- Community
-
Programs
- Schools
-
Careers
- RN Specialties
- Best RN Jobs and Salaries
- Aesthetic Nurse
- Nursing Informatics
- Nurse Case Manager
- NICU Nurse
- Forensic Nurse
- Labor and Delivery Nurse
- Psychiatric Nurse
- Pediatric Nurse
- Travel Nurse
- Telemetry Nurse
- Dermatology Nurse
- Nurse Practitioner
- Best NP Jobs and Salaries
- Family NP (FNP)
- Pediatric NP
- Neonatal NP
- Oncology NP
- Acute Care NP
- Aesthetic NP
- Women's Health NP
- Adult-Gerontology NP
- Orthopedic NP
- Emergency NP
- Psychiatric-Mental Health NP (PMHNP)
- APRN
- Nurse Educator
- Nurse Administrator
- Certified Nurse Midwife (CNM)
- Clinical Nurse Specialist (CNS)
- Certified Registered Nurse Anesthetist (CRNA)
- Resources
- Education
PMFB-RN, RN
5,351 Posts
Yes, just one RRT RN on at a time. Its a full time position and we don't do anything else. We have respiratory therapists on call for RRTs, but only we call them if needed. The only time I call them is to tell them to get a vent ready in the ICU because we are intubating, or to bring me a bi-pap and set it up if I am too busy. I enter initial bi-pap settings and orders. In ICU either a resident will, or the tele ICU doc will.
We don't have a specific physician on the RRT. We contact that patient's provider, or at night the on call doc. We don't really need them initially. We can implement any emergency interventions ourselves.
We have a dedicated IV team and they are very good. We will occasionally be called by the IV team for an especially challenging IV start. We are the last step in the IV start chain. If we can't get one then the patient will get a central line, or in an emergency an IO.
We used to get a print out every 4 hours with "trigger" VS or labs. But we stopped doing that since it was mostly a waste of time and almost never discovered a problem that we didn't already know about.
We don't have patients assigned to us. Our nurses know that we are just sitting around to take their call and have a very low threshold to call us. They have the triggers where they must call us per policy, but we get a TON of other kinds of calls.
From:
"hey, can you just come over here and look something with me?",
"I'm thinking of holding X medication, here is why, what do you think?",
"Can you come and look at my tele strip and help me figure out what rhythm my patient is in?",
"I am having trouble getting this NG (or foley) in, can you come and help me?",
"hey I have to call and update surgery resident Dr. Condescending Jerk, would you mind calling for me?",
"my patient is an infant and her parents are very upset and angry, can you come talk to them?"
"The doc wants a bladder pressure (or name just about any not quite common procedure), I don't know how to do that, can you come and help?"
"my patient is drunk/high & trying to beat the hell out of me/us, can you come here now?"
"X is going on with my patient, do you think I should wake up the doc and update them, or can this wait until morning?"
"my patient just fell, can you come and assess?"
And a lot more I'm not thinking of right now. In addition we do a lot of official and unofficial teaching. I teach a class to med students and new nurses called "The First 5 Minutes". We do all education on placing IO's, nobody, including physicians, can place an IO in this facility until we have checked them off. We are all ACLS, BLS and PALS instructors. In addition I am also a TNCC, Emergency Nurse Pediatric Course, and NRP (neonatal resuscitation) instructor. We also run the mock codes in the SIM lab.
New nurses in the nurse residency program will also spend a few shifts with us, as well at nursing students, paramedic students and sometimes physician interns. I have one of these with me about 3 out of 4 shifts.
Occasionally the nursing supervisor will ask us to go to the ER and assess a patient being admitted when the level of care ordered by the ER doc doesn't seem appropriate to her. Obviously we can't overrule the ER physician, but we can often discuss it with them and bring our intimate knowledge of the different wards and their strengths and weaknesses to their attention and suggest a different level of care if appropriate.
We on night shift also get sign out from the hospitalists on any patient they are concerned about or any patients they would like us to "keep our eye on". The ICU charge will sometimes give us a call when they are concerned that maybe a patient was transferred out of ICU too soon and they are worried about them.
We do a lot of data collection and can show that we have saved the hospital a vast amount of money in preventing ICU bounce backs, and transfers to higher levels of care, either because we intervened early and nipped it in the bud, or because the physician was comfortable with a lower level of care knowing we would be keeping an eye on their patient for them.
There are only 5 of us. Two full time nights, two full time days, and one rotator. We also have two ICU nurses, one days and one nights who are cross trained to cover RRT for vacations.
As I mentioned, we also check on the ICU transfers q4 for 24 hours.
We get an 8% pay premium for being RRT and make our own schedule.
We have long established relationships with the staff and attending physicians and they LOVE RRT, especially surgeons. Residents don't mess with us. We never float.
A few years ago new nursing management thought it was crazy to be paying RNs and not have patient assigned to us and attempted to make RRT just the ICU charge RNs rather than full time positions. The physicians squashed that immediately.
It all sounds very busy, but in reality I only feel busy about 1/3 of my shifts, and occasionally literally have nothing to do. We have our own office where we have tele monitors so we can bring up any patient in the hospital we wish to and keep an eye on them.