Quote from allthesmallthings
2) Can anyone give me some kind of picture of what day surgery and PACU are like? Day-to-day working conditions? What does a PACU look like? I've only been in an OR once, during clinicals, for a C-section, and have never seen a PACU. I'd like to have something relevant to say for the interview!
I know I sound kind of like a bumbling idiot; I want to go to days, and to more critical care; I just don't want to kill anyone or fall flat on my face or lose my license while doing it!
A PACU nurse is responsible for recovering patients from anesthesia. It could be general, MAC, epidural/spinal, etc. Typically you would care for these patients for about an hour, until they either go to their hospital room (if they're awake enough and stable, bed is available- we've held patients in PACU for an entire shift because there weren't any beds available) or are ready to go to the post-op/discharge area. Lots of pain management, monitoring vitals, dealing with side effects of anesthesia (N&V along with others, but that's the most common), handling emergencies (airways on patients who are unable to maintain their own, the occasional code), sometimes invasive line monitoring.
Some days can be pretty crazy, depending on the schedule. Other days, particularly around the holidays (Black Friday is the next one for us) there may be a limited number of surgeries and you could have a low census day off. Some days there may be all quick cases, and the patients are coming out of the OR non-stop. Other days they may all be long, involved cases where they trickle out or all come at the same time needing a higher level of care. The typical ratio is 2:1, although where I work it's 1:1 if the patient is ICU/step-down, comes out on a "wake-up" vent, or is a pediatric patient.
Most PACUs are set up as cubicles divided by curtains (not closed 100% of the time), with the exception of the isolation rooms. If the unit has good teamwork, there's always someone to help you with getting the patient hooked up to monitors while you're getting report. With the open set up, people can also see that you may be in trouble/have your back, etc.
A PACU/day surgery nurse may be one of three options: only PACU; pre/post/PACU, where you rotate between getting patients ready for surgery, recovering them, and discharging them; or cross training to do some combination of PACU/OR or pre/post/PACU/OR. Whoever interviews you would be able to answer that question, or it may be that they haven't determined which combination of units the person hired will work in until they see who they hire. Good luck!