Is PACU (recovery room?) good door to OR?

aqmaryn99 · Apr 10, 2014

Taro,

The best way to make your transition to the OR, is to get into a perioperative training program. If the OR is where you want to end up then look into making your next move into the OR, as time spent in the PACU really is different from being in the OR. This is what I did almost five years ago and I have loved it ever since. Not as easy as I make it sound but worth the effort in the end. So start looking at learning medical center websites job postings. You may find postings for perioperative training programs there. Hope this information is helpful.

tarotale · Apr 10, 2014

thanks for the advice. when you say periop training program, I assume you mean surgery residency program (like for new grads?)

aqmaryn99 · Apr 11, 2014

Yes, where I was trained it was called "periop" training. I and several others in my class were not new nurses. Our experience in other specialties was looked at as a benefit to the OR. Good luck.

tarotale · Apr 11, 2014

thank you

sbfairy · May 14, 2014

I want you to please know that pacu nurses do not just sit, take vitals, and chit chat. I have worked 3 PACUs and days that I could do that were few and far between. Usually you have 2 patient at a time. You keep your patients for roughly an hour. In that hour you must manage the patients airway, do an assessment, take vitals, check dressings, chart, wake the patient, control their pain, control nausea, empty foley's and drains, all while continually assessing the patient for various complications that can occur with whatever surgery they had. All this on two patients in roughly an hour. Hopefully both patients have no issues. If it is a really busy day, it would not be uncommon to have an uncomplicated patient and an ICU patient at the same time, which can really up your stress level. OR and PACU are unrelated to each other. If you want to go into the OR you will need to apply for a residency program (like you stated). OR nursing is different from bedside nursing and the training usually takes about six months. I will tell you, from being in the OR, the downside of the OR is the docs and politics. I've been in two ORs and they can be one of the most unpleasant places in the hospital. If I were you I would see if I could shadow an OR nurse to see if you like it.

tarotale · May 14, 2014

I want you to please know that pacu nurses do not just sit, take vitals, and chit chat. I have worked 3 PACUs and days that I could do that were few and far between. Usually you have 2 patient at a time. You keep your patients for roughly an hour. In that hour you must manage the patients airway, do an assessment, take vitals, check dressings, chart, wake the patient, control their pain, control nausea, empty foley's and drains, all while continually assessing the patient for various complications that can occur with whatever surgery they had. All this on two patients in roughly an hour. Hopefully both patients have no issues. If it is a really busy day, it would not be uncommon to have an uncomplicated patient and an ICU patient at the same time, which can really up your stress level. OR and PACU are unrelated to each other. If you want to go into the OR you will need to apply for a residency program (like you stated). OR nursing is different from bedside nursing and the training usually takes about six months. I will tell you, from being in the OR, the downside of the OR is the docs and politics. I've been in two ORs and they can be one of the most unpleasant places in the hospital. If I were you I would see if I could shadow an OR nurse to see if you like it.

thank you for the very deep insight. by all means, I would like to project that my intentions to go to PACU is not at all because I assume that it's a breeze job. Sure, I did shadow a PACU nurse for about 3 hours at previous hospital orientation, and I won't lie to you, it looked like a breeze: get 1 patient, obtain vitals (automatic machine) doing it every couple minutes, pain management, talk and stay sitted by the patient, then transport and document. But I realize that this is only one encounter and I know that PACU is not a breeze job because my charge worked at PACU for quite long time and told me bits about it and it sounded busy.

I want PACU not because it's easy, but because it sounds challenging; not in the sense of ER or medsurg challenging (where you just run in havoc) but more close to ICU challenging (it's critical and you can afford time for critical thinking because you don't have another 4 schmucks yelling for dilaudid and other annoying things when you need to get critical things done... or I guess in PACU, you will have maximum 2 schmucks yelling for dilaudid)

sbfairy · May 15, 2014

If you decide to go into PACU please get some ICU experience first. Although I went to PACU from med/surg, I actually did spend a little time in the ICU/CCU and ER of the hospital I worked at as a float. Most places require critical care experience or they require you to go to critical care training. The hospital I am at now will not hire you without critical care experience. Make no mistake, you will get ICU patients in PACU. I have had patients who were scheduled to go to med/surg and ended up going to ICU. People do go bad in the PACU and when that happens you don't get to stand around and think about it. I've been bought patients who have had MIs and strokes right in the PACU. You need to know your stuff because your crna and anesthesiologist will expect you to know what to do until they get there to manage the patient. You also need a working knowledge of anesthesia drugs and know how they effect the body, what reverses what, different levels of anesthesia, etc. We get patients on drips and on vents and you will be required to titrate those drips. I can also tell you that having two people yelling for pain meds still sucks. Even on a regular day there is a lot of time management and trouble shooting that has to be done. PACU is not easy, it's just a different kind of challenging. You have a limited time to get your patients in an out. If your turn comes up and someone has to take a patient out of turn because you sat on your initial two patients, you will hear about it. Also, if you do not give the floor a patient they feel is acceptable, you will be bringing that pt back down to PACU and taking care of that patient along with the patient that will be waiting for you. There are a lot of positives to PACU and I love it, I just want anyone who is serious about going into PACU to know that it is challenging and at the end of the day you come home exhausted.

SeaTracer75 · May 17, 2014

PACU is critical care nursing.

I can't remember EVER having a patient for just one hour outside of quick SDS cases, like D & C's or peds circs or myringotomies/tubes, etc... and the longest I ever had only one patient at a time was probably an hour!! On a very slow day, obviously this can be different, and of course as the evening progresses and cases get finished.... or our patients actually get beds! We hold tons of patients awaiting beds, sometimes for 2 hours, sometimes 2-3 days. I remember we had one GB patient that stayed in the pacu for four days... 4! Just awful, felt so bad for her (see: med-surg + pacu at same time haha).

Every day is a new day.

I have had up to 4 patients at a time on a busy busy day, even with full staffing - usually 2 TBA holds and 1 or 2 fresh post-op SDS patients. You can have a AAA repair on a vent and a fresh, screaming, 9 month old post-circumcision at the same time, for example. Very critical patients would be a 1:1.

It is a fast-paced, high energy job, every single patient is different, and whether 2 or 92, can go bad in a moment's notice. I remember when I first started someone told me you had to be "a little bit crazy" to be a pacu nurse hahaa :) I can't sat I wasn't warned, that's for sure.

It's not a line to the OR. OR nurses and PACU nurse are so very different... and if you don't have critical care experience or very strong med-surg skills, the learning curve will long, if even hired. *Your preceptor would have to be top-notch.*

Hope this helps. I would hate for you to be unprepared, like I was. I had the worst preceptor everrrrrrr. I think endoscopy would be a good place to start if goal is OR, if you can't just go straight there from where you are.

Good luck! I hope you enjoy whatever you choose do. :)

TraumaQueen57 · Jun 12, 2014

amen and PERFECTLY stated! Couldn't pay me enough to be an OR nurse!

nursenil · Dec 27, 2014

OR and PACU in the facilities I have worked were under the same director so you would get an opportunity to show them you are a team player and hard worker in case an opening or internship came open in the OR

TheGooch · Jan 1, 2015

The OP doesn't carry a stethoscope so how are they supposed to do an assessment. IMO the OP wants an easy nursing job and after only observing one interaction in the PACU she thinks it fits the bill since PACU nurses have an "easy" job.