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Rapid Response Team for Families

Posted

Specializes in Med-Surg/Tele, ER. Has 2 years experience.

Hi all!

My director just informed us today that after the JCAHO inspection they're rolling out a new rapid response team whereby the family of a pt calls the rapid response if they feel they are not being listened to and their family member is decompensating. I know this is being used in a lot of facilities, I'm curious what your experiences have been - both positive and negative?

woody62, RN

Specializes in icu, er, transplant, case management, ps. Has 27 years experience.

Hi all!

My director just informed us today that after the JCAHO inspection they're rolling out a new rapid response team whereby the family of a pt calls the rapid response if they feel they are not being listened to and their family member is decompensating. I know this is being used in a lot of facilities, I'm curious what your experiences have been - both positive and negative?

I underwent surgery, in January, and a rapid response team was called on me, when my blood pressure bottom out. But it was called by the nurse responsible for my care during the night. A N.P., Respiratory Therapist, a R.N. from ICU and a physician from the ER responded. I was examined, asked questions and they ran a bolus of 500 cc of Normal Saline in to see if they could force my blood pressure up. It did rise some but not a enough and I was put on a 1000 cc of Normal Saline, as well as had a 12 lead EKG done. The EKG showed nothing, other then a very rapid heart beat. My doctor came in later to see me. And he asked for a medical consult. By the time the consult showed up my blood pressure was up to 106/68 and he could find nothing wrong to explain the low pressure. After checking me out, he allowed me to go home.

It was my first and only experience with such a team. I found them to be through, efficent and knowledgeable, although a bit stumped by my low pressure. When they were called, my pressure was 50/20. Since this is not a teaching hospital, it was nice to know they had instituted something like this in order to avoid a patient going into a code.

Woody:balloons:

You have got to be kidding me.

Well, after years of observing the kind of things that families get hysterical about, this should be fun.

God help us.

woody62, RN

Specializes in icu, er, transplant, case management, ps. Has 27 years experience.

You have got to be kidding me.

Well, after years of observing the kind of things that families get hysterical about, this should be fun.

God help us.

I believe it is a good thing, especially in non-teaching hospitals without house officers. It brings into play a neutral third party to evaluate the patient. And it takes some of the stress off the nursing staff. I worked in a community hospital where such a team would have been a God sent, especially when the attending refused to come in and left me handling a patient in septic shock and two worried adult daughters. If such a team had existed then, I could have called it and I am sure they would have made the physician come in to see his patient.

Woody:balloons:

You have got to be kidding me.

Well, after years of observing the kind of things that families get hysterical about, this should be fun.

God help us.

Ditto. We have rapid response where I work but it's called by an employee, not a family member.

I had a daughter run up to me hysterical because her mother was smiling in her sleep and she thought this was strange. No joke. Another was concerned because her father was drooling in his sleep. I guess concerned isn't the right word. More like ready to call 911 herself.

Imagine if they had called the response team themselves.

UM Review RN, ASN, RN

Specializes in Utilization Management.

OK, that's completely over the top.

Is this another customer service initiative or is this another ploy to deskill nursing?

Don't those idiots realize that lives will be lost due to the increased strain on hospital resources?

I believe it is a good thing, especially in non-teaching hospitals without house officers. It brings into play a neutral third party to evaluate the patient. And it takes some of the stress off the nursing staff. I worked in a community hospital where such a team would have been a God sent, especially when the attending refused to come in and left me handling a patient in septic shock and two worried adult daughters. If such a team had existed then, I could have called it and I am sure they would have made the physician come in to see his patient.

Woody:balloons:

RRT are indeed a good thing. I have utilized their services on more than one occasion. That's not my issue with this; it's that the OP states families would be calling in the team, not the nursing staff.

OK, that's completely over the top.

Is this another customer service initiative or is this another ploy to deskill nursing?

Don't those idiots realize that lives will be lost due to the increased strain on hospital resources?

And just when I thought hospital administrations couldn't get any more clueless...

woody62, RN

Specializes in icu, er, transplant, case management, ps. Has 27 years experience.

