[CaliRN29]

Hi PACU nurses,

I am a ICU nurse interviewing for a PACU position in a new hospital. Most of my experience is with NeuroSurg ICU so I am not familiar with cardiac issues and I am a little nervous.

The hospital that I will be interviewing at is a non-trauma hospital that does open hearts, AAA, etc.

Can you give me an idea of what you typically do for these patients?!

Thanks!!! (and advice, info, suggestions are appreciated

[jmgrn65]

Not all Open Hearts are recovered in PACU ours are recovered in the CTCU (cardiothoracic care unit).

[sharann]

Originally Posted by jmgrn65

Not all Open Hearts are recovered in PACU ours are recovered in the CTCU (cardiothoracic care unit).

Our hospital is also a non-trauma community with about 400 beds. All open chest surgeries (open hearts and valve replacements) go to the ICU directly and they have a ICU "open heart" nurse to recover and 1:1 them. Actually they are 2:1 for a while there at times. AAA's rarely are done (I have seen about 1 a year here) and we sometimes take care of them in PACU if they are stable enough and the anesthesiologist or surgeon want us to. Others go to ICU straight. It is just as hard to take care of a bleeding C-section or a tonsillectomy as a AAA. What I mean is that once you have enough confidence in your PACU skills you will find it a challenge but not so overwhelming. Fear is a good thing here, it means you will respect the fact that you need to learn alot. I learn every day and I have done this for over 5 years.
Cardiac patients have the same needs as all PACU patients which include careful airway management. You will need ACLS and PALS(if kids done there). You should get a cardiac monitoring course under your belt(how to interpret and treat). YOu need to know how to spot arrythmias(and normals) immediately. You need to learn about Cardiac output, oxygenation, blood gas interpretation, and vasopressors. With your Neuro ICU you are farther alon than I was when I started! Neuro is a really important aspect as you know. We don't do much neuro so I would pick YOUR brain if you worked with me!
I am sure I am missing alot but this is my contribution. Good luck with the interview. Ask if they have training or how long orientation is. You should get 3 months at least(Even with ICU experience)

[CaliRN29]

Sharann,
Thank you so much for your input! I am more confident now! I see you are from California. What hospital do you work at?

[meandragonbrett]

All of our thoracic cases and big vascular cases go directly to CVICU post-op and we recover them ourself.

[healingtouchRN]

Our hearts, AAA's, valves, & generally most chest stuff goes straight up on the vent to CVICU or SICU. I've cross trained to these units & taught critical care so I am comfortable with these patients. However, the few chest patients that come out with their pleural tubes & Atriums (collection chambers) go on the surgical floor. they do like their narcotics for a good reason. & a good thing to start pulmonary toilet asap to prevent atelectasis. Good luck! PACU can be fun!

[Bronx1560]

Most of our "open hearts" come straight to TICU/SICU. We recover them. Depending on how stable or guarded they come out there a 1:1 ratio for about 24hrs. Within 6hrs hr if stable we like to extubate.

If it's one of our guarded pt's we will know ahead of time to have 2 heart nurses on staff to have 2:1 ratio. We do get information from the OR on the status of our Pt. We get time to prepare for anything or everything. And usually there's always on day shift 3 heart nurses & 2 on night.