[WYRN1]

Read with interest many of the postings from fellow PACU nurses. I am fairly new to this area of nursing but I do have to say that one I can't believe that some of you only received a few weeks of an orientation I was oriented with a preceptor for 4mths. Also I do not think this is an area that a new grad would do well in. I had Critical Care and ACLS background from years ago and years of nursing experience yet somedays I still feel wether I am prepared for this enviroment were the patient is most unstable and anything can happen. I sometimes feel I need to know much more. Its good that I am surrounded by nurse colleagues that are understanding and supportive with there many years of PACU experience, and I hope for me too it will become second nature. My manager told me when I hired in that it would be about a year or so before I would feel really comfortable with my abilities and I believe she may be right every day I get just a little more confident but I am also continually learning. I especially have anxiety with the pediatric cases since I had never worked in a pediatric setting except for in nursing school. They are quite scary, and a bit of a challenge. Any advice you seasoned PACU nurses can give me would be gratefullly accepted.

[enurslw]

I know how you feel. I have been a nurse for 11 years and I started working in PACU 5 days ago. I like the challenge, but I have a lot to learn. I am currently trying to find a postanesthesia nursing book. No luck yet. Good luck to you!

[nmred]

Hello! I just joined the community. I've been a PACU nurse for 8 years and yes it can be very demanding and anxiety producing. As far as Peds patients go... same as adults... Airway, Breathing, Circulation, pain management... Kids will usually awaken with emergence delirium. Fentanyl works great. The dose ranges from 0.5mcg's to 1.5 mcg's /kg. The Circulator or Anesthesia provider should be giving you the weight during report. If not, make that your habit. With pedi pt's you ALWAYS want a weight. Anesthesia should be leaving you that order. I always go for 1mcg/kg. it's the fastest easiest to remember. And with a child that's screaming his head off, you want fast and easy.
Try and get the Parents in ASAP. It's OK for the parents to hold their child in their lap (depending on the size of the child). It's a great bonding time.
There are lots of other habits we can talk about. Remember above all else to trust your nursing instincts. They are your compass.
Pals, TNCC, ENPC are all great courses.
As far as Anesthesia books and info. Try ASPAN. If your not a member you might think about becoming one. They have great resources. Every state has a Chapter. Their web site is www.aspan.org or you can google it. They also offer info on certification as well. If your interested.
I learned anesthesia one on one with a provider. It was wonderful. How to intubate, extubate, complications, meds, the works. Anesthesia LOVE to talk about their profession. Tap into them.
It's long, but I hope it helps.

[nmred]

Check out ASPAN. They are a great resource

[enurslw]

Thanks so much for ALL the info. I will check out ASPAN. I think it will take me at least a good year to feel confident in the PACU. I have a great preceptor and my manager said she would not let me work alone until I was ready. We were busy last week no one had time to train me on the computer we use for our charting. I hope I make it!!

[nmred]

You'll do just fine. I remember I use to go home every night crying I was so overwhelmed. After about 6 months I was pretty comfortable with "minor" cases. By the end of a year I could recover any patient at our hospital.
Best of luck