6west RRT: A Case Study Of The Patient

Per nursing report, patient in 6west rm 6626 (MR 331609) was combative, received 2 mg Ativan IVP per nursing, slumped over, was not responding to stimuli, respirations less than 8 and was desating on room air. RRT was activated. Alison Teel, RRT RN right away responded to RRT. Alison Teel is currently on the Stroke/RRT unit orientation.

I walked to 6 West soon after the RRT was called to see if my stroke team coworker Alison needed my assistance. Upon my arrival, Alison was assessing the patient, effectively communicating with the team and the provider (Dr.Terefe). Also, right away she initiated Emergency standing orders following benzodiazepine administration.

6 west unit manager Susan was present during the RRT. The

manager felt that initiating Acute Stroke Alert was a higher priority than initially trying to reverse Lorazepam administration (patient at that time was unresponsive, resp <8). Alison informed that per Emergency Standing orders Romazicon has to be administered following Lorazepam overdose . Furthermore, Alison informed that the patient has a hemorrhagic stroke, which would be a contraindication for the TPA administration.

6 west unit manager insisted that RRT nurse and not the primary nurse would call the provider. According Alison, at the beginning of RRT primary nurse had more information about the patient, his background and the events that lead to RRT. Alison offered to talk to Dr.Terefe if additional information would be needed or if the primary nurse not be comfortable to talk to the provider.

Lastly, during the Romazicon administration, 6 west unit manager questioned Alison,RN why she is not scrubbing the PIV hub for 15 seconds. Unit manager was informed that the patient had curos caps on, and that we are not required to scrub the hub.

I felt that this kind of manager's behavior was impeding with the patient care.

We all should remain professional and help each other to provide excellent patient care.

Dalia, RN