Eicu

icu_nursie76 · May 19, 2008

At the hospital I worked at in Michigan the EICU RN's although they are referred to as VICU (virtual intensive care unit) are on the same pay scale as staff nurses which is base pay $24.70 and top of scale $32.66.

jedimasterr · May 20, 2008

Nursing is a second career for me after I was basically pushed out of a good paying gig working on a commodity exchange floor because of automation. At the time, many of us felt that our hard earned expertise at what we did would eventually win out. It did not. Undoubtedly, I am extra cynical (perhaps a touch bitter) because of what I went through in my last gig and that may be unwarranted here. That said, though I have only been a nurse for a short time now, I look around at some of the changes I see approaching the nursing world and it feels more than a little like the environment I was in five years prior to the explosion of electronic trading that wiped out the trading floor.

Despite my fears of being relegated to glorified clerk forced to bow to a faceless voice on the wall, I can see the potential benefits of this system. Even though I work in a teaching hospital with very good attending and resident coverage, there are still times when you get stuck with a crashing situation that could be easily taken care of by an order for something basic. And of course, if I worked in a smaller hospital without the coverage I enjoy now, I have little doubt I would really appreciate the backup. Without a doubt, there is upside.

From the managers in our system, what I hear is that it is not going to be one to one coverage and that the Eicu nurse off site is not going to be watching us 24-7. On the other hand, what I hear from agency nurses who have worked in our system hospitals with Eicu is that the off site nurse made their lives miserable by hounding them to fax over progress notes, turn the IV pump toward the camera and just in general chase down their requests. If this is true, I can't see how this is going to help patients or help with retention and job satisfaction.

In just a couple of months, I am going to see this firsthand whether I like it or not. Coming from a business background, it's hard for me to not see this as something that dilutes the control a bedside nurse has over their practice. Nobody likes having someone "sweat" them and that is going to be very hard to get used to. If it truly does become a resource though that we can tap into rather than be directed by, it might not be a bad deal at all.

That's my :twocents:

may2kd · May 29, 2008

I worked in an IMC for 1 year that utilized EICU. We all hated it. The number 1 thing they called about was for telling you they wrote orders for TED stockings and PUD prophylaxis. Most of our docs refused to even have the EICU cover their patients.

Dinith88 · May 30, 2008

this is the wave of the future since intensivists are in short supply, which is why eicus were developed in the 1st place. More of them .

I 100% disagree with you about this. I think you'll find it will falter and go away in the end...or (more likely) be limited to places with poorly-distributed resources and/or people (administration) instituting it because it looks good...but have no real understanding how ICUs work.

Dont you think these resources would be better spent giving good nurses raises? (and thus attracting competent staff?) acquiring updated equipment? staff education?? etc. etc.

A competent crew of bedside nurses will always be better at caring for patients...no matter how many cameras and chair-hugging eicu nurses are reading charts and looking at monitors and cameras.

The ONLY thing that it may help is getting an order a few minutes before one can be had by paging/waking up the patients 'real' doctor...which is almost laughable....because it's certainly a joke.

In a critical and/or code situation that requires basic ACLS-type knoweledge, the ICU nurses should be doing this stuff anyway BEFORE calling the doc...rather than twiddling their thumbs and waiting for a return call. Or.."OH, the patient is crumping...quick! press the EICU button becaue we shant do a thing until we're told!.."

And...IF the whole argument is that an intensivist can be sitting in front of a monitor waiting to give you orders...what exactly are the eicu nurses for? Any bedside ICU nurse that would actually NEED to call the EICU nurse (rather than bounce a question off of her co-workers or Docs) is probably incompetent. This relegates the eicu nurse to a nuisance monitor-tech.

The 'real' doctors with 'real' patients should be just a page/phone-call away...especially if they're caring for critically sick patients. So? spend a bazillion dollars because you might get an order a few minutes sooner than if you called the 'real' doctor? :banghead:Thats what i mean about a POOR WASTE of VALUABLE resources that could be better spent...period.

(as an aside, the whole eicu systems may be valuable in big teaching centers because the baby docotrs can sit at the command center...gaining valuable monitor-time and praticing giving orders, etc... but in no way can EICU's enhance the care a real nurse with real hands and a real face can give. period)

:banghead:

Dinith88 · May 30, 2008

I worked in an IMC for 1 year that utilized EICU. We all hated it. The number 1 thing they called about was for telling you they wrote orders for TED stockings and PUD prophylaxis. Most of our docs refused to even have the EICU cover their patients.

