eICU

[patccrn]

My hospital invested in eICU that is starting up in April. I offered to help as an RN to get the unit started. We had 2 days orientation this week which I felt was very overwhelming. For those of you that work with eICU, what acceptance or lack of acceptance have you had from critical care RNs working at the bedside? Does it take long to get comfortable with eICU technology? I would appreciate any input any of you have on this. I am in Wichita KS.

[Mags4711, RN]

It has been interesting. So far, the director hasn't shown any data as to know how beneficial eICU is. Still is a great deal of lack of understanding vs. not wanting to accept or know anything about eICU from the physicians/nurses in our major hospital that eICU is based out of. We only have an intensivist on night shift in eICU, no dr. on days. I believe the small ICU in the smaller town does accept the concept of eICU better and the physicians have given the intensivist more leeway in caring for their patients during the night shift hrs. Still so much politics in my bigger institution and lack of acceptance of new things that might improve pt. care. But eICU is not going away as my institution spent big bucks buying the system. Many nurses in ICU feel it is an intrusion and it comes across in the tone of their voices when talking to them on the phone. We try not to intrude if we camera in and see the nurses are providing care unless we really have a necessary question to ask. But it is still new for us, so maybe this will get better. We probably are monitoring around 80 ICU beds now with more coming on line in Aug. and the latter part of the year.

Thank you for your comments.

I work in a large academic center, and we are building a new Children's Hospital. I wonder how it would work for monitoring our ICU beds. The only thing is that we have Neonatal, Pediatric and Peds Cardio Thoracic ICU's. I would think in that case it would be a challenge to recruit staff nurses for the eICU who are comfortable with all the ICU's unless they are our current float pool nurses who float all of them.

In our main hospital, we have six ICU's two telemetry step down floors and a new cardio vascular center opening. I wonder again, how does a thoracic nurse staff eICU for a Trauma patient? Are there protocols? Standing orders?

I am really interested in the system.

Thank you so much for your responses.

[LoraLou]

Most of the time at least in the eicu that is in my area the nurses just watch the trending and don't get much more involved in the care, i work night shift so they will call if the notice something (increase hr, decreased hr, etc) or with lab values, which they would be able to do even if they weren't familiar with specific issues of a specific type of patient. The eICU watches over 3 different hospitals with various patients, there is a total of 3 MICUs 2 CCUs plus another CCU that recovers fresh open hearts, two Neuro ICUs and a brain-spine unit. They aren't necessarily knowledgable in the specific care of those types of patients. Their computer system is linked with the hospitals so when lab values are entered into the computer they link to their computers and alarms pop up with lab values, same with ABGs etc.

As far as orders from the docs they are just regular intensivists, no orders or anything come from the nurses, they are just there to inform. There is no doc there during the day, they're there from like 6pm to 7 am i think. They're there for either the nurses at the bedside or if the nurse in the EICU wants them to look at something. At my hospital we have interns if the interns are clueless they can call for help, or if they aren't giving us the orders we need or just ignoring a situation we are also able to call and get orders from the EICU intensivists.

lora

[MidnightSn1]

I work in STICU. Our unit and MICU both have this. No trouble at all to work with. I love it. The Dr. can finally actually see who and what you are talking about. Everything is done by the nurse or Dr. working on the eICU robot. They unplug it by remote control and drive it to where they want to be. The only thing we need to do is to plug it back in after it has maneuvered itself back into it's bay.

Our robot does not make regular rounds, but the MICU robot does. It looks into rooms to make sure HOB up properly, answers questions from Pt. and family.

MidnightSn1

:penguin:

P. S. I use the penguin character because that is how I feel I am running when I run marathons and half-marathons.

[dfk, RN, CRNA]

just remember.. they're watching you.. everything.. so don't pick ur nose, fart, slack, uncover the cold pt, slightly neglect, steal a pain pill, mix all meds in one cup for the ngt, rip the date off tubing and re-date without replacement, etc... THEY ARE ALWAYS WATCHING !!!!!!!

MANY A CAVEAT !!:chair: :pumpiron: :chuckle

[cvryder]

I'm a travel nurse and my last assignment was in a hospital that has had eICU for over a year. I loved it! I work nights and most of the time when you knew what a patient needed you could just call up the eICU doc and get it. They were also a great resource when you weren't quite sure what was going on with a patient and wanted to brainstorm, and they'd call with critical labs that you maybe hadn't had a chance to look up because you were busy with something else but you had a standing order for some mag or K+ or something. They would cam in if asked but otherwise camming was limited to cam-rounds which occurred between 8-9 on nights, and codes. So they were NOT always watching! Our eICU oversaw all critical care units in 5 hospitals.

[dorimar, BSN, RN]

They also read are xrays for us and faxed us orders like... Central line in good position, no pneumo, ok to use central line...

[cvryder]

They also read are xrays for us and faxed us orders like... Central line in good position, no pneumo, ok to use central line...

Yeah, that too. Boy, do I miss them, even though I'm working in a teaching hospital now and have residents on hand (or sometimes underfoot LOL) all the time. If I get a chance to travel to another hospital with eICU I will jump on it!

Jilly

[Misty1]

I like eICU. Its another set of eyes.....always helpful.

Just try not to forget to tell your pt about eICU and what they do. I've seen them beep in and start talking to the patient and the patient just looked like.. "that must be God talking to me"

[adrianwd5]

Hi

just read with interest the discussion on eICU, I work in the UK as an ICU manager where we have a service in ours (and many other hospitals) called outreach, this seems to be a similar concepot in that a small team of Critical Care Nurses have patients refered to them by ward nurses following their assessment of patients, we use a "Early Warning Score" tool to aid them doing this. these Outreach Nurses then offer help and advice to the ward staff and negotiate with the medical staff. Some centres outreach staff can prescribe some resusitation drugs. you find some of the literature available, do a search for CRITICAL CARE OUTREACH or go to http://www.doh.gov.uk and serch in the website for the same

hope this helps

Adrian