RRT are indeed a good thing. I have utilized their services on more than one occasion. That's not my issue with this; it's that the OP states families would be calling in the team, not the nursing staff.

I've read the responses belittling a family member's concern. But that brings another question into play. What is wrong with a nurse who cannot explain why a patient is smiling in her sleep or another one is drooling. When I worked, I frequently explained what I was doing and why to a family member, if the patient was unconscious. It helped relieve a lot of stress for the family. When I was high by a big rig and bought into a community hospitals ER, in critical condition, I later found out my daughter, who was in a nursing program, was not even given the simplest explanations of my injuries or what was being done to me and why.

Last July, I was transported to another community hospital, in septic shock, with acute renal failure, a K of 15, acute gastritis and pneumonia. The ER doctor and nurse, took the time to explain what they had found, what they were planning on doing and what they had done. I spent twenty one days in ICU and whenever my daughter came in, my nurse would explain what had transpired over the previous twenty-four hours, what I had undergone and why and my present state. My daughter was impressed with the knowledge of the nurses and their care and attention for both me and her. And unlike the previous seventeen episode, she didn't have to call my old boss for an explanation.

Families can be a pain. Families can be unreasonable. Families can be demanding. But I found when I worked, all they really wanted was to know what was happening to their love one. And that someone else cared about the outcome. Most of the time, families are demanding because they are generally viewed as a pain by the staff. And if you think you can hide your attitude, think again. And I am willing to bet the farm on this, that most nurses do not want a family member anywhere near a patient when they are circling the drain or in a CODE. And despite studies that have shown that when an individual is appointed to accompany a family member and explain what is happening, the family is much calmer and doesn't get in the way.

Woody:balloons:

Yes, we have a rapid response team at my job and it almost like a code when you call -bunch of doctors, icu nurses, and resp therapist. Staff members are the ones that initiate it. Hmm, if family members are allowed to call RRT at my job, trust me there will be many calls at one time on my floor; it will look like a joke. One family member called 911 that a nurse refused to ambulate her 96 year old mother 2 days after hip surgery; that was a pt with parkinson disease with an order to be ambulated by PT only. One called the attending and reported that I refused to cut her fathers hair- this is hospital by the way.

I think it will be a bad idea to introduce this at my job :nono::nono::nono::nono::nono::nono::nono::nono::down::down::down::down::down::down::down::down:.

Families can be a pain. Families can be unreasonable. Families can be demanding. But I found when I worked, all they really wanted was to know what was happening to their love one. And that someone else cared about the outcome. Most of the time, families are demanding because they are generally viewed as a pain by the staff. And if you think you can hide your attitude, think again. And I am willing to bet the farm on this, that most nurses do not want a family member anywhere near a patient when they are circling the drain or in a CODE. And despite studies that have shown that when an individual is appointed to accompany a family member and explain what is happening, the family is much calmer and doesn't get in the way.

Woody:balloons:

Yes, families can be a pain. Yes, they are concerned and scared and worried. I've been on that end of it myself. I do spend time with them, explaining what is happening, listening and responding to their concerns. There are also families who will remain obstinate and unreasonable regardless of how they are approached and treated by staff.

I understand and agree with what you've said here. But I suppose we'll have to agree to disagree that allowing family members to call a RRT code is a good idea.

NursingAgainstdaOdds

Specializes in Med-Surg/Tele, ER. Has 2 years experience.

Just to clarify - I am thoroughly familiar with the typical Rapid Response Team scenario, and have used them myself when a pt has a change in condition.

What I am talking about are the same thing, except they are called by the FAMILY of the pt, not the nurse.

Here is a link with the story behind this initiative:

http://www.josieking.org/page.cfm?pageID=1

From my perspective, I am cautiously incredulous of this program. I am all for empowering my pts, but I'm just not sure this will be effective or realistic.

EDValerieRN, ASN, RN

Specializes in ER, Peds, Charge RN.