:up:

Well worth the 10 bazillion dollars...

nyck76 · May 30, 2008

I 100% disagree with you about this. I think you'll find it will falter and go away in the end...or (more likely) be limited to places with poorly-distributed resources and/or people (administration) instituting it because it looks good...but have no real understanding how ICUs work.
Dont you think these resources would be better spent giving good nurses raises? (and thus attracting competent staff?) acquiring updated equipment? staff education?? etc. etc.
A competent crew of bedside nurses will always be better at caring for patients...no matter how many cameras and chair-hugging eicu nurses are reading charts and looking at monitors and cameras.
The ONLY thing that it may help is getting an order a few minutes before one can be had by paging/waking up the patients 'real' doctor...which is almost laughable....because it's certainly a joke.
In a critical and/or code situation that requires basic ACLS-type knoweledge, the ICU nurses should be doing this stuff anyway BEFORE calling the doc...rather than twiddling their thumbs and waiting for a return call. Or.."OH, the patient is crumping...quick! press the EICU button becaue we shant do a thing until we're told!.."
And...IF the whole argument is that an intensivist can be sitting in front of a monitor waiting to give you orders...what exactly are the eicu nurses for? Any bedside ICU nurse that would actually NEED to call the EICU nurse (rather than bounce a question off of her co-workers or Docs) is probably incompetent. This relegates the eicu nurse to a nuisance monitor-tech.
The 'real' doctors with 'real' patients should be just a page/phone-call away...especially if they're caring for critically sick patients. So? spend a bazillion dollars because you might get an order a few minutes sooner than if you called the 'real' doctor? :banghead:Thats what i mean about a POOR WASTE of VALUABLE resources that could be better spent...period.
(as an aside, the whole eicu systems may be valuable in big teaching centers because the baby docotrs can sit at the command center...gaining valuable monitor-time and praticing giving orders, etc... but in no way can EICU's enhance the care a real nurse with real hands and a real face can give. period)

I DO think that hospitals need to give nurses more value and better compensation. But I do not think that is ever going to happen, which is why I have been travel nursing for the last 6 years. And no has said that an EICU takes the place of a real nurse, I do not know where people keep getting that from. We as nurses are always quick to think that someone is underminding what we are doing, geez. But like I said in my previous posts, this EICU HAS NOTHING to do with helping nurses, it was developed and researched to acquire intensivists (Some nurses just use it as a resource, which is fine if that is what you need). I only called the EICU for electrolyte replacement and drips usually, never to ask for a nurses advice on something. Some of the EICU's however annoy the nurses with calling for petty stuff, which since I am a nurse, I would not like either. The one I worked at in Miami was not like that. And also like I said before, the EICU nurses are there because there are way too many monitors for 1 MD to watch them all and the nurses go through the orders, trends, and protocols set forth depending on the levels of the patients. Every EICU is ran differently. These have been around since 2001, and all I have seen is more created. The more research that the medical journals and AACN do, the more I have seen a new one opened. Since I have been travel nursing all over the US I keep seeing them pop up. I may not work in it forever, but since they are going to pay me way more than any staff hospital in St.Louis will, I am going to try it out for awhile. I am tired of traveling so I am ready to settle down at home.

And let me tell you, I do not do anything anymore with out an order or a standing order after working in Miami. Florida is the #1 medical lawsuit state for a reason, and most of the nurses I worked with had been in court more than once. And they were good nurses. So some times it is not about twiddling your thumbs, it is about keeping your job, home, andproviding for your family. We are in a recession, and losing the license that keeps food on the table makes me think twice about remembering that there is not "MD" behind my name. I would rather call a code if a doc won't call me back so I can get what I need verses practicing medicine without an order. If you have a protocol established, thats fine. But if not I am not risking it, seen good nurses fired due to the doc trying to save his own butt.

toratora · Jun 4, 2008

I job-share in our Eicu--------2weeks there and two weeks in the icu-- the payrate is exactly the same where I work. It's the PERFECT combo!

