Minimum staffing in recovery

sharann, BSN, RN · Oct 20, 2003

Hi Squeek,

You sound like a wonderful nurse and a team player. It isn't OR verses PACU. You have seen the other side. I personally come in on call, and help in the OR when needed, sometimes as a runner, other times just to support the circulator. In turn, the ones I have hepled have always stayed with me until the pt was recovered. This is at night when there are no resources. When a patient comes out of OR, they are critical. All patients are, until they are awake, oriented with stable vitals. If they go bad they go fast.

squeek · Oct 21, 2003

we all work on the same team!

squeek :nurse: :nurse:

gracenote · Nov 12, 2003

I worked in a pediatric PACU for many years in Ohio. We were almost all members of ASPAN and local chapter and very involved. I can honestly say we followed ASPAN recommendations for staffing. We were always 1:1 ratio in PACU. On call recoveries were done in the ICU extra bed space with ample staff available for assistance (which happened to be adjacent to the OR). OR circulator stayed with PACU nurse until patient was extubated. If all ICU beds were full, OR circulator stayed in PACU with us until transfer to floor. We also were in OR during case as second circulator. I guess I was fortunate to work in a place with proper staffing.

ckalston · Nov 24, 2003

In our recovery room, we recover any after hour patients in a designated area in ICU. We are responsible for the patients but have ICU nurses within earshot should we need help.

I have a question about access to narcotics after hours. We use to have kits that contained multiple medications for use that had a paper we could fill out for each patient that we used medications on. We could use this sheet and kit for all the patients we cared for while on the call back. Now we have to go to the Pyxis station, pull out one of each drug that we anticipate we will need (with a witness), recover that patient, return to the Pyxis, put back any drugs not used and waste those not used completely. All require witnesses. I am curious if others still use kits or do they have to remove medications per patient.

Thanks,

Originally posted by HawkinsRN

Surely you are joking right? Like any PACU is going to abide by these rules? If I am on call, called in at 0200 for an Appy, I get there, get my patient, Anesthesia LEAVES....OR leaves....with the exception of a lowly scrub tech left on phone watch. If I have a problem, ANY HELP is a phone call away...leaving me at least 20 minutes with no help, unless I call a code, which I have had to do in the past, just to get help.

When my patient is recovered and ready to go upstairs, I get to push them up myself, even if they are in a bed that does not steer. If I gave narcotics, and I have stuff left to waste, then once I return to the unit from my trek upstairs, I get the lovely task of paging my beloved supervisor who then makes me wait an additional 45 minutes before I can go home. Of course, this is all on their clock, so it works in my favor, unless you figure in for lost sleep.

I really would love to hear of anyone whose unit abides by the Aspana staffing "suggestions"
~E

Beaner · Mar 11, 2004

The 2001 SOC state that there must be 2 license personnel in the PACU as long as there is one patient and one must be proficent in PACU. On the weekends and at night our 2nd RN is the OR circulator and they stay until the patient is dc'd from PACU.

We are currently having this discussion in our PACU also. When we are "on-call" for emergency surgeries we are required to have two RN's respond to the call back. Because we are so short staffed we wanted to add our 1 LPN and our 2 PCT's to our "call" roster to be used as the second person. Our manager does not agree. She claims that both nurses must be RN's. How do they define "license personnel" to act as a second person?

sharann, BSN, RN · Mar 11, 2004

I am not directly quoting, but from memory---ASPAN guidelines are that TWO licensed staff must be there when a pt is in recovery at all times if ONE is an RN proficient in PACU.

So, I think that the licenced staff could be a LVN but not a tech or nursing assistant. As long as one staff is an RN from recovery room. I hope this is accurate. You could check out ASPAN's site for the actual doc.

I wish our managers would allow 2 RN's at once to recover at all times.

Yapmom · Apr 10, 2005

Do any of your facilities utilize phase II staff to help out in phase I and vice versa?

ckalston · Apr 10, 2005

In our facility, our phase 1 and phase 2 and our preop staff are all the same. We have on average 4 nurses on duty per day and tend to 14-19 surgical patients from preoping, holding, recovering them and if necessary discharging them. This is a inpatient setting and we only do about 50 Phase 2's per month but about 250 cases or more per month.