Newbie - ICU vs PACU

[quote=ngshelton;3394970]


What I am asking is: For those of you that have done both ICU and PACU, did you find PACU as being a more structured setting?

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No. On any given day you could be recovering a bunch of kids getting tubes or T&As, the next lap choles and total joints, then another some vent pt on propofol and vasopressors. Some of that could be all in one shift! It is really just what's on the OR schedule and how the patient does during the surgery. Everyone responds differently to anesthesia. Just like in ICU, you have a wide variety of patients.

However, in PACU the patients typically aren't held as long so you're not usually dealing with some of the issues of ICU patients. Like starting tube feeding, dressing changes, visitors, multiple MD consultants.

You don't say WHY specifically you don't feel ICU is the right place for you. Do you feel overwhelmed, having issues interacting with co-workers or physicians, a lack of support from ancillary staff? Do you feel like you are grasping pt disease conditions, interventions, medications, procedure, etc for ICU patients? It sounds like you are still on orientation and have only been there about 4 months. I would say give it more time to at least complete the orientation and work on your own for a time before you know for sure. Maybe study a little at home on meds and diseases. However, if there is an issue with a toxic work environment that's a different story.

I don't understand what you mean by structure/organization in PACU is greater than ICU. When I worked ICU, it was much more routine. 7am report, 8am assessment and turn, 9 am meds, 10am turn and chart, 11am physician rounds, 12pm assessment, meds, turn, chart. Etc, etc.

I think most PACUs require 1 year of experience in ICU anyways.

Hi! I worked in critical care for many years and at a few different hospitals. I am now working PACU and love it. I will not go back. But would I recommend you leaving ICU right now? No. Although I am glad I am not in ICU anymore, I am glad I have the years of experience under my belt. Stick it out for another year or so. Get at least 1-2 years of critical care experience and then see what you want to do.

As for PACU being structured? Not really, like the above post says. But it's nice having patients in and out quickly rather than for 12 hours straight, day after day. But not as hectic as the ER in my opinion where people off the street roll in for random things.