[Charity]

Originally Posted by pacu_rn

... we had no means to refrigerate them (we don't have pyxis).

Why would one need to refrigerate a package of morphine?

[sharann]

We start them in the PACU immediately upon arrival if the patient is stable and in pain(or even a hint of pain), then we use the normal anesthesia post op orders to augment and get them comfortable. Those IV meds don't last long. If I tried to transport the patient after giving those measly anesthesia IV doses they would be in pain by the time we arrived to their rooms. With the PCA we can have them press the button in the elevator(or we do it for them if they give us permission...they always do). We order a supply of PCA pumps from Central the night before using the next days schedule to anticipate how many we might need. We also "assign" the pump to the patient(using Doctors name i.e: Dr. G#1, Dr G#2 etc..) to facilitate the process as we have to sign the pump out in a log for Central daily.
It seems like more work but it saves a LOT of time. If the doc doesn't order a PCA then we simply remove the name (we use post its) from the pump and it can be assigned to another who needs one.

[Laurel RN]

We do not start PCAs in PACU. We have standing Anesthesia Orders for pain meds that we use. We do fax the orders to the floor so they can get it ready and hook it up when we get there.

[amnesia]

we start them in our PACU

[healingtouchRN]

yeah, I start them in PACU & am in the position to help other depts if they have to start one on the floor for pain management. We always have the PCIA pumps available & I can co-sign with the floor RN & do the double check. It's a good thing plus it's helps out the floor RN's. Goodness knows they have so much going on. Oh yeah, I work 3rd shift, so everyone knows each other on 3rd shift. Teamwork!

[mustanggirl]

We start then in PACU, at first we thought it would be more of a pain thatn it has been. We give anesthesia ordered pain meds until the patients get comfortable or as long as we can safely give them and put the patient on the PCA as we send them to the floor. It is expecially nice when we are holding patients for the floor that we can give the patient a little more control over their pain management.

[debthern]

we always start the pca's as well as hang the floor iv fluids with the pump tubing, it's not required but we do it because we know how busy the floor nurses are.

[ativanni]

we always start them in PACU too. I have an issue with RN's always having to transport these patients. If they are double checked before they leave PACU. don't see the sense in it.

[evonne85]

The PACU where I did my preceptorship always started the PCA's before the patient left the unit.

[anne74]

We always start the PCA, epidurals, cont. nerve blocks, etc in the PACU. When the pt first arrives, we push Fentanyl or Diluadid until we get their pain "tolerable". Then we start their PCAs. They immediately start using them.

We do many of the floor/ICU orders for the floor/ICU nurses - hang their maintenance fluids, set up their pumps, drips, etc; hang antibiotics if they're due, etc. The patients don't leave until they're awake, pain is tolerable and vitals are totally stable. Usually, the pts don't leave when they should anyway, since they wait several hours for a room to be ready. Or, if they're really lucky, they get to spend the night in our PACU!