I just need to vent a little because I'm feeling pretty beat down right now. I love my job in PACU, but some days I feel like every nurse in the hospital absolutely hates me. I try to always be considerate and professional to everyone when giving report, but many times, and today especially, I get flamed by nurses when I try to give them report on the patient they are getting. I can't help it that I'm sending you a patient, it's my job! And I can say that, because I used to be a floor nurse in general surgery and I used to get post-ops from PACU one right after the other too. I know what it's like. I know they think I don't, but I do. At any given time when they are getting slammed with patients from me, I too am getting slammed by the OR. I can't hold the patient for you, even though I'd like to sometimes. It just isn't possible sometimes. Please don't take it out on me when it's totally out of my control. And if I've tried more than 3 times to call report and the nurse still can't take it, then I have no other choice than to just bring the patient over and give a verbal report. I don't enjoy doing that, but once again, out of my control. OK. I think I've said my peace. Do any other PACU nurses feel the same way? If any floor nurses read this post, please reply and let me know how you feel. I truly admire you guys for the excellent work that you do. We all just need to stick together and focus on who really matters, the patient. Have a great week everyone!
i am a charge nurse on a very busy ortho unit. we have 8 to 18 surgeries a day. our average length of stay is 2-3 days. we never have more than 6 nurses on our unit.
the only time i will ever ask a pacu nurse to hold a patient is if all the nurses have taken a report and are either checking a patient in or waiting for one to arrive.
that is the safest thing to do. the nurses may have 3-4 other patients and the new one. once the new one is in and settled we take the next one.
we have worked really hard with the pacu nurses to make sure the patient is stable before sending them up. there was a period of time when there was lack of trust.
the patient might still have propofol in their line or have unstable vital signs.
the last vital sign was decent but by the time we got them we were bolusing them.
then there was the pain and nausea issue. most of our patients get duramorph spinal injections. so we cant medicate them for 12 hrs. its nice to have the pain controlled before we get them!
so we all worked very hard. we have pretty much stopped drilling them during report, they know if i ask them to slow down its because its for the safety of the patients...all is happy now.
we still have one pacu nurse who thinks sending patients out with temps below 95 is ok. that one we are still working on!! the key word is communication!! perhaps the charge in the pacu could meet with some of the problem floors!! just a thought
2. You had better care about what meds were given in PACU, since they could directly affect your pt's recovery. This boggles my mind that someone would not care what meds were given. What would you say if the pt coded and the doc asked you what the pt had in PACU? "I don't know" isn't exactly a response that's going to make you look that great, let alone help your pt.
3. If the pt is pain free/not nauseated, it's pretty difficult to justify giving strong IV meds. How do you explain that: "The pt had a 0/10 pain rating, but I gave him 25mcg of fentanyl because the floor nurse wanted me to"? I've gotten plenty of post-op pts who didn't require meds in PACU. It never even crossed my mind to demand the pt be medicated prior to transfer. I trust the judgement of my PACU colleagues; if in their best assessment they feel the pt doesn't require medication, then I trust their decision. If worst comes to worst and the pt is in pain or nauseated, it doesn't take me that long to get the med out of the Accu-Dose.
Not a PACU nurse, but I am an L&D nurse who spent 1 yr doing OB-recovery we did 2-4 c-sections a day with a post partum tubal or two as well. My job was to do nothing but pre-op and recover those patients. At my old job and now started recovering c-sections where I currently work so I totally understand where you are coming from! There was an LPN at my old job that used to always ask me to pre medicate patients with pain score 0/10. My thoughts on that subject are pretty much the same as yours. She would also give me the same song and dance about not being able to give "the good" drugs on the floor.
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NurseTink
7 Posts
i am a charge nurse on a very busy ortho unit. we have 8 to 18 surgeries a day. our average length of stay is 2-3 days. we never have more than 6 nurses on our unit.
the only time i will ever ask a pacu nurse to hold a patient is if all the nurses have taken a report and are either checking a patient in or waiting for one to arrive.
that is the safest thing to do. the nurses may have 3-4 other patients and the new one. once the new one is in and settled we take the next one.
we have worked really hard with the pacu nurses to make sure the patient is stable before sending them up. there was a period of time when there was lack of trust.
the patient might still have propofol in their line or have unstable vital signs.
the last vital sign was decent but by the time we got them we were bolusing them.
then there was the pain and nausea issue. most of our patients get duramorph spinal injections. so we cant medicate them for 12 hrs. its nice to have the pain controlled before we get them!
so we all worked very hard. we have pretty much stopped drilling them during report, they know if i ask them to slow down its because its for the safety of the patients...all is happy now.
we still have one pacu nurse who thinks sending patients out with temps below 95 is ok. that one we are still working on!!
the key word is communication!! perhaps the charge in the pacu could meet with some of the problem floors!! just a thought
:tinkbll:nurse tink