Loved PACU, hated on-call

[Isabelle49]

I would love to return to PACU, but just can't deal with the on call stuff. One nurse in the recovery room with a patient trying to climb out of the stretcher, swinging a casted arm at the nurse is not a good thing. This happened to me. Fortunately as I yelled for help, the anesthetist who was in the sleep room heard me and came in to help me. The patient was not oriented and had an ET tube in place that I couldn't even get to. Patient was moving the stretcher even though it was locked. Not for me.

[hraneeRN]

i wouldn't have thought about that!! I am considering trying to get into PACU

[brownbook]

haraneRN.

Please don't make decisions about where you will work based on one incident. I have NEVER had an anesthesiologist leave me alone when the patient was brought to PACU still intubated. They stay with me until they can extubate the patient or they stay with me and we transfer (with the help of a cardio-pulmonary tech and anyone else we can get) the patient to the ICU.

ANY UNIT you work on, any post on All Nurses, will have tales of "yucky" (for lack of a better word), situations nurses face.

You will have bad days, bad situations, any where you work, with any occupation!!!!!!

[GHGoonette, BSN, RN]

We have a system where there are always 2 people on call - one RN and one EN or ENA. If for any reason the RN is alone, one of the theater team helps out until the patient is stable and ready to return to the ward. Regardless of what ratios say, no-one, however capable, should be left alone with an unstable patient. It's just too much risk to the post-operative patient. If he/she crashes and you have no help, you can lose that patient in minutes. Like you, I love PACU; there are times when you can handle up to two patients by yourself, but you still need an extra pair of hands around to help you deal with the unexpected.

[Sugamama]

I will never appreciate PACU so much as I will now that I have left and worked in ICU (in two different hospitals/states, for that matter.) Nothing makes you realize how good you had it like letting it go and having the patient on the oscillator with three vasopressors on maximum rate (only one left to go!), xigris, maxed out on propofol as well as versed (and still, miraculously, attempting to breathe spontaneously) a bicarb gtt, and four antibiotics all timed to be given simultaneously, stool the bed at the exact time your new admission arrives from the emergency department in respiratory failure without even ONE working IV.......but, enough of that...I will soon be back to PACU...and I promise NEVER to take it for granted again :heartbeat

But, I know that rant of mine doesn't take away from the fact that it wasn't right, DEFINITELY not safe, for you to be left alone with any patient in PACU, let alone one that was still intubated. The standard in any PACU should be two RNs at all times; that's just ASPAN standards talking!