I think it's a good idea. Sure, it'll be abused and mistreated, but it will also catch a few things that could have been prevented. A patient one time on a floor was complaining of SOB and palpitations. The nurse blew them off. The family member ended up calling the operator and speaking with the house sup, who went to the room. Patient had a Saddle PE, transported to the ICU, and nearly died.

Because she was only in her early 30's, the nurse thought it was anxiety. Didn't check to ask if she was a smoker or on birth control (the patch).

If it wasn't for this woman's family, she would have died, and the hospital would have had a really big lawsuit on their hands. I think this one case alone justifies the use of RRT for families.

Just to clarify - I am thoroughly familiar with the typical Rapid Response Team scenario, and have used them myself when a pt has a change in condition.

What I am talking about are the same thing, except they are called by the FAMILY of the pt, not the nurse.

Here is a link with the story behind this initiative:

http://www.josieking.org/page.cfm?pageID=1

From my perspective, I am cautiously incredulous of this program. I am all for empowering my pts, but I'm just not sure this will be effective or realistic.

http://www.josieking.org/page.cfm?pageID=18

Ah, ok. This isn't the RRT we would use. But more of a patient advocacy team. Fine then. I still think it is going to be abused, but as long as it doesn't take away from the emergency teams, fine.

wonderbee, BSN, RN

Specializes in critical care; community health; psych.

Have had experience with it being used at "X" hospital in Pittsburgh, a large teaching institution with 11 ICUs. I can tell you from experience that putting this kind of power into the hands of family members who are already over the edge with anxiety is NOT a good thing. It brings up the big wigs from their offices and causes unwarranted write ups just to placate family members. This is clearly an unhealthy response at a time when professional nurse staffing is ready to jump ship at the next golden opportunity.

Whoever thought of this obviously had way too much time on their hands and has a warped sense of humor.

I've read the responses belittling a family member's concern. But that brings another question into play. What is wrong with a nurse who cannot explain why a patient is smiling in her sleep or another one is drooling. When I worked, I frequently explained what I was doing and why to a family member, if the patient was unconscious. It helped relieve a lot of stress for the family. When I was high by a big rig and bought into a community hospitals ER, in critical condition, I later found out my daughter, who was in a nursing program, was not even given the simplest explanations of my injuries or what was being done to me and why.

Families can be a pain. Families can be unreasonable. Families can be demanding. But I found when I worked, all they really wanted was to know what was happening to their love one. And that someone else cared about the outcome. Most of the time, families are demanding because they are generally viewed as a pain by the staff. And if you think you can hide your attitude, think again. And I am willing to bet the farm on this, that most nurses do not want a family member anywhere near a patient when they are circling the drain or in a CODE. And despite studies that have shown that when an individual is appointed to accompany a family member and explain what is happening, the family is much calmer and doesn't get in the way.

If you're going to refer to my post, use my name. And I don't view it as belittling. Belittling would be to say that family members are idiots and don't know what they're talking about. I merely stated what I heard from family members.

As far as not explaining things to family members and patients, I have actually been told to not explain so much. Even in a comatose pt I will explain what I'm doing and why.

1) I never said I was a nurse.

2) I never said I didn't explain why they were smiling and drooling in their sleep. In fact, to make the families feel better I took vitals and notified the nurse.

3) I actually like families around when they're dying or coding. They know what works best comfort wise for their loved one. Maybe dear mom doesn't like sleeping on her right side and maybe they like listening to classical music. Unless the pt told me that I wouldn't know what they use to relax.

Neveranurseagain, RN

Has 26 years experience.

YES!!Rapid response teams activated by families would help save lives!!! If there was one at the hospital my husband was at he would still be alive....I commented/complained multiple times that my husband was going downhill and the staff got ticked at me...ignored me after a while...see my first post....

Multicollinearity, BSN, RN

Specializes in Acute Care Psych, DNP Student. Has 4 years experience.

There was a documentary on PBS called Remaking American Medicine that examined RRTs and the family being able to initiate it, among other topics.

My first thought watching this was 'you've got to be kidding, ignorant families will abuse this.' That's what the nurses who were interviewed said they thought. Turns out, they said abuses of the system turned out to be rare.

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