Rapid Response Team for Families

EDValerieRN, ASN, RN · Aug 24, 2007

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.

EmmaG, RN · Aug 24, 2007

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 · Aug 25, 2007

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.

bethin · Aug 25, 2007

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 · Aug 25, 2007

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 · Aug 25, 2007

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.

Home Health Columnist / Guide · Aug 25, 2007

from upmc:results/goals met

in year one, we found that:

90% of patients who called condition h would call it again if they felt it was needed;
100% of callers felt their needs were met by the responding nurse; and
the data suggests that 69% of condition h calls would have led to potentially harmful patient situations if condition h had not been called.

--------

hey i started this trend!!!

2 years ago after gallbladder surgery, my increasing abd pain while ambulating and subsequent nause and dry heaves was ignored by 3-11 rn; by 10:30 pm i started screaming that i was gonna code if house doc not called along with my husband. rr was 40 with oxygen.

turns out i had small bowel obstruction.

100% behind this effort as team should be composed of:

who is on the team

internal medicine house physician
patient relations coordinator
administrative nursing coordinator
floor staff where the condition h is called

all that extra help is certainly welcome when floor staff unable resolve situation.

NursingAgainstdaOdds · Aug 25, 2007

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.

The way it was presented to us at our institution is as an emergency team which is called by the family. I just presume they will end-up doing a lot of pt advocate stuff, since that by in large is what families will call for, IMO.

txspadequeenRN, BSN, RN · Aug 25, 2007

the day they implement this type of thing into ltc is the day i hang my nursing hat up....

EmmaG, RN · Aug 25, 2007

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.

If hospital administrations had a good track-record of supporting their staff against abusive and irrational patients and visitors, I'd really have no problem with this type of program. But given the current climate of going overboard with "customer service", Press-Ganey, etc., I've simply lost trust in them; that's why my gut tells me this will be abused to the detriment of the nursing staff. I hope I'm wrong.

woody62, RN · Aug 25, 2007

When I was in ICU last summer, my daughter, who had to go to work, would call in once or twice a day to find out how I was doing, the results of any test or procedures I had (which were several) and my general condition. All of my nurses, with the except of one, took the time to explain what was happening to me, the results of procedures and my general status. The one nurse who did acted as if my daughter was using her valuable time and generally being a pain. and hung up on her. My being a nurse, and my daughter a former student, called the supervisor. She explained the situation. complemented the nurses and then told her the p[problems with the one nurse. A short time later my daughter got a call from the nurse manager. she filled my daughter in and apologized for the behavior of the one nurse. This nurse hated being floated to ICU and took her hate out on families. I sometimes got float to units I didn't like but I never took it out on my patients or their families.

Woody:balloons:

EmmaG, RN · Aug 25, 2007

There's no excuse for that nurse's behaviour toward your daughter, however (according to the description in the link) that doesn't appear to be a situation where this response team would be called. In fact, I think your daughter did exactly the right thing.