icu policy regarding post op recovery

  1. Lately OR has been bringing ICU patients to ICU :angryfire for us to recover. This lets PACU off the hook. We are not a big hospital, and generally PACU will recover in the ICU for the hour or so. I would like your hospital's policy on this please.
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  2. 4 Comments

  3. by   mattsmom81
    This is the usual for many hospitals and I have felt concerned too at times...and there is no policy prohibiting it. PACU generally wants the ICU patients out of there ASAP or bypass the RR completely if possible 'let ICU recover'. Many times the surgeon and anesthesiologist just want to go home (specially after hours) so they will prefer to drop the patient off in ICU and try to hit the road. I push to get them to hang around a bit while I asess, hook up monitors and machines, etc...cause its scary when the anesthesiologist is seen emptying 'mystery syringes' into my patients IV line as they roll into ICU! I work with some aggravating anesthesiologists who just grin when we ask what drug just got shot into my patient (I'm suspecting its Epi to make the vitals look good for a bit...just until he can get out of there) Love how they don't have to label syringes.....GRR.

    I can get a bit obnoxious about the docs sticking around a bit because of this scenario above and vitals bottoming within 30minutes...can you tell I've been burned?
  4. by   kyti
    Just for clarification, are we talking about ventilated/sedated pts or are we talking about extubated pts.? I need more information. I work in PACU and I worked in ICU prior to that. Our ventilated/sedated pts bypass our PACU. This decision is not mine, the PACU nurse's have no say , it is the decision of the anesthesia provider. If the pt is vented and sedated you will not be "waking them up" They will never meet aldorette criteria for discharge from PACU. If they are that unstable, you would be assigned 1:1 or 1:2 anyway same as in the PACU. I am willing to see both sides of this, I just want to be sure people understand that it is not because the PACU nurse doesn't want the patient or can't take care of the patient or wants to go home! When I am on call I am alone (usually with an aide or nurse unfamilliar with PACU) on the ground floor away from everyone else. This is not the safest environment to be taking care of critically ill patient. I am more than willing to go to the ICU to assist them with the recovery if asked.
  5. by   rwall
    Quote from kyti
    Just for clarification, are we talking about ventilated/sedated pts or are we talking about extubated pts.? I need more information. I work in PACU and I worked in ICU prior to that. Our ventilated/sedated pts bypass our PACU. This decision is not mine, the PACU nurse's have no say , it is the decision of the anesthesia provider. If the pt is vented and sedated you will not be "waking them up" They will never meet aldorette criteria for discharge from PACU. If they are that unstable, you would be assigned 1:1 or 1:2 anyway same as in the PACU. I am willing to see both sides of this, I just want to be sure people understand that it is not because the PACU nurse doesn't want the patient or can't take care of the patient or wants to go home! When I am on call I am alone (usually with an aide or nurse unfamilliar with PACU) on the ground floor away from everyone else. This is not the safest environment to be taking care of critically ill patient. I am more than willing to go to the ICU to assist them with the recovery if asked.
    I too have worked PACU. I am not talking about you and your personal situation nor others like you who do their work. What is the Minimum Time requirement for the patient prior to be brought to their room? Aldrete score would be based on their admission aldrete anyway. Whether or not these patients are intubated or not, they should have the PACU nurse present for minimum time. You know that PACU meds used are different than ICU meds due to the anesthesia interactions. Also, the Anesthesiologist has to stick around until they (the anesthesiologist) clears them. Nothing beats a crashing fresh post op without anesthesiologist present. I don't know. Doesn't seem safe or right to me.
  6. by   stbernardclub
    I agree....Does not sound safe to rush them to ICU. Actually is sad how many corners are cut today for others convenience or to save money.This is why more and more attorneys are malpractice attorneys!
    Quote from rwall
    I too have worked PACU. I am not talking about you and your personal situation nor others like you who do their work. What is the Minimum Time requirement for the patient prior to be brought to their room? Aldrete score would be based on their admission aldrete anyway. Whether or not these patients are intubated or not, they should have the PACU nurse present for minimum time. You know that PACU meds used are different than ICU meds due to the anesthesia interactions. Also, the Anesthesiologist has to stick around until they (the anesthesiologist) clears them. Nothing beats a crashing fresh post op without anesthesiologist present. I don't know. Doesn't seem safe or right to me.

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