Minimum staffing in recovery


  1. I would like to open discussion on ASPAN'S statement on minimum staffing. I am trying to find out how many PACU's do not follow the statement due to the interpretation that recommended means not mandatory. What have you done to encourage management to abide by the recommendation.
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  2. 31 Comments

  3. by   carrie
    Judy: Which ASPAN Standards are you referring to? The latest ones I have were published I think in 1995. And, my hospital (Children's Hospital Los Angeles) is definitely not following the recommendations, and woe to any nurse who should broach the subject.

    Carrie Lybecker
    carriel@earthlink.net
  4. by   Patricia Smith
    The ASPAN communications that your refer to should be used as the "Standard of Care" Every hospital has them--utilizing them is the problem--I have brought these recommendations with me to many meetings and have referred to them. I realize it is not mandatory but it is "safe practice". If your hospital is NOT utilizing "safe practice" there are reporting agencies. DON'T become a part of the nursing forum that doesn't speak out--we would be doding a terrible injustice to our patients and each other! Good Luck to You!
  5. by   jayep99
    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.
  6. by   abby
    we carry a maximum of 3 pts at a time and its not uncommon to have a child under 10yr old and a ventilator pt, and a med surg pt all at the same time. we are currently short staff by 3 full time employees and are covering the available positions. only this month i am scheduled 88hrs of call and in addition 152 scheduled hours. and never make my 40hr per week. i work in new orleans,la. i blame poor management. who needs them.[paper pushers.
  7. by   HawkinsRN
    Originally posted by jayep99
    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.


    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
  8. by   jayep99
    The circulator must stay in the PACU with us until we transfer the patient out. They didn't like it at first but then we (PACU ) must come in when the OR crew is called out. We can help transport or do anything they need us to do. So it works both ways. We are all pretty close too so that helps!
  9. by   HawkinsRN
    In the places I have worked where PACU staff were encouraged to wear hospital scrubs and help out with the OR, there was never a problem. It wasn't us vs. them...and they helped us when we were in a spot, and vice versa. My current workplace has total and complete segregation between the two. Needless to say, they are reluctant to stay any later than they have to to complete their work, and we never cross that dreaded "red line."

    I am sure that if we re-evaluated our policy and tried to do more cooperative type policies, that it would be a better all around place to be. Feeling support from another nurse, even if she really can only run and fetch things, or help hold a patient down, is a very valuable thing to have! You are lucky to have that in your work place, even if you had to fight initially to get it. Kudos to your manager for making this decision and sticking to it.~E
  10. by   SmileyMouse
    Where I work the only department that is fully staffed is PACU. Followed closely by the OR. Hmmmm I wonder why that is?
  11. by   HawkinsRN
    Originally posted by SmileyMouse
    Where I work the only department that is fully staffed is PACU. Followed closely by the OR. Hmmmm I wonder why that is?
    PROBABLY because this is a money maker! Just like OB!~E
  12. by   jayep99
    I tend to think that it is because people who work in those depts. enjoy working there. I have a very low turnover of staff in the PACU and everyone likes working there. "Call" SUCKS but it comes with the job.
  13. by   HawkinsRN
    Not in our PACU! The core people have been there forever, but are nearing retirement. The newbies never stay longer than a year maybe 2. So sad. BUT this could just be our little unit with it's poor office politics. Most other places I have worked as PACU have been a tightly knit unit, like you mentioned. I really miss that.
  14. by   Charity
    Want to hear of a hospital that actually follow staffing guidelines? Mine does. Usually.

    Our OR operates 24/7 and therefore so does the PACU. There is no call. We have a huge full-time day crew and a full-time night crew. Minimum of 2 RN's and a NA during the week and just 2 RN's on the weekend.

    Some nights are so busy we can't even take time to call for help. Some nights we are nicely steady. Some nights we are ICU overflow. Some nights we don't see a single patient.


    Our hospital is extremely short-staffed. We are getting pulled more often to one of our ICU's. If we are alone, they try to provide another nurse (one who couldn't go to ICU) or at least an aide. If all else fails, a nurse in another unit is put "on alert" to come immediately if I call. If it really comes down to one nurse present, the OR is notified so that they can try to close a room. (usually run 2-3/night). Of course, the nurse can always refuse to accept another patient until she feels it is safe to do so. Anesthesia must stay until then. And they do. We take that very seriously (you would also if you saw our anesthesia residents. Scary bunch). The OR nurses themselves are very nice, but mostly useless.

    Our unit's biggest stress is not staffing, but the ICU overflow business. Our night crew are all ICU veterans, but our day people are quite a mix. Lots of whom don't want anything to do with a very ill person.

    My hospital is a complete mess. But somehow they stumbled into a safe standard for our PACU, and we are holding them to it with a vengence. --C

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