PACU/OR nurse issues - page 2

by Trishjlb 8,461 Views | 13 Comments

Hi, I am a PACU nurse and work primarily evening and weekends. During the weekdays all pre op patients go to the preop dept to get ready for surgery. On off hours pts come to PACU since that dept is closed. We have been doing... Read More


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    Another OR nurse here. We take care of the pre-op ourselves, the only thing we do with PACU is we use the "unused" side of recovery for our after hours "holding area" it's just closer. We don't call PACU in until we have to.....
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    Well this is a new concept for me, this PACU RNs holding and pre-anesthesia assessment. On off hours the hospital I used to work in had the OR RN call for patient when Anesthesia got there, the OR RN does not read monitors or start IV and does not give meds, other then handing them to Anesthesia. He/She however does the appropriate Nursing assessment and check list and get report from floor RN. PACU is called in one hour before case ends for recovery. Now, where I work holding RNs are part of PACU, but do not work weekends or off hours. We have PACU phase I staff on Saturday day shift, so they pre-op. On off hours my Nurse manager does not want PACU to be called in to pre-op, sit around for case to end and then recover. Too much call pay to lay out, so on off hours, OR has the pre -op responsiblity, but Anesthesia is there to do IV, pre-med, and monitor. I don't think OR RNs need to have the IV skills, or monitor skills. I certainly can not do their job with out years of training, they are a different specialty. But pre-op Nursing paper work is responsiblity of all RNs, and getting a comprehensive report from unit is also an RN responsiblity, we as PACU get the patient next and who knows if that floor nurse has gone home, so I need an accurate, pertinent report , that is where OR RNs need tobe compentant on, in addition to their OR skills.
    CaliLvr000 likes this.
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    Our OR nurses have lost all of their assessment, IV and patient management skills. The ones I work work have no desire to obtain a patient history. They don't even want to touch the patient. They are used to the anesthesiologist managing the patient. Read a monitor? Are you kidding? They put the leads any old way on the patient. They have no concept of what other areas in the hospital do. then again, I have no desire to work in the OR. I enjoy patient care, patient management. I'm ok with it. Let them do what they like to do. I've seen some OR nurses not question a 84 year old going right to the OR without blood work or an EKG on them. They don't get it.
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    I'm an OR nurse and where I come from, if there's an after hours patient, they are either admitted directly to the floor or come from the ER, and whichever it happens to be, that's the department that takes care of the pre-op. It's pretty common though that the patients who came from the floor didn't get their blood drawn like it was supposed to be, and in that case, either the OR nurse does it or we get anesthesia to do it if the patient is a hard stick. The only thing we ever get pacu nurses to do is an EKG if it's needed because OR nurses aren't certified to do them at my facility. We always have pacu nurses in house though so nobody would ever get called in for it.


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