Why do you like PACU nursing?

Friesw/that · Apr 29, 2004

I applied to dental hygiene school but an now having second thoughts and cannot stop thinking about the possibility of nursing. PACU interests me specifically after recently having surgery and viewing the role of nurses first hand. Do you like your job? I love to stay busy at work and enjoy helping people. How do you deal with seeing people that have passed away? Do you get used to it? That's my biggest hang-up, but I guess you get used to it. The variety of fields in nursing is enticing as opposed to doing the same thing everyday in dental hygiene. Please tell me why you chose nursing and if it's what you expected once you got in.:)

PACU is like a box of chocolates--you never know what you're going to get.

In our level one trauma hospital, we take all comers.

You may come on shift and have 4 ICU patients waiting for you, 7 more cases to come, and several people waiting to go to phase 2.

Night shift is always unpredictable in PACU--something about those quiet hallways.

Since we are a level 1 trauma center, we quite naturally get those friday night mva's, domestic altercations etc...who just happen to have been drinking and/or druging. they then undergo general anesthesia, subsequently wake up, still drunk and/or druged, and promptly proceed to vomit all over themselves, and any handy nurse. post-op etoh-combo anethesia breath is the absolute worst!!!!

of course there are other cases, which are rewarding, and others which are just plain sad. it all comes with the territory.

to cut to the chase, i like PACU because it is never dull.

hope this helps

kyti · Apr 29, 2004

Agree with above post. Also, I work at a mid sized level 3 hospital so we only staff 7-1730 monday-fri with someone on call during off hours. No family unless you request them to come back. No weekends or holidays (unless on call ). They are with you for an hour or two then gone. People rarely die in PACU. I can only remember 2 deaths in the past apprx 10 yrs. They were very old and very sick. Generaly a great place to work. :)

MissMelMcRN · Mar 10, 2007

I was wondering, What is your role as an RN in PACU. I had one day in PACU and I really enjoyed it. Would appreciate your response.

Thanks, Melissa RN Student:nurse:

tazski12 · Mar 13, 2007

I was wondering, What is your role as an RN in PACU. I had one day in PACU and I really enjoyed it. Would appreciate your response.
Thanks, Melissa RN Student:nurse:

As an RN, you are and will always be the patient advocate. Such as, the RN will be the patient's last safety device before a medication is made sure has is for her and is safely for her. Or that the patient's right to live according to his/her will is upheld. It doesn't really matter which unit you go to. We nurses are the patient's advocate.

What does differ is the level of expectation on critical thinking. Since the cases you get on PACU are not stable, as nurses, we have to stay (or atleast we try?!) to be one step ahead.

I'm a two year old (in IMC/Rehab/Hospice -- I liked experiencing a lot of things) RN and I'm doing critical care course while being precepted in PACU. I made a note at how my preceptor is treating me like as if I'm a newGrad. The educators I talked to and a colleague that I talked with told me that it is normal. As the line goes "When she says: JUMP! You say: How High?", is expected.

Did I go off track? Pardon me, I couldn't help sharing you a piece of my experience.

healingtouchRN · Apr 1, 2007

I use all the skills I learned in CCU, ER & in massage & energy schools for assessment & management of everything, from airway to pain scale. I like having that one on one close up time to watch the process of waking up. I work alone usually so my time management skills are honed by having to play secretary, get orders into the computer or get meds not in pyxis from pharmacy, get a room assignment made & a housekeeper to clean that room. I have a cell phone for my use with MDA & CRNA as well as hospital numbers at my fingertips so I can coordinate care without having to leave my bedside. I have alot of autonomy by working as I do. If the stations are not stocked with supplies, then it's my fault, blankets warmers not filled, my fault. I take great pride in keeping things running on the night shift & safe for the patients who choose to have their surgery our medical center. It's the best job I've had in a long time in the hospital. My team leader, CRNA's, MDA's, OR nurses, house supervisors & CST's make it a real team effort for good patient care. Critical Thinking can be exhilerating!

JennieO · Apr 17, 2007

PACU is great. It is where you go after ICU. We are a level one trauma center and always have two RNs on at night. We never leave an RN alone--I actually think that would be illegal. People do NOT die in the PACU. At all costs, the pt. is not to die in or around the OR. Bad for M&M. It they are crashing they go directly to the ICU. If you are an ICU RN, have you ever worked with a nurse who has worked PACU. Probably not. That is like going from ICU to the floor. Highly unlikely. PACU is like the lotto of nursing. Oh, and the doctors treat you very well and call you by name.

healingtouchRN · Apr 17, 2007

In my area, it is not illegal to work one RN in PACU. I have criteria I follow to care for no more than 2 adults simutaneously or 1:1 with peds. I have an on call RN less available in less than 30 minutes. I have a CRNA & MDA just a door away in their call rooms. Plus the OR RN (a former neuro ICU RN) & a CST available for help. The house supervisors (who are former ICU RN's) check in with me each night. My team leader is on call 24/7 by cell phone & has come in when we've been busy, without complaint. I feel quite comfortable in my work place.

Charity, RN, APRN · Apr 17, 2007

In my area, it is not illegal to work one RN in PACU. I have criteria I follow to care for no more than 2 adults simutaneously or 1:1 with peds. I have an on call RN less available in less than 30 minutes. I have a CRNA & MDA just a door away in their call rooms. Plus the OR RN (a former neuro ICU RN) & a CST available for help. The house supervisors (who are former ICU RN's) check in with me each night. My team leader is on call 24/7 by cell phone & has come in when we've been busy, without complaint. I feel quite comfortable in my work place.

ASPAN standards just say 2 RN's IN THE SAME ROOM. And adult care should be 1:1 for the first minutes of admission. Not illegal, but if other hospitals in your area do 2 RNs, then you are deviating from the established standard of care for you area. Not to mention plain risky. But hey, that just me.

To the original poster: PACU RNs manage airways, pain and the complications of anesthesia and surgery. That usually involves emesis, confusion, positioning and post op testing. Some days everyone wakes up smoothly, bright-eyed and smiling. Other days you swear you have a 100kg rabid raccoon in the bed. Of course that is the one with all the drains!

I love PACU nursing.

healingtouchRN · Apr 17, 2007

as far I know, I am the only full time 3rd shift RN in PACU in the city. All the other hospitals (smaller than this one) just have a call person for 3rd shift. I don't feel uncomfortable at all since the staff from OR does not leave the PACU until I give them the ok to do so. If I know that we've got a kid in the OR or a trauma then I go ahead & call in my back up.

MissMelMcRN · Apr 17, 2007

Thank you for all of your replies concerning a nurses role in PACU. It was very helpful! Thank you again!

Melissa, RN Student ( 2 weeks left of my first year :monkeydance: )

almostretired, BSN, RN · Apr 28, 2008

According to ASPAN standards, 2 licensed nurses are present in PACU whenever a patient is recovering in Phase I.