Any pediatric PACU nurses here?

[djmatte, ADN, MSN, RN, NP]

Just have some questions about working in this setting. I have been a PACU nurse for a couple years. Did two years at a good size adult PACU in downtown detroit, six months moonlighting as a pain service nurse, as well as about 5 months now at a different PACU with a mixed adult/peds environment. From the adult side I have seen it all...from heart procedures, back procedures, cranis, ex laps, limbs, really unstable ICUs, etc. On the child side its been mostly small scale procedures like circumcisions, tympanoplasty, and one really big AVM surgery on a 13yr old, and the occasional ligament reconstruction.

I recently got an offer to interview in a childrens hospital here in the city I live. If I got a job here it would be a huge cut in drive time (save me 35min driving one way). I actually really like the current place I work and the people I work with, but the drive can be dreadful, especially 5 days a week. I really want to work with kids and this place JUST openned their new facility and is known for cutting edge procedures. Would be an incredible opportunity if I got an offer here.

So I guess my questions are more how do you like the environment? Were you an adult nurse first and moved over to peds? Is there a personality trait that would be more fitting for a PACU nurse in this environment (aside from the "I just want to work with kids")?. Is there a downside that I should anticipate? Do you find the nursing environment comparable to the adult side or different and how?

Thanks in advance for any answers you can give!

[GHGoonette, BSN, RN]

Can't really answer your question, as I work in a "mixed" PACU setting. We don't see all that much major paeds surgery, and those which we do are, as you have already stated, mostly confined to ENT or dental work.

What I find is that when we do get paediatric surgical cases, the anaesthesiologists are unfamiliar faces who wake the child up fully before coming to PACU, so our only tasks are pain control. This is in complete contrast with the practice of our regular guys who dope for the ENTs, and rush apnoeic, intubated kids to PACU for us to do the complete waking up and extubating thing, which is probably more like what you'll be able to expect in a specialized paeds hospital.

Look closely at their staffing before accepting a post there. If I'm working with kiddies who have had major surgery, I want to know that there are sufficent staff available to provide a minimum of 1:1 ratio at all times, with extra on hand for a 2:1 if I have a problem with a patient. As you know, any post-op child is supposed to carry the highest acuity rating, so there's no excuses for not having a minimum of one RN for each theater list running.