HD-RN · Jun 5, 2008

we have it here in st. louis at my hospital which is a large teaching facility.... when it first came out they said it would reduce the paper load in the charts and medical records, boy did they lie. every time a patient is transferred from the unit you have to print out a bazillion pages. whatever happened to going green?? one of our cardiologist agreed with me just yesterday about this, he said that the charts are MUCH thicker now. its sad how much we waste.

i dont know how much those cats up there make...maybe they can chip in on my massage next week because im the one turning the patients they are watching....

STREGA55 · Jun 9, 2008

I Love Eicu. I Worked In 2 Hospitals-one On Kansas City And One In Hays,ks, That Used Eicu And It Was A Lifesaver At Times. The Primary Intensivist Is A Genius And A Generally Good Doc Who Dkes What He Can To Help You Out When You Need Help Fast. The Eicu Rn's Do Not Harass You. I Felt That My Patients Had An Extra Set Of Eyes Watching Them Via Computerized Information Transmitted To Eicu Headquarters And That Because Of That, They Received Better Care. That Particular Eicu Announced Its Presence (turning The Camera To The Patient And Turning It On) With A Doorbell Sound. They Only Did That When You Were In The Room And Either Acquired Their Presence By Pressing An Eicu Button In The Room Or The Patient Was Going Down The Tubes And They Would Begin Issuing Orders Via The Camera And Send The Orders Via Fax Machine. This Particular Eicu Was Based In Lees Summit,mo And I Recommend Their Presence In Your Eicu To Any Hospital In Their Service Area.

sockov, ADN, ASN, BSN, CNA, LVN · Aug 27, 2008

I work as a unit secretary in an EICU and I know that the nurses make around $60 an hour. Then too they have to have at least 5 years of experience in critical care nursing.

wow!! THE NURSES WHO SIT MAKE MORE THAN THE NURSE WHO ACTUALLY DO!?!?

so wrong! :banghead:

Conrad283, BSN, RN · Aug 28, 2008

I have no idea what the pay rates are, but would like to throw out my two cents about the value of the eicu. I work in a large teaching hospital on a 22 bed neuro surgical trauma icu and we LOVE the EICU!! First of all the camera is not on 24/7, they rank the patients in order of how seriously ill they are and that will reflect on how often they camera in on the patient. Also why would it ever be considered a bad thing to have another nurse and intensivist looking in on a patient. Me personally, if it were my family member I would appreciate the extra eyes. Also we love the fact that when we need someone quick, like in 30 seconds we can count on them to help us out. Once I got an admit who was an upper and lower gi bleeder, homeless guy who was going through some major ETOH withdrawal and the camera zoomed in as we were struggling with this guy who was about to extubate himself even though there were two of us holding him down and he was restrained. The Intensivist called the unit and ordered some sedation/antianxiety meds and told the nurse on the phone to quickly draw it up and bring it to me, then he miked into the room to let me know what he had ordered and that it was on the way.
I could give you so many more stories of how they have assissted in code situations and of how thankful the night nurses are to have them there because there are tons of examples. This has increased nursing satisfaction at our hospital and the families of our patients have seen it as an incredible resource rather than a waste of resources. As far as costs go, the cost was higher when we were one of the only hospitals footing the bill, but now other hospitals have joined in to share both the benefit of EICU and the cost of it with our hospital. I thank the EICU!

That is pretty darn cool.

jedimasterr · Aug 28, 2008

After a couple of months now, I have to say I am not real fond of the EICU. On the one time I did call for consultation with a Doc, I was given an un asked for critique of nursing care, an order for a CBC that I could have gotten without him and a suggestion that I should call the cardiologist. After that the EICU doc washed his hands of the matter. Luckily it was not a life threatening situation.

Prior to going live, we were given a view of EICU that doesn't really match the actual practice. I don't think the staff is incompetent or inexperienced, but I do sort of feel like they are basically fixated on things that will electronically flag like nothing being prescribed for stress ulcer prophalaxis or when a pt disappears from a monitor due to transfer or transport to a procedure. As a group, I think our floor is very prideful and as a result not very friendly to being called in the middle of solving a crisis that an EIUC nurse has become aware of after the fact because something started to flash on their screen.

So far, not much synergy exists between our floor and EICU and I'm not sure that's really going to change. As a floor nurse who really tries to stay ahead of the curve, I don't see myself collaborating with an off floor nurse to direct my patient care when I have people I work with who may have even cared for my patient in days prior. I hate to see that kinda money going to waste, but I haven't seen any value added from it yet. I hope that changes.