Am I Being Unrealistic?

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    I work in a busy PACU that has no ancillary help. There is no secretary or transporter "assigned" to this PACU. The phones ring off the hook and the RN's are expected to answer the phones, take off orders and enter them into the computer, fax, scan orders to Pharmacy, BedBoard, Call BedBoard to get a room assignment (or not
    as is the usual case). The Surgeons sit at this 2 person desk, dictating orders, writing notes, having loud conversations with other surgeons and anesthesia. The OR nurses sit at this desk also finishing their charting
    and we are climbing over everybody trying to get all this work done.

    The Pain in My Side, literally, is that this unit has no transporter to get the 30-40 cases per day to their rooms.

    About 95% of the patients are on Telemetry, which means an ACLS person has to go with them, which rules out
    most of the OR staff. We have to accompany any "PCT" and transport the patient to the floor (which can take up to 30 minutes). We have to BEG the already shortstaffed OR PCTs to help us all day long, and by the end of the day, they run when they see us... (and I really can't blame them)... this is not "their job"..

    The weekends are a nightmare, in that they do 10-15 cases with no transporter available and only 2 RN's working. (And we all know, 2 RN's have to be in the PACU at all times).... Most of the patients are ICU patients
    so holding these patients in the PACU for hours and hours can be an "experience" if you know what I mean....
    Things can turn sour quickly...and before you know it, you are running an ICU Unit with only 2 people in the room!

    This past weekend, we had to BEG the floor nurses and ICU Charge Nurse, to come and get their patients! We had no one to get them out of the recovery room!! (Of course this took hours to get everybody out!)

    Managment is fully aware of all of this and they have no one that can do this job on a regular basis. They have no plans to hire a secretary either... as this is the way "they have always done it"... (And they have lost 6 nurses in the past 4 months because of the way this unit is run)

    Physically, I can't do this much longer. I can push stretchers, but the big hospital beds cause my previously repaired hernia to ache for hours after a 12 hr shift and I am so afraid it will need to be repaired again if I continue doing this. I want to be a "team " player, but is this really in my job description?

    Do other PACU's expect their RN's to push patients all day?

    Thank you for any suggestions or advice...
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  3. 9 Comments so far...

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    What a mess!!! We run two floors of OR's and Recovery. On our second floor we have no secretary or PCA's and I thought that was bad!! I can't believe you guys have to transport your own patients. We would never be able to do that as there wouldn't be enough staff to safely take incoming patients! Sometimes, we call our manager to come push beds and/or admit patients if we are short staffed. She isn't happy about it, but that gets her to at least pretend like she is going to fix the problem because she hates to do it. Good luck!
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    Although not quite that bad I worked at a hospital that had the same mind set "it's the way we have always done it". It is amazing what you will get used to. It took a long time of hating my job and comming home and beating on a punching bag to get out my frustration before I decided to make a change. You know the saying the grass is always greener, well sometimes it actually is. I used to work at a hospital that had a small number of PACU nurses. On a good day we had enough to run all the bays with a free charge nurse to relieve for lunches and breaks. We also took call by ourselves with no other RN or ancillary staff to help unless you got to busy then you could call in your back up. If you did call in your back up it better be for a good reason, you know budget and all. After almost 10 years of working in that PACU environment with no change in site and yet another outside consulting group telling us how to do things I left.
    I now work in a PACU at a magnet hospital with a staffing ratio that actually meets ASPAN standards. We have various commities throughout the hospital that our nurses sit on as well as a unit based committee. We have the ability and are encouraged to make practice changes based on research if it will have a postitve effect on our patient care or working environment. It's very empowering to know that you have the ability to effect change within your unit and house wide if needed.
    I'm not telling you to quit your job. I just want you to know that if you ever get to that point the grass can indeed be greener you just have to do a little research to find it.
    GOOD LUCK!
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    I work in a Pacu in a smaller hospital, we have no transporters or secretaries. Sometimes it can get really busy and hectic. That said, we are not allowed to push the big hospital beds by ourselves. OMG! Does the hospital realize that they will be paying workmans comp for injuries?!! Nurses have more trouble with knees and backs than most other professions as it is. We push the carts back to floor by ourselves, most of the time. We now have a pt liason for OR who keeps the families informed and tell them when they leave Pacu. She helps us push when needed. The floor is supposed to come help if able ( have never seen this happen, they are usually swamped anyways), and have also called the house supervisor, manager, or outpatient to help. Sometimes, I have had to keep pt longer than needed if not able to leave. We do have a transport crew, they could help, but not take pt to floor, as our policy is for RN to transport and give report (even if phone report given). We are small and not a magnet hosp (although working on it), but things definitely need to change where you are or the there will definitely be more turnovers.
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    Wow. That's just crazy. We have ancillary help all week long and have someone on call during the weekend. When we work the weekend and the ORs are working too fast (i.e. 2 RNs have 4 patients already). They hold or the anesthesia provider recovers.

    I do not think it is fair to you and just ridiculous to work under that much stress.
  8. 0
    To the Original Poster,

    I have to say that what you describe is so bad,I am (almost) speechless. And I mean off-the-scale bad. If I were in your position,without a doubt,I would under no circumstances work in this ridiculous chaos. Life is too short and nursing is too wide a field to suffer this incredible abuse and mismanagement. What a nightmare...

    (I am assuming that you are not unionized, and that the RNs have officially detailed their concerns, in writing, and in the form of a meeting with management rather than put up and shut up or fade quietly into the night.)
  9. 0
    Quote from PACUJennifer
    To the Original Poster,

    I have to say that what you describe is so bad,I am (almost) speechless. And I mean off-the-scale bad. If I were in your position,without a doubt,I would under no circumstances work in this ridiculous chaos. Life is too short and nursing is too wide a field to suffer this incredible abuse and mismanagement. What a nightmare...

    (I am assuming that you are not unionized, and that the RNs have officially detailed their concerns, in writing, and in the form of a meeting with management rather than put up and shut up or fade quietly into the night.)

    I do not have a union at my hospital, but we are a magnet hospital and have a LOT of say in what goes on. There is NO WAY we would put up with the OP's situation. They put a lot of emphasis in patient satisfaction and since we are a large reason why people come to our hospital, they make sure the nurses AND ancillary peoples are happy.
  10. 0
    My heart goes out to you guys that sounds like hell, I feel exhausted just reading your posts. I work in a non Union Magnet hospital and we have 4 CNAs during the workday into PMs to do transports and stock and help out with patients. We have two bed mover machines that we use on 90% of our transports unless we are going to a unit nearby to the PACU. I gotta admit it would be wonderful to have someone to answer phones though because keeping on top of all of the ORs calling out and numerous other calls gets crazy at times.
  11. 0
    I live in a rural area, and our hospital (the one I am doing clinicals at) even has transporters for PACU, and all units I believe. Yes, the nurses in PACU have to answer the phones and receptionist duties a lot of times, I didn't see a receptionist type person, but at least they are near the patient when they do that and not on another floor.
    The fact that you do not have transporters is crazy, and dangerous in fact if there is not enough people to cover the patients.
    I work at an ambulatory surgery center, and they do not have transporters because its one building and its not very large, but at a hospital, just crazy, I hope things work out and that you don't get hurt pushing your patients.
  12. 0
    Sounds like a very scary situation. Not only for the nurse's sanity, but for the patient's safety. I would VERY CAREFULLY consider what aspects of your RN license may be getting pinched in these circumstances.


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