PACU frustration

Specialties PACU

Published

Hi all experienced PACU RNs! I have just started working (finished 12 days of orientation) in an outpatient surgery center with no previous recovery room experience. My background is home health for the past 6yrs and 4 years of med-sug prior to that. I really want this PACU job to go well but am having a difficult time remembering all the nuances of different docs and keeping up with the experienced staff. There are so many things I like about this department - the team work, my co-workers, the fix-m-up and dc, and the fast pace. I especially have trouble when the patient first arrives although the whole team helps....the monitors make me feel like an idiot! I really want to stay in this area but am doubting my capability :mad: Any words of wisdom, suggestions, would be much appreciated.

Specializes in PACU, OR.

What bothers you about receiving a patient? And what kind of monitors are they? Are you not familiar with the type? We only use oximeters and dynamaps in our PACU, and only attach ECG monitoring if there's and evidence of cardiac arrhythmia. Give me some more details...

Specializes in PACU.

give yourself a bit more time, 12 days of orientation does not make you "ready"for PACU, I do feel some critical care background is a must for PACU, but that doesn't mean you can't be a competent RN. The PACU nurses should be a team in accepting a new patient into unit, but once patient is settled one nurse usually takes over. Hopefully you are not shying away, your fellow RNs know your new, but have expectations that you will be there for the opportunities to continue to learn. If you really have an interest in the this field of nursing, which I consider the best area to work as a nurse, then keep going... nursing jobs don't get any better then PACU. You made a big change, and it will take time, but it is doable if you really want it. EKG monitoring can be confusing, but plenty of books, cheat sheets out there for review. We all know NSR, so if it is different, ask... that is how you learn. If you want it you'll have to work for it, but the personal rewards will outweight this "PACU frustration" you now feel. Good luck.

Thanks for the replies. Yes I do think this could be one of the the better nursing jobs available and I really want to succeed because of that. And, it is definitely a team approach when that patient arrives....maybe that is why I feel a bit incomptetant because the team is like a well oiled machine and then there is me, definitely feeling shy. I think you are right though in stating 12 days isn't so much. About to start another week so hopefully I will do better and not hold back.....

Specializes in PACU, OR.

Sometimes you might feel like you don't have enough arms when you're receiving a patient. Remember, your first responsibility is to attach the correct breathing circuit, depending on whether the patient is intubated, has a laryngeal mask in situ or a Guedal airway, and to ascertain whether the patient is ventilating adequately. Your pulse oximeter is the first monitor you attach-the rest can wait a couple of minutes. Listen closely to what the anaesthetist tells you; the good ones will give you a detailed account of the drugs they administered, and that will tell you what to expect. Watch out for signs of inadequate reversal. Awww-I can go on for hours. After 20 years in PACU, I'm not seasoned, I'm curried and chillied! Anything that bothers you, come back and I'll try to help you.

Thanks CC-do! I'll take that advice with me this week :p

If you have been working in the PACU less than 2 weeks, feeling a bit overwhelmed at times would be normal, just as I would think anyone would have moving to a completely different area. It'll get easier when you have been there a bit longer and get into a routine.

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