RRT RN

Dominican Hospital (a member of Dignity Health) is a 222-bed facility that offers a wide range of services to residents of California’s Central Coast. With 24/7 emergency care comprehensive care in cardiac orthopedics oncology women’s and children’s services we continue to lead the region in medical innovation and excellence in healthcare. Comprehensive CareDominican offers emergency services and is a Certified Stroke Center and Chest Pain Center. Dominican’s services include the only comprehensive Cancer Center in Santa Cruz County a Total Joint Replacement program and advanced neurological and endoscopic services. Dominican regularly receives ‘A’ grades for hospital safety from Leapfrog Group and has received national recognition for superior patient safety cardiac care and stroke treatment from Healthgrades a leading provider of comprehensive information about physicians and hospitals.As Santa Cruz County’s heart attack (STEMI) receiving center Dominican Hospital provides cutting edge cardiac care. The hospital’s heart attack treatment times consistently beat the national average and the hospital offers two cardiac catheterization labs available 24 hours a day 7 days a week. Groundbreaking cardiac procedures at Dominican include the Transcatheter Aortic Valve Replacement (TAVR) procedure which allows for heart valve replacement without opening a patient’s chest.Dominican Hospital has forged significant partnerships with area hospitals to bring exceptional care to Santa Cruz County. The hospital offers a level III Neonatal Intensive Care Unit (NICU) through a partnership with Lucile Packard Children’s Hospital Stanford. Neurosurgery at Dominican is also offered through a partnership with Stanford Health Care.

• Primarily responsible for rapidly responding to the bedside of a patient who has been identified as having acute changes in his/her condition and/or showing signs and symptoms of stroke or shock. The Rapid Response RN (RRRN) functions as a resource RN for the primary RN caring for the patient.  In this role the RRRN assists in assessing the patient consulting with MD and initiating treatments as ordered by the MD. The RRRN initiates RRT standardized protocols. The RRRN monitors the patient as needed or assists in transferring the patient to a higher level of care.   He/She may assume care of the patient until a bed and or RN is available to take over the care of the patient.  The RRRN follows up with each rapid response call over the next 24 hours or longer if needed. 
• Stroke/TIA:  responds to any potential stroke patients on the floors assess the patient according to the Acute Stroke SBAR notify the neurologist on call for any suspected strokes and initiate Code Stroke Alert if instructed to do so by the neurologist. They will assist in getting the patient to the correct level of care as indicated by the neurologist.  RRT will provide stroke teaching to patients with diagnosis of stroke/TIA for discharge.
• Rapid response calls may also include dealing with code status changes as well as dealing with difficult families or patients. The RRRN must be able to use therapeutic communications skills and be able to assess and handle emotional distress in patients and/or families.  Makes referrals to Palliative Care as needed.

• RRRN will complete the admission process for ED patients and direct admits as time permits in the hierarchy of RRT priorities and triage. The RRRN will attend the 0830and 0100 bed huddle.  The RRRN will collaborate with the Nursing Supervisor to promote flow and patient placement. The RRRN may confer with case management as well. This knowledge combined with excellent critical nursing judgment allows her/him to assist in bed placement issues.  During times of bed crisis the RRRN may assist in opening and closing 2 Central.
• When the ED is impacted the RRRN can assist with patient flow by transferring and admitting patients to the floor. The RRRN understands the different levels of care that each unit provides and uses his/her nursing judgment to assist ED staff in assuring that patients are admitted to the appropriate floor.
• The RRRN provides support and education to the RN’s on the floor by collaborating and sharing his/her skills regarding patient care in a non-judgmental and non-critical manner.By working closely with the primary RN at the bedside knowledge and skills are shared and the primary RN becomes more comfortable and knowledgeable in assessment planning implementation and evaluation of patients who are acutely deteriorating.The RRRN can offer resource and support to the new grad decreasing the feelings of fear and isolation. In addition to bedside teaching the RRRN is available for formal lectures and workshops as needed.As an experienced communicator the RRRN will play an active role in increasing the skill of the bedside RN in SBAR communication. Promoting his/her role and having a open and trusting relationship with staff throughout the hospital is an important part of the RRRN position and ensures that the RRRN is called whenever needed by the floor RN’s.

PROCEDURES:

• In order to reduce length of stay and assure that necessary procedures are done in the most timely manner the RRRN is available to assist with bedside procedures cardiopulmonary procedures; ie: TEE’s cardioversions and Cat Scan’s and MRI’s with procedural sedation.She/He can assist with transfers to and from the permanent and portable MRI trailer.
• RRT can assist floor RN’s with difficult IV starts when IV RN is not available.
• Assist L&D in preparing patients for crash C-Sections.
• Nuclear Med:Administration of CCK and Lasix injections.

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Experience: