Here are the different perioperative stages,which are similar in all hospitals. Perioperative meaning the entire process of having a (usually) surgical procedure to walking out the door to home, or out to a postoperative nursing unit. In our centre it goes like this:
- Pre Admission Clinic - this is where some pts begin the process,a week or more before their surgery,usually those with more complicated medical histories (e.g. diabetes,chronic renal failure,coronary artery disease,etc - who are worked up before their surgical date: lab work,pulmonary function studies,ECGs, CXRs,etc.
- Pre Op - those mentioned above and all other cases check in here the morning of surgery and v.s.are taken,npo is confirmed, a ride home is clarified (or the case will be cancelled),and patients change into gowns and booties,etc. Any preop medications ordered are given here.
-IntraOp - pt is having their procedure or surgery in theatre, cared for by Anesthesia and Nursing staff (mostly anesthesia)
-Phase 1 or PACU (Post Anesthetic Care Unit), some hospitals call it PARR Post Anesthetic Recovery Room. You arrive here immediately after your time in the OR. This is a critical care area - a patient's airway,vital signs,pain and nausea management, and fluid status are the primary focus here. Complications postoperatively are not uncommon - Laryngospasm, cardias dysrhythmias,bleeding; because all anesthetics - general or spinal, sedatives, analgesics, and nerve blocks have the potential to affect vital signs (usually a depressive effect).patients are carefully monitored to assure safe and comfortable recovery. Xrays to confirm placement (hip,pacemaker,etc)and that no damage was caused (e.g.pneumothorax). The APS - Acute Pain Service ,if consulted,see patients here - often Patient Controlled Analgesic or a Continuous Nerve Block are initiated here.
When a patient's nurse has decided, based on set criteria, that the pt is dischargeable from PACU, she/he will call report to the receiving floor nurse, ICU,or IMCU nurse, and send the patient to a floor/Unit bed. Or,if the patient is a day patient they go onto Phase 2....
-Recovery Phase 2 (in my hospital it's called PRL (Post Recovery Lounge) - is where the patient goes when the PACU nurses have made sure that the patient ; has reached an optimum level of consciousness and comfort, and has stable vital signs which must be within 20 % of their preop readings (Aldrete Score). It is usually in this area where pts receive another set of vs,a snack,and preop teaching (verbal and brochure) is given. Appointment for followup visit with surgeon is arranged.
If you think you might be interested in pursuing a career somewhere in the PeriOperative process, I'd look for permission to shadow a nurse in each of these areas. They differ vastly.
The training needed is very area - specific; to my knowledge, an OR course is necessary to work in the OR theatres.Several months long here. To work in PACU,you would require an ICU course or experience, or a PACU course (3 months long here) or previous experience. As far as Phase 2 is concerned,to my knowledge there is no specific course;you are educated via a preceptor (an experienced RN) - on-the-job training,if you will. Nurses who need lighter duties e.g. back injury are sent there (here) - no previous perioperative experience needed. This may not be the case everywhere, however.
If you find something which interests you as you shadow,then look into getting the specialized education needed - that you can't
The OR course is focused on becoming a scrub and/or circulating nurse. There, largely,it is the anesthetist,anesthetic resident,and anesthetic tech who have hands on care of the patient That is completely
different from a PACU course - PACU being very much a hands-on area,where the emphasis is intense observation and advanced intervention needed to safely care for potentially unstable patients who,for a time,cannot protect their airways - we do that for them. In depth knowledge of all sorts of anesthetics,narcotics,sedatives,nerve blocks and their potential side effects are learned.
I would suggest shadowing a nurse - no commitment,no outlay of $$ and you could get the 'nitty gritty' (the good and the bad) from someone at the front lines. All the best!