... so that there is little chance of missing one of those key indicators that should trigger the RR team by signaling that urgent intervention is needed. Right now, the data is aggregated about every 4 hours & a report is generated that shows if there are any patients with lab results or VS that indicate a problem. The report is reviewed by RR leader to make sure that they are aware of the situation. We are trying to move toward a more real-time solution instead of the Q4 h reports. Already, we are seeing a difference with earlier sepsis interventions & fewer non-ICU/ED resuscitations have been needed.

I think it's a great example of harnessing technology to improve patient safety & make our jobs easier.

PMFB-RN, RN · Jul 10, 2012

I think that 'hardwired' RR teams are going to become a lot more common as more hospitals see what a difference they make in patient outcomes... and therefore, the bottom line.
We have begun automating MEWS indicators via our electronic documentation systems... so that there is little chance of missing one of those key indicators that should trigger the RR team by signaling that urgent intervention is needed. Right now, the data is aggregated about every 4 hours & a report is generated that shows if there are any patients with lab results or VS that indicate a problem. The report is reviewed by RR leader to make sure that they are aware of the situation. We are trying to move toward a more real-time solution instead of the Q4 h reports. Already, we are seeing a difference with earlier sepsis interventions & fewer non-ICU/ED resuscitations have been needed.
I think it's a great example of harnessing technology to improve patient safety & make our jobs easier.

*** Our rapid response team (actually just one RN) gets a print out every 4 hours of any trigger VS or labs. We are responsible for making sure they get addressed. What I learned when we first started doing it is how careless many of our CNAs are at entering VS, and how irresponsible some of the RNs who are supposed to be supervising them are. We pretty well haev them trained now. They know if they enter RR 85 and pulse 18 (most common error I see, transposing values) we will either be calling them or showing up, print out in hand asking why they haven't corrected it, or failing that called RRT or a code?

Real time would be GREAT!

I agree that full time RR teams will become more common. However, as much as I love this job I do have some concernes. It often seems that we are concentrating the critical thinking and clinical skills into just a handful of RNs in the hospital. When a new Rn's patient develops chest pain she calls me and I handel it for her. If she is interested I am very happy to teach and coach, but sadly many are not interested in learning. Some see the call to RRT as the end of their responsibiliety for that situation.

allnurses Guide · Jul 11, 2012

That sounds freaking awesome. I would think one would have to have some pretty solid experience to do it.

silentRN · Jul 11, 2012

We don't have a "rapid response team", but we in the ICU cover certain sections of the hospital that we are responsible for if they are to call one, or if there is a code. I love going to them. :)

PMFB-RN, RN · Jul 12, 2012

That sounds freaking awesome. I would think one would have to have some pretty solid experience to do it.

*** There are only 5 full time RNs on the RRT and turn over is very low. We don't have a training programs. When there is an opening we recruit a nurse with the skills we are looking for. It's not too hard since we are non-Magnet, pay well and have good benifits and working conditions.

MomRN0913 · Jul 12, 2012

That sounds like my dream jobin nusring! I used to do ICU, and we responded to RRT's. If it was our turn, we had to drop our patients and go, which was different. but I loved the rapid fire critical thinking and intervention. Sounds awesome to do that without the additional patient load. Go for it!