What Is an RRT Nurse?

• An RRT nurse is a rapid response team nurse who responds to emergencies when called upon. 
• An RRT nurse is a part of a medical team referred to as MERT, or medical emergency response team. These nurses are critically trained. 
• Often the rapid response nurse helps in the transition of a patient from the unit they are on to a critical unit should the need for a higher level of care be required. The RRT nurse can then serve as a link between the two units to help with a faster transition. 

What Is an RRT Nurse?

An RRT nurse is a “rapid response team nurse” and is part of a medical team that includes other health care professionals trained in critical care who can respond to a medical emergency in the hospital.  

Sometimes they are called a “MERT” or “medical emergency response team”. Each hospital may have their own internal code system or name, but each facility should have a clearly trained and identified critical response team.  

The team can include a critical care nurse, respiratory therapist, pharmacist, and emergency room physician who can respond with quick actions and orders needed to prevent a medical emergency from turning into a cardiac or respiratory arrest.  

The goal is to have a trained internal hospital team as a resource for nurses who are not working on a critical care unit can call for help.  

Nursing is a truly a team sport and we need the smart insights of each other. When patient to nurse ratios are high it is difficult for a nurse to give undivided attention to each patient and when that nurse needs help, it is valuable to have an RRT. An RRT nurse is one who has a regular patient assignment but is asked to join the rapid response team when called to help in an emergency.  

Nurses should be able to recognize when the patient is trending downward who needs additional help. When a nurse recognizes worsening vital signs or a deteriorating patient condition, the primary nurse can call a rapid response team or MERT, which dispatches the team to the bedside of the primary nurse. The primary nurse then summarizes through a clear and objective SBAR format the current situation so the team can collectively come up with ideas and a plan of action.  

SBAR stands for situation, background, assessment, and recommendation and is a simple format used in most healthcare facilities to communicate patient information quickly to another healthcare professional.   

The RRT nurse is there to assist with possible solutions to the problem and carrying out additional orders. Sometimes just having a RRT nurse and team members to see the situation from different perspectives can help identify the problem.  

Ideally, critical care nurses are more experienced nurses with critical care training and can identify a problem quickly, whereas a non-critical care unit may have younger nurses who need additional guidance. Together patient outcomes can be improved.   

Often the rapid response nurse helps in the transition of a patient from the unit they are on to a critical unit should the need for a higher level of care be required. The RRT nurse can then serve as a link between the two units to help with a faster transition. 

How Do I Become an RRT Nurse?

Experienced nurses who work on a critical care unit are generally eligible to become part of a rapid response team.  

In our overworked nurse population, nurses are generally happy to accept the help of other willing nurses. If you’re interested in becoming an RRT nurse, let your manager know and take a critical care course.  

You may be eligible to begin a critical care course even while you’re working on a non-critical care unit. Some facilities have formal training programs that begin with classroom instruction and shadowing a critical care nurse ending with a formal assignment change to a new critical care unit.  

Take or renew your BLS and ACLS certification and keep your hospital IV skills sharp.  

Unfortunately, being an RRT nurse may not mean a raise in pay unless you are transferred to a critical care unit. Serving on a rapid response team may be part of your regular nurse duties for your shift.   

If you don’t receive higher pay, you may receive higher job satisfaction being a part of a team that can turn around a bad patient situation.  

How to Help an RRT Nurse

Leaving when the RRT nurse and team comes to help is NOT the right action. The rapid response team needs the primary nurse to be in the room and ready to give a report to the team when they arrive.  

It is best to delegate tasks to another nurse such as medication administration or retrieval of supplies than to hunt for the primary nurse to get a report of what has happened to the patient. The primary nurse should expect to give the SBAR report including a brief medical history, review of the hospital stays, diagnosis, recent medications given, current vital signs and acute changes. Another nurse should be sent to retrieve the crash cart.

Although the defibrillator and full CPR may not be needed, the crash cart has oxygen, IV fluids, medications, and equipment that may be needed to thwart the emergency.  

A nurse should never be made to feel foolish for calling an RRT nurse and team. If a staff nurse calls for a medical response team and was an unnecessary call, it is an opportunity for more staff education and not reprimand. Staff nurses should be educated when to call for help and what conditions are symptomatic of a deteriorating patient. 

When to Call a Rapid Response Team

Some hospitals have specific protocol to help nurses know when to call for a rapid response team, which is helpful. Generally, any significant change in vital signs with a heart rate over 130 beats/minute, a systolic blood pressure greater than 180 mmHg or less than 90 mmHg is cause for alarm.

Any difficulty breathing or respiratory rate above 24 breaths/minute or less than 8 breaths/minute is cause for alarm. If an SaO2 drops below 90% despite oxygenation it requires additional help including intubation. Any acute change in orientation or consciousness requires additional medical help.  

A rapid response can be called by anyone including another nurse not caring for the assigned patient, a family member, hospital staff, family, or visitors if they recognize the patient is not responding correctly and has a threat to wellbeing.  

Nurses should ideally complete a thorough head to toe assessment of their patient early in their shift to recognize the normal range and status of their patient so they can more quickly recognize changes. Assessment for skin color, respiratory effort, vital signs, and responsiveness should be done early.  

Here are some good guidelines to help identify when a rapid response should be called:  

• Staff worried about the patient 
• Acute change in heart rate 
• Acute change in systolic blood pressure 
• Acute change in respiratory rate 
• Acute drop in O2 saturation 
• Acute change in mental status 
• Drop in urine output 
• New, repeated, or prolonged seizures 
• Fractional inspired oxygen of 50% or greater 
• Failure to respond to treatment for an acute problem/symptoms

The Bottom Line

Nurses are the eyes and ears for the entire medical team to monitor acute changes in a patient. Recognizing signs that a patient’s condition is deteriorating is an important role.  

Knowing when to call for additional help from the rapid response team is important to appropriately use their expertise to protect a patient. Everyone on the medical team, even if not on an assigned rapid response team, is a valuable part of helping each patient achieve the best possible patient outcomes.  

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