Team Training Video: Sharp Chula Vista

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Transcript

(Sirens wailing)

Josh:  Ninety percent of what we see is not an emergency, not something that’s going to kill somebody, or that they’re going to lose their arm. What people think is an emergency and to parents, at two in the morning when their kid’s crying and they don’t know why, that’s an emergency.

Dad: Saying that his head hurt, and I noticed that he was warm.

Josh: Right now in our ER, every single bed’s full and we have patients waiting to be admitted upstairs and, ya, people still checking in.

Brian: Because the ER is always open, no matter what. Hi I’m Brian. I’m going to be running the…

Josh:  It’s busy. We have a plan to be able to see the patient, yet still have that connection with them so that they know that we really care about them and want them to get better. We immediately have a triage nurse talk to them. They come here to Sharp because they know that we’re doing something, they’re not just sitting at waiting, and what they’ve done is ordered tests in advance so that no one’s just waiting for nothing, you’ve got some lab tests pending. We have systems in place like team coordination to make this place safe.

Brian: What it does is it organizes and it coordinates emergent care.

Josh: We use it especially for code situations, it’s very hectic, there’s a lot going on, there’s a lot of people in the room and a lot of communications that need to happen to save someone’s life. That’s when we really rely on team coordination especially call-outs and check-backs. A 16-16. 16-16 milligrams IV.

Josh: Call-outs and check-backs are something that we got from the airline industry.

Brian: They identified that airline pilots and flight attendants were not talking during an emergency; planes were crashing and people were dying. I’m going to go ahead and push the lasiks 40 milligrams, and I’m holding neuro-seven. You’re holding the neuro-seven, lasiks 40. IV push. Lasiks 40 and IV push. It’s how I communicate critical information to another nurse, a physician, a physician assistant. And let’s give him two milligrams of morphine, please. I’ll run for your morphine. OK. Attention, all available staff board rounds. Board rounds brings keys players together to review the entire status of the emergency room, which is one of the key dimensions of team coordination.

Doctor:  Eighty-year-old lady complaining of headache.

Josh: No one person has the answer. Each team member needs to speak up, and needs to say something. It makes every single person accountable and responsible for the patients. We’re talking about team coordination, it’s a structured setup to help us be a safe place, and part of that structure is involving the patient and involving their family.

Woman: This morning, he was sitting down by the table and drinking a little bit of coffee.

Brian: Nobody knows the patient as well as their family; they’re part of our team too.

Josh: She said, “I’ll be better as soon as I get to see my daughter,” OK? Here she is. Now are you better now? We got your daughter.

Brian: Team coordination brings down the level of anxiety, it brings down the staff stress level, it brings down the patient’s and family’s stress level.

Josh: That’s our big challenge is to take all the programs that we’ve set up to make this a safe place.

Brian: Put up another IV line, we’re going to draw blood. We’re going to help you, everything’s going to be fine.

Josh: But at the same time, having someone who’s stopping and grabbing their hand and just saying, how are you doing, are you OK?

Brian: Making a difference is minute by minute in the emergency room, and the day I became a registered nurse was the very best day of my life.