ICU RN in need of less physically demanding unit, PACU? - page 2

by SunshineRN32

6,724 Views | 18 Comments

I have been working in the ICU since I was a new grad a little less than 2 years ago. I love it SO much, but I know that I physically cannot continue. I am on worker's comp right now for a back injury while pulling up a patient... Read More


  1. 0
    Hi, I am a PACU nurse, it is still a very demanding job. People seem to think that it is easier, but it has to do with what you describe as easy. We run a very fast moving PACU. Hurry get them in, hurry get them up to recliners or up to their rooms. When you return from either of those, guess what you have pt's already in your slots waiting for you. Lots of tasks before you can send them upstairs. Yes there are bedpans, incontinent people, fighting sometimes when they first awaken. Of course the airway is your primary responsiblity everything after that is gravy. Pain meds, setting up PCA's arranging for correct orders to be placed on charts, getting cpm/crutches and teaching family/pt., you need to arrange home health if ordered, you will sometimes need the case manager and last but certainly not least you will need awesome public relations to help families when they are already stressed. We strive to do this all within 2 hours max.. You will be pulling pt's up in bed constantly so they can breathe better. You are rearranging/fluffing and placing pillows to help relieve surgical pain. I really think you might want to visit you PACU before transferring, just so you know there really is no less involved RN position any where. I love my job, but the grass is not always greener on the other side, just a different set of problems. We have staff shortages often just like every where else, while one of our ICU's was under renovation some came to work with us, some very seasoned nurses. Their thoughts were" I thought this was going to be easier here. I will never tell the PACU that we are not ready to accept their pt's and I will spread the word to my co-workers". Maybe after you visit a PACU, you will realize all nursing units work very hard for all our pt's needs. I truly believe the hardest I've seen nursing working is on MICU or long term vent floor. Now that's some very hard work and heavy work. My hat goes off to them and I think I could probably learn a thing or two from all of them. Good luck with your decision.
  2. 0
    Thank you, sbfairy, I appreciate that insight very much. I hear mixed things, so it does sound like it varies depending on facility. Yes, pre-op or an ambulatory surgery center is definitely on my radar. Thanks again

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  3. 0
    Hi Suz, I didn't even see your post until I had already replied to the one after it. Wow, that sounds like a lot. I know all nurses work really hard and I wish I was better physically equip to deal with it. It's hard to come to this realization as a 27 year old. I appreciate your detailed description. I agree with checking out the PACU first. I wonder if that would raise red flags with potential employers, as to why I'd want to see it. And of course preop is an option I'd consider as well. Thanks again

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  4. 0
    PACU can be very physically demanding on busy days, especially where you have more than one fast-moving theater list. If it's ent with a lot of peds, you can be run off your feet, and you'd be amazed how strong those little ones can be if they wake up confused! That's the downside. On the upside, not every day is like that, and you'll have your days in between where you can catch your breath and take it - well, not easy, but a lot easier! But yes, if your PACU is adequately staffed, it's generally a lot less demanding than any ward, or what you call floor, setting. Tends to be more mentally stressful, when you find yourself counting the seconds while the sats are plummeting
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    PACU involves a lot of standing as well as the activities mentioned in the other posts. I move around the bed a lot to keep the blood flowing! We do boost patients, and every patient leaves our unit in a bed, on a stretcher, or in mom/dad's arms in a wheelchair, all of which have to be pushed by the nurse. That happens 4-6 times in a normal shift, and the beds are brutally heavy, even with a normal-weight patient in them and someone to help push! The patients range from totally mobile (can boost themselves, sit up without help, etc.) to totally dependent (either pharmacologically paralyzed or coming in with preexisting paraplegia, etc.). We also turn patients to look at epidural sites, remove Hovermats, change bedding, and check perineal dressings. The good thing (and I have no idea if this is also typical of the ICU) is that our unit has a couple of fantastic LNAs, and the nurses all help each other with positioning and transfers when the LNAs are busy.

    I have had some back problems in the past and have learned to move the right way at work to avoid aggravating it. The strangest things can be a problem; I used to really struggle with picking up our IV pumps, which are surprisingly heavy, especially when they are loaded up with multiple channels, PCA set-ups, etc. Now I know to pick it up with both hands and place it on a high surface. Also, like the ICU and anywhere else, it is vitally important to put the bed, bedside table (where we do our charting on laptops), etc., at a good height for you. Our PACU patients don't get out of bed, so I can put the bed or stretcher up pretty high so I'm not straining to reach them. Just have to remember to lower the bed when we take them to the floor!

