Specialties PACU
Published Feb 17, 2015
Samt9
26 Posts
I will be graduating in May and was wondering if I would be able to start in PACU w/o doing 1-2 years of med-surge?
Rose_Queen, BSN, MSN, RN
6 Articles; 11,910 Posts
Depends on the job market and facility policy. My facility will take new grads in PACU; another facility I interviewed at required every new nurse to do a year of med surg before applying for any positions in other specialties. Some facilities may not have any openings in PACU for new grads or experienced nurses. It's something you'll have to research to see what's available in your area.
Nurse_
251 Posts
Most PACU nurses have ICU background. But it depends on the hospital you're applying.
afterseason, ASN, RN
189 Posts
I started in pediatric PACU (still in it, too). Just depends on the place!
nursebubby
5 Posts
My unit takes newly qualified nurses, but I started after several years experience on a variety of surgical wards. I sometimes think the more you know, the more you know you don't know. I certainly feel experience gives a more holistic outlook and I do think there is a case for only accepting those with ITU experience in a busy acute unit.
Aliareza, BSN
91 Posts
In my hospital, it's impossible to get into PACU. Everybody wants it because the patient load sometimes gives you time to actually breathe and the hours are better than ICU. Good luck seeing if you can :). There's only one way to find out: contact the nursing manager of the PACU floor at your chosen hospital and ask. Maybe get your foot in the door by shadowing first.
Mavrick, BSN, RN
1,578 Posts
Why would you want to go into PACU without any experience?
I work in a fairly busy PACU with both inpatient and outpatient surgeries. Nurses here work very independently relying on superior clinical assessment skills and the chops to intervene in airway emergencies without a physician at your elbow. Sometimes I even overrule the anesthesiologist when I am at the bedside and he/she is on the phone. A not uncommon order is "whatever you think". After getting an order for 8mg of Dilaudid for pain the Doc started another case and was not readily available. In the next hour and a half I gave 63 mg of Dilaudid IV using my clinical judgement as my guide.
Patients are charged by the minute in Phase I PACU so we are constantly pushed to move 'em out and get another one. Any patient here over two hours requires a reason for delay report and your fellow nurses start razzing you about "starting adoption proceedings".
My most valuable skills are Prevention and Prediction. Don't let anything happen that should have been prevented and know when they're ready to be discharged before they do.
All this comes from experience and mistakes. Try not to make too many mistakes before you get the experience not to make them. I think Rita Mae Brown put it thus, Good judgment comes from experience, and experience comes from bad judgment.â€
And, yeah, I love my job. It's a good gig. My reward for 20+ years in ICU.
As they say, "PACU is where burnt-out ICU nurses go to die"
Have you thought about OR?
desert_MP, BSN, RN
40 Posts
I love the PACU. I worked four years in the OR and now that I'm in the PACU I can't think of anywhere I'd rather be aside from a NP in surgery. The autonomy in the PACU is amazing. I've never had ICU experience but it would definitely help. I'm taking a handful of courses on drips and lines to sharpen up.
gizmopacurn
28 Posts
Hi Desert, can you elaborate on what courses you took on drips and lines etc? We get a lot of Nursing students and other PACU RN's who would like refresher courses or just to learn.
Was it online or books? Or classes?
traebabes
Hi Desert, can you elaborate on what courses you took on drips and lines etc? We get a lot of Nursing students and other PACU RN's who would like refresher courses or just to learn. Was it online or books? Or classes?
Yes i would also like to know what course you could take for drips and lines??
We took classes. The ICU educator for the hospital I work at put them together. We took a 6 hour class on CVP's/PACs and a 4 hour course on vasoactive drips. I felt both were amazing and since I'm a hands-on learner I really enjoyed that portion of the class for the PAC.
Even working in a trauma 1 center I don't get much work with the PAC (or swan ganz) lines. The hearts are direct recovered by the heart teams. With that said-I wish there was a way to keep my skills up concerning the use of PACs but due to the low occurrence it's just not within the interest of our department to re mediate often enough.
As for the drips, primarily vasoactive drips, the course was informative. Coming straight out of the OR I didn't know anything about titrating neo (or anything for that matter). The educator gave us laminated cards with the most frequently used drugs and it had starting dose, max dose, how much you can change it by with each titration, etc. I keep that taped down to my computer at my station in the PACU as it's a lifesaver.
Hope that helps :)