Various R/T Roles??

mac23 · Feb 11, 2005

All 3 Nicu's I've worked in the R/T's performed as you described the "palace".

Gompers, BSN, RN · Feb 12, 2005

Pretty much like the "Palace" over here.

We always have at least 3 RTs on, more if our census is high. We have a core staff of NICU-specific RTs who are always there, and then to be able to float to our unit the hospital-wide RTs must be specially trained first.

Our RTs do everything you described in the "Palace" except we like to retape our own ETTs, but always with their help. They also run our lab on evening and night shift, doing all the blood gasses, sugars, lytes, and crits. The ones assigned to our unit each shift don't leave the unit except for breaks, so they're always someone around. They also go down for every high risk delivery wth an RN and MD, and on every transport (also with RN and MD) unless the baby is on room air.

If we're especially busy and they have enough RTs, they'll even "give" us one to work in our step-down room as kind of a nursing assisstant. These are just the NICU-specific RTs, and they've all been nurse-trained in patient care. They can do baths, weights, vitals, NG and PO feedings, etc. They just can't give meds, and an RN has to do a hands-on assessment of each baby at least once per shift.

sparkyRN · Feb 12, 2005

rts? you get to have rts?

we hear that in the not too distant future we'll have an (as in 1) rt in the unit around the clock. of course, we've been hearing this for awhile. i guess they will magically appear from the same place all those new nurses we are supposed to get will come from. (hmmm...sounding a little cynical here :coollook: )

right now the rn's do it all--vent setups, neb tx's, suctioning (that's one person suctioning), asst. with intubation, taping and retaping etts, et and mask bagging, chest pt, adjusting vent settings, ncpap setups, bnc and oxyhood setups, calibrating oximeters, changing all tubing as scheduled. i have now learned to calibrate and set-up the oscillators. the no machine is the only one we refuse to set-up. it is way too complicated and expensive to run. our nm, nurse educator, and pcc's can do that.

i'm guessing if we ever do get rts they will primarily be responsible for equipment set-ups and changes. we've been running a census of mid 60s in an 80 bed unit with 30 icu beds. i doubt they would have time to do much more than that

MishlB · Feb 12, 2005

We would be lost without RT...just like your palace described in original post. They are awesome!!!!

NoCrumping · Feb 13, 2005

rts? you get to have rts?
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wow sparky, no r/t's? i can't imagine setting up the vents too...when you guys eventually get one, think of how much you will appreciate them...lol:uhoh21:
see? a lot of difference between nicu's

sparkyRN · Feb 13, 2005

It's just like anything else you do...the more often you do it the easier it is to do and the quicker you can get it done. Nearly every shift I work in ICU, I either have to setup a vent for an admit bed, or change out the tubing because it is due

KRVRN, BSN, RN · Feb 15, 2005

It's like "the palace" where I work too. They receive assignments just like the RN's and work with the RN's to care for the babies. They usually staff themselves for 3 on per shift but they call in extra if they are running more vents or have sicker babies than usual. We were running 17 vents the other day, including 2 HFOV's, 2 iNO's and a Heliox (which they also manage)! They must have staffed 5 or 6 RT's that day... their clinical lead was even out helping! And this is addition to being available to go to all high risk deliveries.

What I think is interesting is that our RT's are allowed to intubate and draw blood gases in the adult world, but our NICU doesn't allow them to do either, even though it's included in their licensing/training.

nekhismom · Feb 17, 2005

For instance, I worked in 2 level3's, and in one, I call it the "Palace"... The R/T's did SO much... their role was to do ALL the chest PT, gave all the nebs, changed all the suction caths (they used strictly in-line for every vent) changed all vent tubing, cannulas, etc, we never extubated w/o one of them there , they fitted and placed the kids on cpap, and even did ALL our re-tapes, cpap and vents, I mean it was literally, call over the intercom to the unit sec, and say "Can I have resp. to G bay for a re-tape, please".. etc And they were specific Neo R/t staff and we had at least 3 on plus a sup around the clock (boy I miss it there) It was a 50 bed unit.

Our RT's don't do chest PT and we rarely give neb tx here (don't know why), but I guess they would do that. They handle EVERYTHING with the vents, fit kids for cpap and maintain those machines, basically they maintain all resp. equipment. They can draw blood gases from our babies, both art samples and capilary samples. They also do blood sugars and iStat's. They do NOT like it if we try to re-tape. When I first started here and I was re-taping, I got laid out!! That is ONLY a resp. function in my NICU. RN'S NEVER EVER EVER re-tape! Some of our RT's also go on transports. We usually have one RT per suite, unless someone is on transport.

Last NICU, we were still trying to figure out what the RT's were there for. THey physically rolled a vent into the room and put some tubes on it, then walked away. Didn't test it or anything, just left it. THey didn't assist with anything. During codes, they were usually standing off in the corner somewhere watching, not helping. THey only went to deliveries if it was multiples and nurses were short. Nurses drew all samples, art or cap. THey did do CPT when and if they felt like it, and nebs were the same. Usually didn't happen. One of my kids had nebs ordered q1 and I was LUCKY to see an RT ONCE per 12 hour shift. Basically, the RT sat in their little room and put the cap tubes in the machines when a nurse brought it to them.

Gompers, BSN, RN · Feb 17, 2005

During codes, they were usually standing off in the corner somewhere watching, not helping.

Wow, that sucks!

Whenever we have a code, one of our RTs is always there bagging the baby through the whole thing. We've had codes go on for over an hour, and the same RT will still be there, bagging away. I don't know how they do it - my arm cramps up after 5 minutes of bagging - but they just keep on going. They're always offering to take over for each other, but usually they want to stay with the baby and say, "I can just take some Advil tomorrow." :crying2: