Is PACU nursing the answer to my prayers?

brownbook · Apr 29, 2016

Except for rare exceptions family is not allowed in PACU. The patients are under the effects of anesthesia and usually more on the sedated side than agitated or "crazy". If they are crazy, anesthesia will have standing orders for versed on some other intervention. I guess you could occasionally have a patient in PACU having surgery when their family wanted a last ditch attempt to save them, but even then you would not deal with the family, and the patient would be sent back to the crazy world of neuro ICU.

I hope you like it. Be realistic, all areas of nursing have issues.

hs276009 · Apr 29, 2016

Thank you so much for responding. Have you worked anywhere else other than PACU? How do they compare? What made you leave?

brownbook · Apr 29, 2016

I've worked in all areas of nursing as a float in a smaller community hospital, even management for 5 years. I worked ICU 5 years but it was nothing like your Neuro ICU. Major trauma, neuro patients, didn't come to our facility. They went across town or were life flighted to a larger city hospital.

I transferred to out patient surgery simply because they worked Mon through Friday, closed holidays etc. We did PACU for patients being admitted post op, and took call on the off hours for emergency surgeries. It was mainly less acute patients.

But still the same general rules apply, family never allowed, patients sedated, anesthesiology and co-workers close by to help out when needed. And best of all your patient is sent to ICU, or the floor, or level II PACU, usually after one hour. You are not with the same patient a full 8 hour shift!

chickhatz · May 2, 2016

The joy of PACU is the fast turnover rate. Even if a patient is mentally unstable they will be moving on to another area within an hour. Enjoy, and I agree every area has it's issues.

Collor · May 2, 2016

Having worked med-surg and ER for most of my career, PACU has been a welcomed change! Quick patient turn over, camaraderie with co-workers, overall better work conditions with ratios of 1:1 or 1:2. Coming from ICU and ER it is an adjustment. You will be putting some of your skill sets on a shelf. Autonomy is similar to other critical care areas.

whichone'spink, BSN, RN · May 2, 2016

It's been a year in PACU for me and I have found this is the best job I've had in my almost 4 year career. It's far from perfect, and I do believe some things should change. But I like not having to deal with a**hole patients and family members so much. And if I do have an intolerable schmuck, it's only for a few hours and then they either go to the floor or back home. I'm not stuck with them for 12+ hours like when I worked the floor.

wannabecnl · May 9, 2016

I've been in PACU for over 3.5 years, and I echo the sentiments above. With your ICU background, you'll do well in PACU, but the pace is different. I love the autonomy, the variety of ages and cases, and the "surgical flavor." I don't love call or feeling understaffed at the end of a shift when we end up having to discharge patients direct from PACU. There is good backup support from docs and a pile of nurses with more experience than I'll ever have (at least during the day; on call, the ICU nurses are our backup, and the docs are on pagers, but it's not the same). I love the patients; they range from infants to 90+ years old, and from wide awake and asking for food to completely schnockered with an oral airway in place and needing a jaw lift!

Have you had a chance to shadow in the PACU? I'd try to do that so you have an idea of what it's like. Good luck!

gen88 · May 15, 2016

I love PACU. I get bored easily- so with every pt being different, & things can be a little unpredictable at times, there's always a bit of laugh with some pts 'coming down,' and there is a nice level of autonomy- not to mention the turnover- it makes your life at work more stimulating!