    Go visit your PACU for the day, and move along with the nurses so you can see what the job would feel like. Expect to be very tired the first day as you will be working different muscles than you are used to! Good luck; I love the PACU and wish I had ICU experience to bring to my job!

    BTW, a good hiring manager should welcome your interest in shadowing; you're making sure you like the department BEFORE they invest anything in training you!
    Last edit by wannabecnl on Feb 26, '13 : Reason: Added one more comment... (as if it weren't long enough)
  6. 0
    Quote from veeveeRN
    I have been working in the ICU since I was a new grad a little less than 2 years ago. I love it SO much, but I know that I physically cannot continue. I am on worker's comp right now for a back injury while pulling up a patient only a few weeks after a neck injury! Additionally, I have a rheumatologist trying to diagnose a possible autoimmune disease that has left me fatigued, lightheaded, with joint pain and numbness.

    I am considering applying to the PACU. Now, I am in no way saying PACU nurses have an "easy" job. I'm just looking for less turning every 2 hrs, cleaning incontinent patients up, getting OOB to chair, running from room to room, etc.

    I thought PACU would be a good transition. Any input or thoughts? I don't know much about the PACU.

    Thanks!

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    PACU is not less stressful or physically demanding. I am a NM for a Perioperative setting and would say you should explore other options. I also have 10 years experience in NICU and that is a high stress job as well - it's a calling not for the faint of heart. Newborn nursery may be an option.
  7. 0
    Quote from GHGoonette
    PACU can be very physically demanding on busy days, especially where you have more than one fast-moving theater list. If it's ent with a lot of peds, you can be run off your feet, and you'd be amazed how strong those little ones can be if they wake up confused! That's the downside. On the upside, not every day is like that, and you'll have your days in between where you can catch your breath and take it - well, not easy, but a lot easier! But yes, if your PACU is adequately staffed, it's generally a lot less demanding than any ward, or what you call floor, setting. Tends to be more mentally stressful, when you find yourself counting the seconds while the sats are plummeting
    Thanks for that insight! Coming from a very acute Trama Center ICU, I know that I work with a lot of stress and pressure. And often times I like the rush of intense situations. I was just looking to take down the physical a notch, but still leave room for some acute situations. I think the PACU, as you described it, maybe able to offer that.

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  8. 0
    Quote from wannabecnl
    PACU involves a lot of standing as well as the activities mentioned in the other posts. I move around the bed a lot to keep the blood flowing! We do boost patients, and every patient leaves our unit in a bed, on a stretcher, or in mom/dad's arms in a wheelchair, all of which have to be pushed by the nurse. That happens 4-6 times in a normal shift, and the beds are brutally heavy, even with a normal-weight patient in them and someone to help push! The patients range from totally mobile (can boost themselves, sit up without help, etc.) to totally dependent (either pharmacologically paralyzed or coming in with preexisting paraplegia, etc.). We also turn patients to look at epidural sites, remove Hovermats, change bedding, and check perineal dressings. The good thing (and I have no idea if this is also typical of the ICU) is that our unit has a couple of fantastic LNAs, and the nurses all help each other with positioning and transfers when the LNAs are busy.

    I have had some back problems in the past and have learned to move the right way at work to avoid aggravating it. The strangest things can be a problem; I used to really struggle with picking up our IV pumps, which are surprisingly heavy, especially when they are loaded up with multiple channels, PCA set-ups, etc. Now I know to pick it up with both hands and place it on a high surface. Also, like the ICU and anywhere else, it is vitally important to put the bed, bedside table (where we do our charting on laptops), etc., at a good height for you. Our PACU patients don't get out of bed, so I can put the bed or stretcher up pretty high so I'm not straining to reach them. Just have to remember to lower the bed when we take them to the floor!

    Go visit your PACU for the day, and move along with the nurses so you can see what the job would feel like. Expect to be very tired the first day as you will be working different muscles than you are used to! Good luck; I love the PACU and wish I had ICU experience to bring to my job!

    BTW, a good hiring manager should welcome your interest in shadowing; you're making sure you like the department BEFORE they invest anything in training you!
    I REALLY appreciate this detailed insight. I agree about visiting PACUs first and about the importance of body mechanics. I'll miss the ICU, but I'm hopeful that the PACU maybe a good fit.

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  9. 0
    Quote from Syhuggins

    PACU is not less stressful or physically demanding. I am a NM for a Perioperative setting and would say you should explore other options. I also have 10 years experience in NICU and that is a high stress job as well - it's a calling not for the faint of heart. Newborn nursery may be an option.
    I appreciate that advice. I'm getting so many mixed reviews, I guess it really is dependent on the unit itself. Is there anything about a PACU (ie size) that accounts for how much the work load varies?

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