Managing the Complex Patient

Question 1

How do you start the process of asking for help?

Answer 1

Begin by asking your colleagues
- Then charge nurse

Question 2

When do you call the provider?

Answer 2

You call the provider when there are major changes in the pt’s status
- Change in VS
- Change in LOC
- Bleeding

Question 3

What information should you have when contacting the provider?

Answer 3

1) Your name/title (I am the nurse caring for…)

2) Patient’s name, diagnosis

3) MDs (service & names)

4) Location (unit name)

5) Briefly describe current situation

Question 4

Order of Information to Give Provider

Answer 4

1) Begin w/ asking: “Do you know the patient?”
-> If not, list admitting DX

2) Give background on what led to the patient being hospitalized

3) List reason for the call

4) List what interventions/assessments/diagnostics you have already done

5) Give the provider your thoughts (recommendation)

Question 5

Indications for Calling Rapid Response (RR)

Answer 5

Changes in VS, chest pain, major changes in LOC, bleeding…

Question 6

Reasons for Calling Rapid Response (RR)

Answer 6

1) You feel like something is “wrong” with the patient

2) You have already contacted the MD, performed recommended course of action and the patient is not improving

3) You cannot reach the MD

Question 7

Background Information to Give the RR Team

Answer 7

Reason for the pt being in the hospital

Past procedures

Current situation
- VS & changes in VS trends

Reason behind worry
- Be SPECIFIC
- TRUST YOUR GUT

Question 8

Indications for Calling a Code

Answer 8

Cardiopulmonary Arrest: Pt’s HR stops, stops breathing

Cannot maintain a stable airway

Seizure(s) that will NOT stop after an “appropriate” amount of time

Uncontrolled bleeding of some kind

Patient loses LOC and does not seem to be coming back