Just about if not all hospitals these days have a program that deals with in hospital clinical emergencies. Emergencies such as a patient suffers a respiratory or cardiac arrest, or other critical medical problem that isn't quite that dire but needs immediate attention nonetheless. These situations could include patients that are suffering from acute respiratory distress or patients having a stroke or other concerning medical problem while in hospital. Most hospitals call these programs "Rapid Response".
Rapid response teams as they are called are made up of several healthcare providers. The exact make up of the teams may vary from facility to facility but typically there is a physician, an intensive care unit (ICU) nurse or emergency room nurse, the nursing supervisor, and a respiratory therapist. Again depending on what your facility's needs and resources are the team members may differ a bit. This team of healthcare professionals are always in the hospital twenty-four hours a day, every day of the year. They carry pagers or other such notification devices that alert them to when there is a medical emergency in the hospital. When their alert system goes off they respond quickly to the ill patient. Sounds all well and good. There a few catches though.
In many hospitals all the nurses working in the ICU are busy caring for critically ill patients. These patients need constant interventions and monitoring. When a page for a rapid response goes out an ICU nurse has to leave their patient(s) and respond. Who watches those patients while the ICU nurse is away? What happens if the ICU nurse is really busy and is unable to respond to a rapid response call?
The other nurses in an ICU setting depending on your hospital's staffing matrix may not be able or in a position to safely take over the care of the patients left when a fellow ICU nurse leaves the ICU for a rapid response. If that happens these patients are left on their own for sometimes up to an hour or more until the rapid response nurse returns to the ICU. Perhaps the ICU is very busy with very sick patients and the call comes in for a rapid response. None of the ICU nurses are able to leave their patients and respond. The patient that is suffering from an acute medical emergency is denied the expertise of care that an ICU nurse brings to a rapid response team. Surely this doesn't happen or if it does it doesn't happen very much. Don't be fooled.
While rapid response teams have shown to be highly effective and worthwhile in the acute care setting, these teams can only function properly when the staff for these teams are made up of nurses and other healthcare professionals that are not already tied to other responsibilities. If an ICU nurse is to respond to a rapid response they can not be tied down with a patient assignment. They may work in the ICU assisting colleagues caring for other patients but they should not be forced to care for their own patients and then abandon them to respond to an emergency call. Conversely if the ICU staff is bogged down and unable to respond to a rapid response, the patient who the call is made for is denied the appropriate care if nurses with patient assignments can't leave. There needs to be an additional nurse that is appropriately trained and able to respond at a moments notice.
In a time of fiscal hardship and a focus on the quality of care hospitals that do not develop rapid response teams as a separate staffing entity are in direct violation of the Joint Commission's national patient safety goals. Rapid response team members may provide assistance to other staff members caring for patients during times when they are not needed to respond to an emergency but they can not be part of a regular staffing pattern for patient floors. They must be free to respond anywhere in the hospital at a moments notice to provide care to patients that are in acute distress.