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One minute you might have a fresh lap chole who rolls into the door talking....and an hour later you have an immediate post-op liver resection who is bleeding and requiring large volumes of fluid, albumin, blood, pressors, and is intubated.
either/or. I realize it depends on the hospital/PACU. and do PACU nurses stay in PACU or are they expected to work pre-op/OR, too?
Very much hospital/facility dependent. Some surgery centers expect their nurses to work PreOp and PACU. I've never worked in a hospital that had that expectation. OR RNs and Pre/PACU RNs are almost always two separate staff.
I work Per Diem in a Level I Trauma Hospital's PACU so we are staffed 24/7 . I work an off-shift and by the time I get there in the afternoon, most of the cases are coming out. I'd say the beginning of the shift is pretty hectic! I'm managing my pt, and at time calling the doc for orders or waiting for anesthesia to sign my patient out (basically saying they're ok to go home/tx. to the floor), charting, charting and more charting or I'm transferring them. By around 9/10PM things do start to die down but that's the time you never know what you're going to get! Obviously after this time, the cases are unscheduled emergencies, usually a stabbing or shooting... I've also had nights where it's 9/10PM and I'm sitting around doing nothing for the rest of the night (rare).
Can anywone here share any advice.. I've been an OR nurse for 5 + years and I'm about to start a PACU training program. I have no ICU experience... do you think I will be okay? I have my ACLS & PALS. I've been the Code Blue/crash cart resource person in the OR unit and I am very experienced with high aquity, ICU patient population. Any suggestions or ways I can prepare? Thank you.
RNSOCAL......your "resume" sounds better than mine!!!! But all I can think of off the top of my head is OR nurses don't give many IV meds. Learn about giving opoid pain meds, the reversal agents, Narcan and Romazicon, and antiemetics. Sometimes you hang antibiotics. Depending on the acuity of your OR you may deal with more complex vasoactive drips.
OR is a whole different animal than PACU. Hopefully your training will be as extensive as I'm sure your OR was. Experience with high acuity patients in the OR is different than dealing with that patient post op. Post op you may have to extubate them, manage a vent, or manage drips. You do have an advantage as you know each surgery is and you probably already have a relationship with many of the surgeons and anesthesiologists. Just try to recover as many different types of patients with your preceptor as you can. There are books out there such as Drain's Perianesthesia book that may help. To begin with I would suggest you get familiar with different types of pain meds and their dosages as well as blood pressure medications for hyper and hypotensive conditions. Good luck!!