[Zoe's Mom]

We also initiate the PCA in PACU. We use post-op orders from anesthesia for immediate pain, nausea PRN and reserve docs orders for the floor. The patient gets PCA teaching pre-op and we re-enforce in PACU. Even though the patient is usually receiving some type of narcotic they still respond well to the teaching since they got it pre-op. We do not administer antibiotics unless specified to start first dose in PACU. We do not change out IV fluids. If necessary, we will hang more LR or NS to maintain the line.

[JustaPatient]

I am not sure if it is started in the PACU where I am a patient, I do not believe they do, it never has been, and everytime I was hospitalized I had one.

[kezza444]

We always start our PCAs in PACU. They are often used to give the patient bolus doses before going to the ward.

[I love my cat!]

We always start our PCA's (in PACU). It is set up and then the settings are double checked by another PACU RN. Once the patient is DC'd to the floor, the floor RN will also check the settings and then we can sign off the patient.

[Siss]

We start the PCA in our PACU. It seems to help relieve pain sooner that way.

[at2726]

We start all of our PCA's in PACU. Although today I have an order to start the PCA if the patient can't tolerate PO fluids or no pain control with Lortab. So if this patient needs the PCA they won't get it until they get on the floor.

[PACUJennifer]

If the pt is awake/alert and pain has been brought under control,we give them the PCA teaching and they start administering it. Even if someone is still too sleepy to have it started,it is ALWAYS connected up in PACU -has to be right at the hub of the intercath,so we have to take down the IV drsg - the control won't be given to them though - that happens up on the floor once they're wide awake.

[Babs0512]

We always start PCA's in PACU. It is often the only pain relief we have. Obviously patients who've had Duramorph in their spinals will have to wait for the PCA, but if it was a spinal/epidural without duramorph, the we can start the PCA.

My problem is the PCA is considered a high risk med, and is suppose to be signed by two nurses. We have a small hospital. So, when I'm on call, I'm the only one in PACU in the middle of the night. Usually, the OR has left within 15-20 min. What do you all do if you need another signature?

Calling the supervisor helps depending upon which supervisor is working. Some just don't want to work.

I often triple check myself and then start the PCA, as I don't want my patient in pain.

Suggestions appreciated.

[JustaPatient]

Originally Posted by Babs0512

We always start PCA's in PACU. It is often the only pain relief we have. Obviously patients who've had Duramorph in their spinals will have to wait for the PCA, but if it was a spinal/epidural without duramorph, the we can start the PCA.

My problem is the PCA is considered a high risk med, and is suppose to be signed by two nurses. We have a small hospital. So, when I'm on call, I'm the only one in PACU in the middle of the night. Usually, the OR has left within 15-20 min. What do you all do if you need another signature?

Calling the supervisor helps depending upon which supervisor is working. Some just don't want to work.

I often triple check myself and then start the PCA, as I don't want my patient in pain.

Suggestions appreciated.

Not a nurse here but have an idea, though I am not sure if it is feesable. Find out what they are planning to write for before the surgery is over. Then you can get it ready, and before leaving the OR nurse can check it. Since I am not a nurse, I obviously do not know if this would work.