ER to PACU?

[GOMERNATOR]

I am an ER/Trauma nurse. Been one for close to 13 years now and am considering a position that has come open in our hospital's PACU. I would be nights and would recover Phase I/Phase II. I have already interviewed and been offered the job. The Unit Manager says I will fit in great, should have no problem transitioning, orientate until we all feel comfortable cutting me loose by myself at night. I would recover the emergency surgeries, appy, ortho, etc. type stuff. No hearts. No major trauma as in my facility they go straight to ICU where a bed is ALWAYS kept open. The "occasional" late case and sometimes care for "holds" when needed.

So, you "salty" PACU nurses, cut through the bull for me and give me the straight dope. Does all this sound correct? In your opinion is it a fairly smooth transition for an ER nurse? What should I be wary of? Questions that I need to bring up before strapping in?

Thanks for your insight and please for your no holds barred comments. (I'm a seasoned inner city ER nurse. My skin is thicker than you can believe!)

Again, thanks!

GOMERNATOR

[sparky56]

I have been working in PACU for 8 years and have seen many ER nurses make the transition beautifully. Your biggest risk is being bored! As long as you have "good" anesthesiologists and you are not being left alone to deal with extubations you should be fine. Our hospital always staffs 2 nurses on call from 2300 to 0700 but we do not have "good" anesthesiologists and often hold ICU pt's. Your biggest problem will be getting food and potty breaks! Good luck and let me know how it goes.

[Tylerdurden]

We've got a couple of nurses who are either veterans of ER or did a short stint there. They've all come to PACU to get away from the hell that is ER. Or so they tell me. Seems believable.

[PostOpPrincess, BSN, RN]

The transition shouldn't have a problem as long as you do some of your own studying and look into surgeries, what they entail, etc.,

Look into what the anesthetics do and how people should be recovering from them.

Look into ASPAN.org so you can get some insight into what is expected of our patients.

The biggest hurdle will be medicating someone without an airway. You never want to push them over the edge to apnea (happens frequently), but at the same time you can't leave them in pain.

THAT is an art.

Good luck, you will like this specialty--it's got the pace of ER and the "see ya later have a good life"--but "cleaner" patients.

After all the stressors of the other departments, I really like this one.

[azhiker96, BSN, RN]

I think you'll do fine. We run a night nurse but always have a nurse on call. When a case goes to the OR, call in the on-call nurse. If the patient comes out before the call nurse gets here the circulator must stick around. It's unsafe to have only one nurse with a patient in PACU. Get some experience with extubating patients while on orientation and find out your resources at night.