Our Level I Trauma centers sends overflow TICU patients to the PACU. Occasionally we get patients directly from TRauma Admitting who do not need OR. TICU patients will go to the OR and be "Downgraded" to Trauma stepdown or floor while they are being operated on. They have not even recovered from their surgery or GA and are still intubated/vent. We must care for them the best we can. Recently our manager will mandate TNCC or ATLS courses for us. Has anyone else had Shock/TRauma patients in their PACU? We have ICU and floor boarder patients all the time. We are staffed 24/7 so we care for them until a room is available in ICU or they are "downgraded" to a Stepdown bed. The Trauma Attendings are not on hand in the PACU and the anethesiologist wants to sign off on their cases ASAP. We are left trying to page a resident who usually does not know who the patient even is... Is anyone else in this situation? I would be glad to hear some feedback. Thanks.