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Discussion

Rapid Response team & decrease in codes

Since our facility began staffing us with a Rapid Response RN 24/7, we have had almost no code white/code blue situations.

What about your hospital? I was wondering if anyone else has thought about how this could be a poor reflection on the physician's response when the nurse calls with a concern? After all, code rates were much higher when we had to rely on the MD to address our concerns.

I was just reading in the "Take that doc!" thread about the poster's inability to get the pt's surgeon to take seriously the fecal drainage the pt's wound was having, and also "Tired MD"'s response. This is typical of what we as nurses deal with - there are MDs that respect a nurse's judgement, but there are far too many that will just blow off any concerns. It is so nice to be able to page someone who is willing to come look at your patient and do something.

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We've had a massive decrease in the number of patients who arrest since introducing a Medical Emergency Team. ICU stays are shorte and general outcomes are better, whcih is fantastic. I don't know if it's coincidence, but the junior doctors are also way more comfortable getting help when they're out of their depth.

Those hideous days when we had to wait for an arrest if the resident wasn't interested in reviewing a crashing patient and was afraid to call the reg! I vividly remember one occasion when I was newly registered - the patient was obviously pre-arrest but the night cover was "too busy" to see her. My colleagues moved the bed into the middle of the room and took off the bed head, connected the crash cart cardiac monitor, applied defib pads, drew up meds, grabbed the IV trolley... and I (the most junior) stood by the phone to ring switch when her heart finally stopped.

At first there was some flack if a MET call was initiated for something that wasn't a real emergency, but the policy (which is really strongly reinforced) emphasises responding to any concern. Best. New. Policy. Ever!

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