Does your OR have to hold til theres a PACU bay?? - page 2

by PACURN1818

Ok.... So nearly ALL our patients scheduled today came out in a three hour time span, like stacks of three at a time, killing us. At one point we are out of PACU bays, putting people on the edges with transport monitors. THEN we... Read More


  1. 1
    i work in a level one trauma center( PACU rn for 18 out of my 27year career).. we have 30 OR's and we frequently put the OR on hold--happens pretty much 4 outof 5 days a week ( they dont like it!) if it is a long wait ( longer than about 20 minutes, you can bet the docs want to know WHY they are waiting and often have no problem calling the manager and saying " ummm fix the problem!"--- often, upper management comes to solve problem --always the problem is that the floors or ASU can't take the volume at which we are sending them... so STAFFING-- be it on the floors or ASU or wherever is the problem.....
    and i can say that better managers work right beside you ... and we always explain to surgeons and anesthesiologists it is STAFFING.. need more nurses in other places of the hospital to handle the volume--teh docs always get it...
    the administration NEVER GETS IT...
    azhiker96 likes this.
  2. 0
    My understanding is that where I work, yes the OR must hold until a spot opens up in PACU. Of course, when that happens, they all come out of the woodwork to help PACU get them moved out.
  3. 0
    I agree with all the posts. Our OR must call and we tell them where to call. There have been times when they forgot to call and there have been no bays and we turn them right around back to the OR. ASPAN is awesome. THey have a clinical practice forum that you can ask questions and not have to join. I have worked at 2 PACU's 1 a very busy Level 1 trauma center and they still call report 10-15 minutes before the patient is coming out. I don't agree with a portable monitor and O2 at a desk for a fresh post op. You are setting yourself up for a possible bad event. I would move a patient that is nearing the end of their recovery to the desk and put the fresh post op in a bay.
  4. 0
    I work in a 17 bed PACU and we have OR hold patients frequently. We hold by our standards of PACU nurses not being able to take care of any more than 2 patients at a time and 1 ICU patient (unless really stable). If all our nurses have 2 patients, we simply make them hold in the OR. Usually the delay is caused because we are holding patients that are ready to go to the floor, ICU, CCU , or Outpatient Center and they don't have the space to take them. When management gets involved, usually space is made somewhere but we pretty much stick to our "guns" and make them hold them in OR until we can take them, we get a lot of flack about it but we figure it's the only way we can provide safe patient care because we know if they are being held in the OR with a CRNA in attebndance, they are getting the care they need. I say, pull out some guidelines from CPAN and use them to your advantage!
  5. 0
    Our Facility is one in which if you tell the OR to hold you can set your watch and in 2 1/2 minutes the CNO is marching into the room asking why Dr ........ cannot bring his patient out? fix it now and don't hold them up ,this is irrelevant of how full the room is or how busy stretched thin the nurses are .
  6. 0
    Quote from cymrudenver
    Our Facility is one in which if you tell the OR to hold you can set your watch and in 2 1/2 minutes the CNO is marching into the room asking why Dr ........ cannot bring his patient out? fix it now and don't hold them up ,this is irrelevant of how full the room is or how busy stretched thin the nurses are .
    The simple reply in almost all cases at our PACU would be, "Bedboard has not given us rooms for the patients. Here's their number. Yes, please fix it."

    We have criteria for discharging patients and we follow the ASPAN standards for staffing and practice. I won't risk patient safety or my license by ignoring published standards.
  7. 0
    I couldn't believe my eyes when I read that the OR just barges in and you have no clue what you're getting! The ORs always call before they're coming out with a quick report. And, if we don't have any nurses or if the CRNA/Resident can't sit with the patient until a PACU nurse becomes available, then the OR is on hold. Also, when the ORs go on hold a page goes out to the entire hospital, and the charge nurses work on getting rooms opened up.
  8. 0
    At my last job, the OR had to call before they came out and if there was no slot, they were placed on hold. At my newer job, the OR does have to call out and get a room, but if "nobody answers the phone" (aka they didn't bother calling), they just come out and put the patient in the first slot they see. Whats worse with this is they spend more time asking where to place the patient which is more time that O2 sats aren't monitored. I have been raising the issue at this new hospital, but in the push to decrease turnover times, the management is less than thrilled to push the issue. It is a sad state when it does happen and makes me ask a lot of questions when there is a lack of rigidity in the rule structure/enforcement.
  9. 0
    Yes! When pacu is full, we call OR front desk and they then have to call to see if there is room for them...if not, they hold pts until a spot comes available.


Top