OR Nurse in PACU

Specialties Operating Room

Published

Long story, but I have been working for the last three months in PACU after being an OR RN most of my career. I had 9 years away from nursing - worked as an OR secretary, scrub tech, went to school for performing arts, then SAHM to my daughter, returning to nursing after passing NCLEX in 2009 (I trained overseas but have lived in the US since 2001). I was working in an ambulatory surgery center as a circulator & occasional scrub, loved it. Then we had to move. Through a misunderstanding with HR at the hospital where I now work (they told me I was interviewing with the head of perioperative services), and me getting no response from anywhere else, I am now working in PACU.

I feel like a fish out of water.

My stress levels are through the roof.

I suspect I may have a gastric ulcer.

Oh, and I might mention I started distance education graduate study in Public Health 3 weeks ago. :-/

The staff have been good to me, very patient and (mostly) understanding, but I always feel like there's something lurking waiting to bite me in the butt (I never felt like this in OR nursing.) I'm not starting to feel more comfortable like I thought I would, just stressed and anxious all the time, even at home. We have to go in on days off for compulsory staff meetings every 2 weeks, and they're really getting onto us about doing lots of continuing education, which is also not helping my stress levels. I've only started about 3 IVs in my life (on reorientation program), have never taken bloodwork before, and I am terrified of making a mistake. I feel fairly useless.

I talked to the periop director about transferring to the OR, but they have nothing part time open right now (can't do FT because of grad school).

So do I stick it out a bit longer? Or do I start sending out resumes again? Or do I start looking for something in the Public Health field? Or quit altogether and do grad school full time? I really loved OR, but the PH thing is for the long term view - can't see myself doing OR nursing into my 60s. Working in PACU just makes me feel like a square leg in a round hole.

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Specializes in Peri-op/Sub-Acute ANP.

I would suggest you stick with PACU even if for a little while longer. I recently moved from the OR to PACU and I have to say that a lot of what you are saying rings very familiar to me. Just try to recall how overwhelming the OR was when you first went into that specialty. It got better, didn't it? You soon became an expert and no long lay awake at night worrying about what your assignment was going to be the next day. You could handle everything that came through the door! One day it will be like that in the PACU. I still have "stupid" days in the PACU, and expect that I will for some time to come. It took me about a year before I was fearless in the OR, and I imagine it won't be too much less in the PACU. You are learning a new skill set, and that will be true what ever new field or OR you go into. Embrace the discomfort if you can - it tells you you are learning and growing!

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Thanks, TTA. I know I probably will eventually feel more comfortable...I just worry that I will inadvertently do something to jeopardize my license in the meantime. Or a heart attack. :-P

Good to know there are others who have made the transition. Every OR nurse I've talked to about it basically said "Heck no. I'd never work in PACU."

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Specializes in Surgery, Med/Surg/ICU, OB-Peds, Ophth.
Thanks, TTA. I know I probably will eventually feel more comfortable...I just worry that I will inadvertently do something to jeopardize my license in the meantime. Or a heart attack. :-P

Good to know there are others who have made the transition. Every OR nurse I've talked to about it basically said "Heck no. I'd never work in PACU."

Is there some specific task that you are doing that is making you feel this way? I moved from the OR to PACU/SSU 2 months ago for the first time and I am loving the change, but whoa...very different!

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Specializes in PACU, presurgical testing.

Every OR nurse I've talked to about it basically said "Heck no. I'd never work in PACU."

That amazes me; I would give anything to get back into the PACU! I did my 400-hour clinical immersion in an acute care hospital PACU with 16 beds, infants through elders, and LOVED every second of it. Now I am looking for a PACU to hire me as a new grad with this clinical experience. But my classmates said the same thing: "Why on earth do you want to work in the PACU??"

It was very different from the OR, so I can certainly understand that you feel like a fish out of water. I found that my assessment and documentation skills came a long way in a short time when I was doing 10-minute vitals and 15-minute assessments, constantly monitoring airways, and addressing pain needs, things that were done in our OR by the anesthesia staff, not the nurses. It was fast, with lots of autonomy and a laser-focus on one patient at a time, just to switch to a new patient with a different surgery every 1-3 hours! I also found the teamwork to be incredible, with nurses and LNAs pitching in so much more than I've seen elsewhere. There is a flow that I've seen in 3 PACUs now, and you'll get it--you have so much experience that you just have to apply in this new, weird setting! :) And if you really don't like it, let's hope for an OR slot to open up for you... (and if you're nearby, maybe I can have your job when you go!)

BTW, I know there is a lot more on the line for you as a licensed RN than I had on the line as a student. It's not the same situation, and I don't want to sound like the PACU expert that I most certainly am not. I did observe the same level of support for the nurses who were transitioning into the PACU from other units while I was a student and hope that you find the same thing!

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