Calling All My PACU Nurses

[Misszilla]

Question for my PACU peri operative nurses. What is the flow of patients in your surgical setting? 

Specifically, once the patient comes out of the OR to PACU the nurse recovers the patient and once the patient meets criteria to go to phase 2 does the PACU nurse keep the patient to discharge him or her or do you hand that patient off to a Phase 2/discharge nurse? 

[Glam03]

Usually we staff PACU 1 and PACU 2 with different staff. We occasionally have to keep our patients from PACU 1 and follow then to phase 2. It just depends on if phase 2 RNs need help. We tend to keep them if they are a peds patient too. 

The RNs are expected to float wherever staff is needed. 

[Misszilla]

Thanks. We used to have assigned staff to do pre-op, assigned staff to do PACU, and assigned staff to do phase 2 staff, but we are all trained to do each area. Once the patient met criteria in PACU we would hand them left to a new nurse for phase 2 and we’d go back to Pacu to recover another patient. Several months or maybe a year ago they switched it up and now we don’t have assigned staff to do Pacu and phase 2. We recover a patient in Pacu and keep them to discharge. It becomes challenging doing it this way when you have a phase 2 patient wanting to go home but have a recovery patient that needs 1:1 while the airway is there. 
 

I am trying to get a feel for how other areas do it before I talk to my manager and head of anesthesia about it. Thought maybe if I ask here I would get some ideas I could suggest to help make it better. 

[Glam03]

We also have CNA's that can be pulled. We have 2 Charges- 1 for PACU and Prep and Hold. They try not to assign patients to Charge as they can be an extra set of hands. If they are busy, they page anesthesia CRNA or MDs to help. Our OR nurses if they aren't busy will assist as needed.

We are expected to be very flexible and help each other out as needed. We can float between prep and hold, PACU 1, and PACU 2 all in one shift. We definitely earn our pay checks and the day goes fast. 

[LovingLife123]

I could not see that working if you have a ton of surgeries happening.  We recover in phase one until they meet phase 2 criteria then they go to a phase 2 nurse.  We have people coming out for recovery constantly.