PACU RN requirements

[smnurse]

Hi!

This is my first post.

I am interested in knowing the level of nursing experience your facility requires for RNs providing Phase I care of patients, particularly pediatric patients. Our PACU is combining with our Same-Day Surgery dept., so that Phase I/Phase II care will be delivered by the same nurse in the same location.

In our present PACU staff, we have always required our RNs to have a minimum of 2 years Critical Care experience. However, with the merge, we will now have nurses with no Critical Care background--and limited med/surg experience-- caring for patients in Phase I, including ICU overflow patients. Despite cross-training, several RNs have put patients in jeopardy. Thankfully, our regular PACU RNs were readily available to help correct what could have been disasterous situations.

We have shared our concerns with the managers from both areas, but they seem to feel that they can learn "on the job" with the help of clinical resources.

What do think about this? Any experience with this or a similar situation? If so, what did you institute to help the less experienced staff safely care for patients?

Thanks for your help!!!!

[wanna learn]

true! No one is perfect. Yet, no one should judge the others as burden when it comes to learning.

[PostOpPrincess, BSN, RN]

It is very difficult to work with someone without critical care experience. The problem comes the day you are without support (weekends?) on call and sometimes wheels right in through the ER.

You have to be able to handle WHATEVER it is--especially when your anesthesia doc is busy dealing with some other issues.

At night. Geez, now my heart is palpitating..

[MOTOXRN2004]

Would like to recieve feed back from ER nurses who are now working PACU ....pros and cons of PACU nursing, I noticed there are different levels of PACU noted on this blog, which level would an ER type training fit in, etc.... or PACU nurses who have worked with an ER transplants......do ER nurses on average adjust well to this line of work and do they end up staying in PACU

[metroishka]

I am an ER transplant to our PACU and outpatient surgery. There are many similarities to ER and PACU- the need for excellent assessment skills, IV proficiency, cardiac rhythm interpretation, short patient stays, strong organizational skills, etc. I had a lot to learn when I transferred to PACU, but I also feel that I had a good background of critical care/thinking skills that made the transition easier. I loved ER, but I think that PACU is the next best thing (better hours and a bit more controlled environment). I have been in PACU for 10 years, so I guess I like it!

Phase I is the immediate post op period when patients are emerging from anesthesia and require the most intensive monitoring. Phase II recovery continues with monitoring of vital signs, pain control, and preparing the patient for discharge home. Both of these levels of care are very similar to what you do in ER- assess, monitor, intervene, evaluate, and teach. It's very rewarding!

[lsvalliant]

Im a fairly new nurse with only a few months of med/surg and a few months of OB experience. I got into the PACU training program at a level 1 trama center where I work and I am going crazy with how difficult the training really is. The hardest part is trying to take an ICU competancy exam without ever having set foot in an ICU! I would say its ideal to have ICU experience, but I also think if the training program is extensive enough, as this one is, it should be sufficient.