ICU nurses covering Rapid Response. Help!

[kdubose12]

Okay guys I need opinions. I have been working in a for-profit hospital in the MICU for almost 3 years now with previous experience in the ED. At my hospital we have a Rapid Response beeper that used to be shared from week to week between the different ICUs. Long story short, due to budget cuts and staffing issues over the past year my director thought it would be best for our unit to keep the beeper. Even if we are short staffed and even if we have multiple high acuity patients. This is a problem. We also have been on critical care diversion a lot over these past couple months meaning that when I'm called on a RR and there are no ICU beds, I sit and babysit the patient until someone in the unit is able to be transferred & the room cleaned. Just today I was called for a RR & was stuck in their room for 4 hours. Might I add that this patient was SOB with the flu who had a moderate amount of upper airway secretions and could easily be cleared with occassional NT suctioning and had an oxygen saturation of 97%. All this time I am responsible for my ventilated patient & confused patient in restraints. thank goodness I had a coworker who was able to help out after she started her CRRT today.. see the problems here?!

I guess what I was hoping to get from you guys is your opinions. How Rapid Response is handled in your hospitals? Any advice or help would be appreciated.

[Penelope_Pitstop, BSN, RN]

Our unit is the only RRT-covering unit. When an RN is designated as RRT, he or she does NOT have a patient assignment. When there is a shortage of beds in the hospital, we try to have two RRT nurses in case the situation you've described comes up. Also, if the RRT nurse is out on a call and another RRT occurs, the charge nurse covers it.

[Lev, MSN, RN, NP]

An ICU nurse responds to every code blue and every rapid response. We only have one 16 bed ICU. (Small community hospital)

[nrsang97, BSN, RN]

I work in a 300 bed community hospital and we have dedicated RRT. I think there should be a RN dedicated to covering RRT and the charge nurse as back up. I am a dedicated RRT nurse, and there are times I have to be on a call for a while if we have no ICU or CCU bed. It happens. My house manager is my back up. Happened to me the other night I had to stay with a freshly intubated pt on the medical floor, and there was a code blue in dialysis. Thankfully the code blue didn't need a bed in ICU and was ok. I also have the back up of ICU charge as well.

Thankfully we have a dedicated RRT as well. We had to do a ton of data collection to prove how we would be useful. Our ICU beds system wide have been at a premium this last few weeks. Our large sister hospital having no ICU beds either.

[AJJKRN]

We have what we call a "STAT RN" for every 12 hour shift that has an extensive history in mainly ICU and sometimes ED that comes to all codes, along with RT and the MD's.

This was done specifically for our hospital to not have the scenario of having an ICU RN repeatedly leave their Pt load each time a code was called and to relieve this unneeded stress! (As was the way before implementation)

In the mean time, the STAT RN helps out with difficult IV sticks and helps the floor nurses problem solve any patients that are questionable to go south as well as trouble shoots other things like wound vacs or mediport access or will transfer an unstable Pt to tests (like CT) if the floor nurse or charge nurse are unable to.

We have been doing this for about a year now and this seems to have really worked out given that a STAT RN is available to cover each 12 hour shift. Hope this helps!!!