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

[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 send total joints over to inhouse holding. THEN three more come out with an ICU at the end, all angry we have no where to put them and crazy impatient as we scramble to put them places.

One of our nurses is a long time PACU nurse with experience in other hospitals and said several places she worked the OR had to call and see if they could come out, and had to actually HOLD patients in the OR until their bay was available. Our OR chugs along completely unconscious of our capacity or resources, and we are all getting a bit worried about missing something, or not giving people enough attention.

Whats up in your PACUs?

[pacurn60]

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.

[pacuvanessa]

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!

[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 .

[azhiker96, BSN, RN]

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.

[anne74]

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.

[djmatte, ADN, MSN, RN, NP]

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.

[Celaine54]

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.