Jump to content

Rapid response in the clinic

Ambulatory   (1,381 Views 8 Comments)
by Gamecock RN Gamecock RN (New) New

422 Profile Views; 9 Posts

Does anyone have some sort of response team in a small clinic? Whenever we have code purples (i.e someone passes out during a blood draw) it seems like 50 people show up and it's chaos. I suggested a RRT but then all the "what if's" started. What if the RRT nurse is in patient care? What if the physician is at lunch?

Does anyone have a system that works? I was a RRT nurse for 5 years inpatient so I'm not used to the outpatient side of things.

Share this post


Link to post
Share on other sites

1 Follower; 3,223 Posts; 45,166 Profile Views

I'm no expert.... hopefully you don't have that many RRT incidents.  Even in the hospital RRT do patient care and go to lunch. The few moments it should take to tell a patient you are needed for an emergency and a coworker will take over, and someone at lunch just has to finish their lunch later. Or if they leave the facility for lunch assign a coworker to cover for them.

 

Share this post


Link to post
Share on other sites

24 Posts; 1,653 Profile Views

I work in a busy Ambulatory Care clinic, and we have RRTs all the time. Typically, it is only one-to-two ER RNs and an RT. In our hospital, a RRT is meant to be a low key event: it is not advertised over the hospital intercom. The ER RN who shows up decides whether it should be a full-blown Code, or the patient should be transported to ER before it comes to that (which is always what happens). There are no MD who show up, or 100 Residents wanting to get their hands dirty. RRTs should be on the DL, until they need to be upgraded.

Share this post


Link to post
Share on other sites

105 Posts; 2,684 Profile Views

We do have a RRT where I work but it doesn't seem at ALL efficient to me! They overhead page- sometimes code purple, sometimes Rapid Response, sometimes code BLUE!!- but the response time is very lagging. A crash cart is brought (just in case) even though most are patients who vagal from vaccinations or blood draws; an MD, nurse (RN or LPN) and anesthesiologist are on the team but they are coming from all different areas of the clinic; and our overhead paging system can't even be heard from all patient rooms (of the door is closed). It's a very nice idea, but just not executed well. In my opinion, in a facility full of doctors & nurses there is no real need for an RRT as we all are required to have BLS (many of us have ACLS as well) and we send everyone who really needs help out 911 anyway.

Share this post


Link to post
Share on other sites

1 Follower; 1,319 Posts; 12,305 Profile Views

On 2/9/2019 at 6:17 PM, Gamecock RN said:

Does anyone have some sort of response team in a small clinic? Whenever we have code purples (i.e someone passes out during a blood draw) it seems like 50 people show up and it's chaos. I suggested a RRT but then all the "what if's" started. What if the RRT nurse is in patient care? What if the physician is at lunch?

Does anyone have a system that works? I was a RRT nurse for 5 years inpatient so I'm not used to the outpatient side of things.

Why not just assist to the floor, elevate the legs and let the patient recover? An MD and RRT is needed for that? If it is a bona fide medical emergency then all hands on deck doesn't look pretty but it isn't the end of the world. 

Share this post


Link to post
Share on other sites

xoemmylouox has 13 years experience as a ASN, RN.

1 Follower; 3,150 Posts; 38,662 Profile Views

We have different codes. We have the usual code "blue", but we have a specific code "white" for those times a patient passes out, has a vagal, etc.

We have a specific team that responds, and there are enough people on it that we are typically fine.

If someone is on lunch they still come, and we sort out time cards after. We have "go bags" which contain pens, documentation paperwork, b/p cuff, stethoscopes, accuchecks, and biox machines.

We have people from all over respond. Maintenance responds in case they need to direct an ambulance, our "green shirt/greeters" respond with a wheelchair in case it is needed, even admin shows up in case more support is needed. It isn't always perfect, but we often have the staff we need to address the issues as they arise.  

Edited by xoemmylouox
wanted to add more.

Share this post


Link to post
Share on other sites

139 Posts; 3,931 Profile Views

I asked this same question not long ago. The nurse manager at the clinic explained to me that it was fine for employees to practice good teamwork and to operate informally as a sort of RRT, but that our clinic would not adopt an official RRT policy because if we have a policy it would be scrutinized and would be part of any inspections of our clinic. There would have to be an official record of who was on the RRT schedule for each day, etc. and we don't have enough staff at our small clinic for that sort of thing. I think my nurse manager was right; so long as there's at least one nurse who knows what to do and they recruit a couple of medical assistants to help when necessary, things seem to work out alright around here. We get few true emergencies anyway.

Share this post


Link to post
Share on other sites

7 Posts; 244 Profile Views

We don't have any alert system in our office but as a whole we have different teams, I am not sure how each team operates however my team (2 LPN's, and 1 MD) have an established plan if needed.  We currently will have one person preferably the MD stay with the patient in distress while one calls 911, 1 LPN gets the AED & oxygen upon returning I am on chest compressions if CPR is needed, MD is on bag mask, while other is helping with 911/AED/family members/minutes/ with a plan to rotate every 2 minutes of chest compressions until 911 arrives.  I have mentioned in the past a practice scenario and suggested each team also plan and practice this to avoid chaos and delaying CPR, however my management has done little to follow up which is why my team developed the plan we have as for-mentioned.  

Share this post


Link to post
Share on other sites
×