I have just started a new job in a PACU. I am in my 5th week of training. I have been a nurse for 2 years and worked in a step down unit prior to this job. The other day my manager called me in to inform me they were going to keep me on orientation for another 2 weeks, which is fine with me because considering I have had 8 different preceptors in this time I am not feeling very well oriented at this point and was going to request some more time anyway. However, when she told me this she also stated that I seem "too quiet" to be a PACU nurse and these nurses are usually loud and in your face. She told me she wants me to feel frustrated and to lose control. I am sorry....I really do not want to lose control because it is not my desire to harm a patient which is very well what could happen if I lose focus. She also said I do not "jump in there" when a patient comes in. That part threw me because I do jump in and help get the patient situated except when there are 4 other PACU nurses around the patient along with the people that have come from the OR. I do not see the need for me to get in there when there are 6-8 people already around the patient. Anyway....any suggestions would be appreciated. I have already reached out to some friends to look for another job because I honestly am thinking maybe my personality does not fit.
Sep 1, '12
Well, I don't have any experience in the PACU except as a patient, so I have to say she full of total you know what! Too quiet? She wants you to be loud and in their face? In the PACU?? Really??? The PACU isn't a place where you should be loud and in someone's face. Because, let me tell you, if I had someone screaming at me, I'd be one to throw a punch to get you OUT of my face, especially with being groggy from anesthesia! I don't get that comment at all!
Sep 6, '12
I hope I am not too late in responding. You may be right about not a good fit but not for any of the reasons your manager suggested.
Every job situation is going to have some bumps along the way. It may be best to find another job, but it has been such a short time, you don't want to quit or give up for every bump in the road.
Sit down with your manager and tell her you are confused by her comments. (They sound really crazy to me? Is she normally a rational person?) Take a pen and paper so you can write down what she wants you to do so there is no confusion or mix ups later. Tell her what you have written and ask if that is what she meant?
"You want me to lose control?" "You want me to jump in there when there are already two or more nurses, the surgeon, and the anesthesiologists assisting the patient, no acute distress, and leave other patients in the unit unattended?" etc.
Sep 22, '12
PACU RNs should be composed and intelligent ... with astute assessment skills. You don't have to be loud and out of control. What matters is how well you recover the patient and anticipate their needs. The quiet ones are usually more observant and can see things way before the loud one realize it. My gut feeling is that your composed behavior may be even more therapeutic for a waking patient compared to the loud nurses who make a big fuss out of something that can be managed more calmly.
Sep 23, '12
Very confused by her statement to 'lose control'. I agree that some clarification would be helpful. Wondering if she is just regurgitating what her 'loud nurses' have told her about you. This may not be a good fit related to the fact that this is a different kind of PACU!
Sep 23, '12
Sounds confusing at best...coming from my POV as a PCT on a busy cardiac unit, it is just terrible and rude when I have to work with some of these old-time(crotchety) CNA's/Nurses...that barge into the patients room calling them all kinds of degrading things like honey and love and sweetie etc... always in a loud and condescending tone that makes me and the patients want to take ipecac. My point is be quiet and confident and professional...in my short time I have spoke with so many more patients that are scared and want somebody to be quiet and kind and introduce themselves to them...simple right? I wonder sometimes with some of the idiots I work around. (I do not say with). Loud is not better...loud is simply loud and uncalled for in a therapeutic setting in my mind.
Oct 4, '12
Thank you all.....but I decided to go ahead and save myself and I resigned my position. Kind of a shame because I really enjoyed the work. However it felt kind of exhilarating to tell them I was not going to be back. I am headed into hospice care....where I think my quiet demeanor will be appreciated, not only by the patients, but to the staff as well.
Oct 13, '12
Kath, I'm happy that you made a decision you are pleased with, and if you feel that Hospice nursing is for you, I have no doubt that you will do a great job! So congrats.
I did want to weigh in on the personality/PACU issue. I am a new grad orienting in the PACU (same unit where I did 500+ hours as a student last year). I remember my old preceptor saying that she thought 2 personality types do well in the PACU, at least in our unit: those who are assertive, in-your-face alpha types, and those who put their head down and do their job quietly and efficiently. I fall more into the second category, and I find I do well in our unit. We have several nurses in both camps, and we all work pretty well together. As long as someone is assertive in his/her care of the patient and is willing to call up a doc to get what the patient needs, it is not necessary to be confrontational to do a good job. Losing control is not helpful; you do need to have a high stress tolerance for the situations that quickly go down the tubes.
As far as what type I think would not do as well: probably someone who needs a lot of hand-holding (there just isn't time, but we do all pitch in and help each other more than I've seen in other units) or someone who isn't proactive. Of course, I can't imagine not being proactive in any area of nursing; it's just that in the PACU, you are constantly anticipating problems that can occur quickly, without warning. Again, not too different from other areas of nursing. Best of luck in your new job!
Nov 10, '12
Well...hand holding was not an issue.....just a lot of "alpha type" personalities. I think the final straw for me was after a 2.5 months there I was given my orientation book.....after 2.5 months I thought...my God....maybe they should have given me this on my first day.....hospice has given me the chance to be more independent and I have found I am using a lot more critical thinking.
Nov 14, '12
Glad you found something that better fits you. I don't think loud is appropriate for a PACU nurse. I work in a PACU setting- not in the medical hospital, I recover people post ictal and post anesthesia in a psych/ECT unit. Actually you need to be quieter because sometimes being loud can agitate the patient or make them restless and that will reflect in their vital signs becoming unstable and 9/10 times once you quiet down and decrease stim their vitals return to normal.
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