Family initiated MET/rapid response?

[mama_d, BSN, RN]

I'm wondering if any other hospitals have such a policy in place. We very recently started including in our patient admit information binder a paper which explains to the family and patients how to initiate a MET team response, including which number to call if they feel the nursing staff is not taking appropiate action. It does indicate to notify the primary nurse first if certain things are wrong, like increased SOB or mental status changes. That's great, no problem there. It then goes on to say to ask for the charge nurse if they feel the primary nurse isn't getting the job done (although it's phrased differently, that's what it boils down to). Again, perfectly within reason when a loved one's life is involved.

But then it goes on to say that if things still aren't being done to their satisfaction, to call the number for the MET team. Which means that a page goes out over beepers for multiple staff members hospital wide, pulling them away from their duties, automatically...it's a fully automated system and no human is involved in the paging process asided from the one dialing the phone. Um, hello? Multiple nurses and quite possible support staff such as RT have already addressed the issue, explained our interventions (or lack thereof) and supporting rationale, and have likely already consulted with the attending and/or any applicable specialists. I'm just wondering what management was thinking when they gave family members access to that number...seems like at the least there would be a different number to differentiate what were family initiated and what was nurse initiated.

Any thoughts or am I way off base here? I can think of a few family members of frequent flyers who would really be abusing this situation if we were actually pointing it out to them, instead of hiding it amongst more boring paperwork in the middle of the binder. You all know the kind I'm talking about...

[Nightcrawler, BSN, RN]

The administration in your hospital has no choice in the matter. It is a new mandate by JCAHO. I have known that this was coming down the pike since April, when it was announced during our yearly skills validation. We all responded in much the same way that you did, and have all hoped that it showed up in microscopic print on the last page of the patient handbook. It hasn't happened yet, but there will be no escaping from it soon.

This has come about as a response to certain incidents where staff have not responded appropriately to a change in patient condition even in the face of family reports and distress. One of the families that lost their family member in such an incident has been very active in advocating for this requirement.

[brissygal, BSN, RN]

I have never heard of a family having access to that sort of information before.

If I was the patient family and having a problem with the nurse not responding effectively to a patients condition. I would request to speak to the supervisor or ask for a Doctor to see the patient.

Would not that be the best process?

What do others think?

[XB9S, BSN, MSN, EdD, RN, APN]

I agree with you Brissygal but then our healthcare systems are so very different to the US.

[mama_d, BSN, RN]

Frickety. Why they gotta be messing with my shifts like that? It's always JCAHO this and JCAHO that....

[pinksugar]

Just another reason to leave the bedside as soon as possible.:chuckle

[StNeotser, ASN, RN]

Good grief.

[jmgrn65, RN]

my hospital has just implemented something similiar. it is called "clinical conern alert" and patients page the nursing supervisor then they will come and assess the situation, if appropriate call the rrt. ( supervisor is a member of the rrt) They give this info upon admission.

[lpnflorida]

I have loved that our hospital has the MET team, it has been proved to improve outcomes. However to have family members being able to enact the team.. OH MY GOD. This should not be a first recourse for families or patients. I believe they should be able to contact person in charge and then the person in charge should make the determination not family or patient.

I sure can perceive this becoming a problem. Bet the wording becomes changed by next year.

[NurseCard, ADN]

we have this at my hospital as well, only the number is posted RIGHT on the wall of the patients' rooms. The sign simply says "If you feel that there is a dangerous change in the patient's condition, you may dial this number and ask for the Rapid Response Team". Or something like that.

I'm not sure that it is the BEST idea in the world to let family members have such ready access to this number, but I've yet to make a big stink about it or anything. I've never actually had a family member use it; not on my shift.

[FireStarterRN, BSN, RN]

Unfortunately, this is response to some dire cases where loved ones have died because noone answered a calllight. This happened to a BIL of a collegue of mine. He had suffered a traumatic leg amputation in a grain hopper and was recovering, he had a decreased LOC, the wife pressed the calllight and no one responded for 20 minutes, and he died. I never heard what the final ruling was as to cause of death, maybe too much morphine via PCA.

Not long ago I had a pt who had almost died because the nurse was ignoring signs of resp failure post CABG, but the family ended up bypassing the nurse and calling the doctor themselves. The patient survived after a number of days on a vent and vasopressor gtts.

Of course there will be abuse of this by some families. The Joint Commission always seems to create lots of problems with their mandates.

[CoffeeRTC, BSN, RN]

I think local hopitals started this a few yrs ago...Condition H?