Rapid Response Team and Families

Specialties MICU

Published

Our Rapid Response Team (RRT) is about one year old. It has been a success. The nurses on the med surg units have appreciated the assist.

Part of the JACHO requirements for the Rapid Response Team is to involve the pt/families, allowing them to call the RRT themselves. icon5.gif Has anyone started this aspect of the team function?

I don't want this to be a taddling on their nurse or underminding the pt's nurse. I want it to be part of the pt's orientation to the room/unit. Given positively and part of encouraging the pt's participation in their care. Ex: do your I.S. DB/C and call the RRT if you feel like you are in a crisis and your nurse hasn't been able to help. Talk with your nurse first.

We have the Joint Commission "Speak Up" posters everywhere and it would play into that theme.

Do you have a family handout?

Who receives the call from the pt/family? The team itself? A "screener" like the nursing supervisor - to screen out irritation calls? (no one is answering the call bell fast enough).

Specializes in CCU/CVU/ICU.

Hoping that there will be no RRT calls so that one will not be called away is a fool's utopia..

What???

A 'fools utopia' is one where the RRT doesnt have patients.:yeah:

In the very lucky, very big, awesome level-1 trauma there may be resources allocated for staff (including doctors?) to be a designated RRT and not have patients.

However, in reality, 99.9% of hospitals dont have dedicated patient-free RRT's.

And...any hospital that lets family members call RRT's, DOES NOT trust the floor nurses' judgment. Period.

A critical-care nurse (or two)...a RT (or two)..and perhaps a doctor...who dont take patients and only respond to codes and RRT's??...THATS your fools utopia for the VAST majority of nurses/hospitals in the nation...(but i agree it would be nice. Just not reality.)

And if you think famlies are better at assessing patients than nurses...well, umm...the floor nurses at the very awesome level-1-trauma-best-in-the-nation hospital must suck. Or adminitration thinks so.

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Specializes in Advanced Practice, surgery.

There is some great information within this thread could I remind all members to please debate the topic and refrain from personal comments as it only serves to derail the thread.

Thanks

Sharrie

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Specializes in Mixed Level-1 ICU.

"In the very lucky, very big, awesome level-1 trauma there may be resources allocated for staff (including doctors?) to be a designated RRT and not have patients.

I sense a bit of sarcasm in your reply.

While it may be "lucky" to have extra staff, the fundamentals are the same regardless of where one practices, how big or small the institution, whatever level.

If nurses are pulled away from their patients, for whatever reason, it opens the door for increased morbidity and mortality for those patients left behind.

You may argue that nurses are assigned to codes and they are pulled away when one is called. But code calls are far fewer that RRT calls and the nurse may be at the RRT call for a very long period of time only to be followed by another call. Sure it happens in codes, but we're talking odds here, not exceptions.

Take nurses away from their patients and it's another place that talks the talk, but doesn't walk the walk.

"However, in reality, 99.9% of hospitals dont have dedicated patient-free RRT's."

Perhaps those places need to reevaluate their budgets in light of the research.

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Specializes in CCU/CVU/ICU.
"In the very lucky, very big, awesome level-1 trauma there may be resources allocated for staff (including doctors?) to be a designated RRT and not have patients.

I sense a bit of sarcasm in your reply.

.

Just a bit?

I agree with you. It would be nice to have dedicated RRT with no patients. NOw...if you can lobby for this and convince hospital administrators across the nation...

A pipe dream i'm afraid...

for most of us at least.

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Specializes in CCU/CVU/ICU.
Well my team had a family initiated call today. The patient was diophoretic, cp, sob...etc..etc, well the flor nurse told the pt. and family it was anxiety, so the pts. family called are rrt, being the supervisor I went down and checked it out first, well let me tell you it was not anxiety, this patient was having a true emergency, when I got there she was like exausted and almost half dead, well she had a hip replacement 2 days before, and Im glad the family called us she had a massive PE, she was transferred to my SICU immediately, we couldnt get the emboli with the cath lab it was to big, we ended up taking her down to OR for a ride sided thoracotomy, she also ended up with a pneumo. from the CVC. Im just glad we got there and I hope she pulls through.

If this is a common occurence at your hospital then yes families probably need to call RRT's. Or better yet, stay away from your hospital! :typing

That nurse was retarded. Hopefully the rest of your nurses arent. But it sounds like you (and/or administration) thinks they are...

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Specializes in ER/SICU/Med-Surg/Ortho/Trauma/Flight.

