Thoughts on calling an RR?

Are you on an ICU or PCU type of unit? I can't imagine a physician refusing to put a central line in for a patient in her condition.

We always take manual for a-fib. If you had several nurses verify a manual then I absolutely would trust that over the automatic.

Who all responds to a RR? House supervisor comes to any at my hospital and should/would have backed us up in your scenario. Although I probably would have called the sup ahead of time to let them know what was going on, and see if they could talk to the physician prior to us calling a RR out of desperation. Most of the time when the supervisor gets involved, the physician gives in.

It sounds like you advocated for your patient and got the care that she needed. Those vitals themselves would warrant a RR in many facilities. Patient was a full code, unstable with multiple medical issues, she needed a line.

Speaking as a rapid response nurse, YES! you can and should call a rapid response in this situation. Even if you feel something just isn't right call. Your patient met many of our parameters.

Are you on an ICU or PCU type of unit? I can't imagine a physician refusing to put a central line in for a patient in her condition.

We always take manual for a-fib. If you had several nurses verify a manual then I absolutely would trust that over the automatic.

Who all responds to a RR? House supervisor comes to any at my hospital and should/would have backed us up in your scenario. Although I probably would have called the sup ahead of time to let them know what was going on, and see if they could talk to the physician prior to us calling a RR out of desperation. Most of the time when the supervisor gets involved, the physician gives in.

It sounds like you advocated for your patient and got the care that she needed. Those vitals themselves would warrant a RR in many facilities. Patient was a full code, unstable with multiple medical issues, she needed a line.

Yes I work on PCU. We did call the supervisor to let her know, she was actually on the floor with us at that point. Mandatory staff to respond is the NS, hospitalist, ICU charge nurse, and respiratory.

Sometimes I think we as a facility underutilize the ability to call an RR, to be honest. The hospitalist said last night, sooo you called this for hypotension? I felt like saying, YES just the hypotension (let's forget everything else and the fact that we have way no way to quickly Medicate). He was not paying attention at all, he's like okay let's give her a 500 cc bolus. First off, no. At that point I swear the whole room said in unison for what felt like the 10th time, SHE HAS NO IV ACCESS!

At this point, the ICU charge nurse took control and called the MD and said were taking her to ICU so you're gonna have to come in for a line whether you want to or not. I was so glad she took control of the situation.

Some of the nurses on my floor who used to work in ICU said they have seen this happen before, but I have never experienced that.

Once the hospitalist listened to what I was saying, he said wow this is really sad and he is notoriously known for being the laziest doctor in the hospital... Though at least he did his job!