PACU/OR nurse issues

  1. 0 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 more and more surgeries on off hours and it has become a big issue between the OR and PACU as to which dept is responsible for preoping the pts. I'm wondering how this is handled in other hospitals??? Thank you!
  2. Visit  Trishjlb profile page

    About Trishjlb

    47 Years Old; Joined Feb '10; Posts: 2.

    13 Comments so far...

  3. Visit  MsBruiser profile page
    0
    Quote from Trishjlb
    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 more and more surgeries on off hours and it has become a big issue between the OR and PACU as to which dept is responsible for preoping the pts. I'm wondering how this is handled in other hospitals??? Thank you!
    And I thought my hospital was the only one with this issue! An OR nurse working call with me this weekend put it best and actually answered the question about why they do not pre-op after hours - "I have not given an IV medicine in years, I cannot remember the last time I had to start an IV, I cannot remember how to administer blood products - I can check them, I can't remember how to give them." And this is an OR nurse I really, really respect. 25+ years of experience.

    I cannot tell you how many times I have been woken up (while on call) at 2 am, told to come in to pre-op a patient, and basically hooked up some IV fluids and gave some Versed. Little did I know that those simple tasks can throw an experienced OR nurse into spasms. No matter how much we try - we always get called. Such is life.
  4. Visit  Trishjlb profile page
    0
    Grrr...this just seems so ridiculous to me! Especially in today's world where every penny is watched. Do we really need to spend money paying call pay for pre-op??? The hospital I work at is a teaching hospital so there is always an anethesia resident to do anything that requires much experience. Basically someone has to just do the obvious stuff: check ID band, consent, allergies, site marking, etc. Nothing complicated. Really it is about sitting with the patient until they are taken into the OR. There must be some standards or usual practice out there to refer to?!
  5. Visit  MsBruiser profile page
    1
    I'm not complaining...easy money.
    PaKuRN likes this.
  6. Visit  GitanoRN profile page
    1
    Evidently, this wouldn't go well in the facility I work, for the simple reason that once a staff member states that they are not familiar with any given procedure, I send them to get the training necessary to address the issue. Furthermore, even if the staff member has 30+ years like myself, but he or she is lacking on skills they are going to get them even if I have to come in and do the training myself. Moreover, issues like these are address during nurse's week, and also during the staff evaluation period. Lastly, this is a matter of saving money to your facility and delivering a high standard of care to our patients without any delays. Best of luck to your facility resolving this matter
    PaKuRN likes this.
  7. Visit  All4Seasons profile page
    0
    Shhhhh.....at the moment we have no preop responsibilities in our PACU. On weekends,the OR is responsible for getting the pt from the waiting area and escorting them into the theatre. Anesthesia does the preparatory work. Mon-Fri,the preop area does this (though not any ivs or iv meds...are you kidding me?!) they have totally lost their bedside nursing skills, and refuse to do anything -they return the pt to PACU for the smallest thing....even tried to recently for a pt who was ordered a CXR just as the pt was heading out the pacu DOOR....you'd thing they were being asked to DO the xray themselves!

    Sometimes a pt is brought from another hospital by paramedics for a pacemaker or AICD insertion and we have to hold them for a few minutes - but we just put them on the moniter and take a set of vs -not much else.

    I feel for any of you having preop duties added to an already FULL shift!
  8. Visit  GitanoRN profile page
    0
    PACUJennifer, my sentiments exactly, I strongly feel that this issue needs to be brought to light in order to be addressed properly. Best luck to all of you that are going through this dilemma.
  9. Visit  scoochy profile page
    0
    I was formerly a PACU nurse; it was mandated by the Dept of Public Health in the state where I reside that pre-op patients could not be placed in a PACU to await surgery. The OR had to take on the responsibility for pre-op pts "after hours" when the pre-op area closed. The PACU staff could no longer "be dumped on" as they always had been in the past.
  10. Visit  All4Seasons profile page
    0
    Quote from scoochy
    I was formerly a PACU nurse; it was mandated by the Dept of Public Health in the state where I reside that pre-op patients could not be placed in a PACU to await surgery. The OR had to take on the responsibility for pre-op pts "after hours" when the pre-op area closed. The PACU staff could no longer "be dumped on" as they always had been in the past.
    WOW! That's excellent!!
  11. Visit  Tiffany, RN, BSN profile page
    3
    I'm an OR nurse and we pre-op our own patients on call. Its a good way to brush up on skills. If there's an IV, I usually will try 2 sticks and then wait for the anesthesiologist if I don't get it. I give my own heparin, hang my own fluids, etc. Its not hard at all and I wouldn't want someone calling me from home for something so trivial. If there's any problems or meds I don't feel comfortable giving, I know I can always call anesthesia.
    CaliLvr000, PaKuRN, and SandraCVRN like this.
  12. Visit  SandraCVRN profile page
    0
    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.....
  13. Visit  PaKuRN profile page
    1
    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.
  14. Visit  sukiathome profile page
    0
    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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