Dinith, I dont think shes stupid at all, she should have just paid more attention, thats all, for gods sakes shes new anyway, and I work at a very distinguished level 1 trauma facility in St.louis, Im just one of the SICU and ER house supervisors, I just also happen to be someone in charge of a trauma team and an rrt team. I dont think shes stupid at all and she should have just called one of us house sups for help and guidance thats all.

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Specializes in Not too many areas I haven't dipped into.
Are you serious? Your hospital is allowing FAMILIES to call RRT? That's (for lack of a better term) stupid. S.T.U.P.I.D.

I almost didnt want to respond to this...and i hope you're not serious.

From my understanding, this is what the goal was from the beginning.

I would imagine that a life saved vs 20 erroneous runs is ok. We will see how it plays out. I know that we were taught that the family knows the patient the best and they will notice the subtle changes taht we would never know to look for and that might just be the tip to saving a life.

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Specializes in Not too many areas I haven't dipped into.
From my understanding, this is what the goal was from the beginning.

I would imagine that a life saved vs 20 erroneous runs is ok. We will see how it plays out. I know that we were taught that the family knows the patient the best and they will notice the subtle changes taht we would never know to look for and that might just be the tip to saving a life.

it wouldn't let me edit so ....

I also wanted to add that I was very fearful when I first heard that families had the right to call an RRT, but it has not turned out as bad as I thought. Most families in our hospital have a good enough relationship with the nurse to be able to have their concerns heard. We have had some that were silly, but we have had some nurse called RRT's that were "worthless" as well but we are always supposed to thank the person for calling ans asking for help or another set of eyes.

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Specializes in ER, Med/Surg.

If you as a family member think that something so bad is happening that you need to dial "911" in the hospital, how about stepping into the hallway and yelling that you need some help?

I have to agree, STUPID.

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Specializes in CTICU, Interventional Cardiology, CCU.

At my hosp. if you call a RRT during the day, you have alot of support, all kinds of MD's, Nurses and Resp. people show up. But my exp. working night shift, if you call a RRT at 3am the only people who show up are a resp. therapist, nursing supervisor, the House MD if you are lucky, and I mean very lucky and well that's about it. I have had more than my fair share of frustrating RRT's working night shift.

I had one pt. who was status epilepticus, and began siezing at 4am. I called a RRT nd only a resp. therapist showed up. I was so mad that I called a code blue just to get the MD there to eval. the pt.

I have pt. s/p STROKE, end up stroking out a second time and know tht if I call a RRT I will have no help. So I call the MD's directly. They come and eval.

But RRT teams are great at my hosp. during the day, once night falls, forget about it.

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Specializes in Combined ICU (CCU/Neuro/SICU/MICU.
Guess I could go either way on this one, since IM on the code team and the RRT and Im a house supervisor, guess what you get the same members when you call either, and Im just waiting for an idiot call, thats what everyone on my RRT team calls it when we get some stupid jerk calling us to give his mother a bedpan, or roll her, or betteryet get him something to drink, but its good for the patients that need it we actually try to get them stabilized before they crash, its funny to my teams also the trauma team lol! So if you call us for something stupid the RRT physician just might be a trauma surgeon and he might just rip you a new one.

This is obviously an issue with very strong opinions, you either agree with it or not. As nurses, we are supposed to have the patient's best interest in mind. Instead of saying that having family members activate the RRT is dumb and stupid, shouldn't the cause of why they are asking for those things be explored more (ie, bedpan)? Maybe that floor is so short staffed, and that patient isn't getting those simple things taken care of. As silly a request as that may sound, if we were in those patients shoes, wouldn't that matter?

My facility uses RRT as well; and not all the calls are warranted, but we shouldn't make those floor nurses or family members feel like they shouldn't have called us. Its been my experience that a lot of ICU nurses think that they're better than other nurses. We all have our strengths and weaknesses. Instead of bashing this idea, we need to find ways to make it better.

How is answering an RRT call that's "not worthy of our time" a waste of our time? Is that call keeping you away from sipping your coffee or gossiping? At least, that's been my experience. Fellow staff, (the more experienced staff), get annoyed when asked for help because they are too busy reading the paper, magazine, drinking their coffee or gossiping. Bottom line, patients come first; and whether we like it or not, family members do know the patient a lot better than the nurse at times.

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Specializes in CVICU, ICU, RRT, CVPACU.
Are you serious? Your hospital is allowing FAMILIES to call RRT? That's (for lack of a better term) stupid. S.T.U.P.I.D.

I almost didnt want to respond to this...and i hope you're not serious.

My facility allows it as well. If a family feels that a floor nurse isnt giving them the attention they need in a change of pt status situation, they can pick up the phone and call the operator who will immediately page us. I think it works well for the most part.

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