amnesia 1,790 Views
Joined: Jul 23, '05;
Posts: 54 (4% Liked)
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They use Propofol where I work...People seem to do well with this.
I think the redhead stuff just has to do with the fact that most (generally speaking...not all), are more sensitive to pain/nausea and require more medication to control it. Don't know the whys.
Zofran, Dex, Reglan, Pepcid, Benedryl, Scopolamine patch, rare visteril.
Our burn patients all go straight back. Also any stable unit pt that came to OR already intubated can return straight back as well. Obviously any pts. that require stabilization post-op do come to us at the discresion of Anethesia.
The PACU is not a very forgiving setting for learning the basics as listed by KrustyThe Nurse. I would encourage you to get previous ICU/ED experience and then try for PACU. Good luck!
Our PACU was having the same difficulties with calling report. Our nurse manager did a 3 month survey in an attempt to determine just how many delays were caused by the floor turfing patients because of staffing issues, no beds, dirty rooms etc. Our PACU is a very busy one ranging from 60-100avg. cases per day. Her survey provided specific information and data that she presented to the "floors". As a result of this study, a new policy was instituted whereby floor RNs have to take report on the first call or we redirect our calls directly to their supervisor who takes report for them. Things were a little rough at the beginning, but are starting to flow better now. I know this is very frustrating to the "floor" staff, but unfortunately we are getting slammed just as quickly as they are!
we start them in our PACU
This is just another clear indication that our medical system is in trouble. It is so sad that our patients are put at such great risk just because of continuing staffing shortages. Sorry you had such a difficult shift:flowersfo .
MD/CRNA has traveled WITHOUT oxygen AGAIN, and when SAO2 reads 80 something they say " uh... could you hurry up with that face mask?"
One guard explained to us that safety of the nursing/medical staff is also their concern. He went on to say that they have had the family of prisoners attempt to liberate the prisoner during these procedures. It is notible to add that the family trying to free them was ARMED! I have always been thankful from that point on that there are guards present! I had never thought of that before!
[QUOTE=suzanne4]Cases should not be started if there will not be a bed available. PACU staff should not be utilized like that as a back-up because the ICU is short. The big issue will occur when those PACU nurses start to quit.
:angryfire Burns me up that they continue to do surgery when there are no beds to transfer the recovered patients to!:angryfire
Lately our haospital has started sending patients with a high BMI and with history of OSA/CPAP to a monitered bed (similiar to telemetry but includes SaO2 monitering as well). Well, lets just say that the demand outweighs the supply, and we get bottlenecked in PACU holding them. This is in addition to all the ICU overflow we routinely keep. I should say we do have a very good manager that is involved and proactive, but the medical staff always WINS out. This is a growing problem that seems to be nationwide. Where will the MADNESS stop?
I work in a PACU that is always very busy! We do an average of 80-100 cases per day (adults) -- our kids go to a pediatric recovery and run 20-40 each day. We have staffing every day, around the clock. The only call shifts we share are Saturday and Sunday nights. We also rotate 1 minor and 1 major holiday.
Our cases range from vascular, GYN, ortho, plastics, trauma, burns, general surgery, some OB interventions, acoustical, nasal/septal, GI, GU, colo-rectal, etc. You name it. The only patients that bypass our unit is PICU and CABG pts.
Nursing in this area is very fast paced and ranges from minimal to intensive interventions. Ambulatory pts are 2:1 and ICU's are 1:1 and sometimes 2-3:1 depending on the situation. I love the fact that the skills you use for this specialty is so diverse. Truly every day brings a new learning situation. you must have excellent assessment skills and equally matched decision making skills, so that you can CORRECTLY intervene with in seconds. ABC's are our mantra! Pain control is a huge protion of our recovery process. (I am sometimes amazed at how many narcotics some people can tolerate!)
I think PACU nursing offers the best of all worlds. You really get to use ALL of your nursing skills, you really do not have to deal with families too often (a blessing in MY opinion), you get to interact with awake/talking patients and then you will get a vented/sedated pt. next, you also get to transfer the difficult/abusive patients! Thats a beautiful thing in MY book!
Anyways that the crux of PACU nursing.
We have several nurses in our PACU that came from ER and they are all very proficient and skilled nurses in the recovery setting. The turnover/acuities are very similiar. Vents can be intimidating but remember that their airway is already PROTECTED if they are tubed so thats more than half the battle right there. There is also always lots of other nurses/MDs within shouting distance if you ever need help. Best of luck with you application/interviews. I hope you will enjoy PACU-- I think you will find that your experience will be very valuable!
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It sounds like you are getting started in the right direction. I guess that with regards to doing PACU now it would depend on the acuity levels of your patient populations. If you plan on doing same-day I would think your experienc would be applicable, however if your patients are primarily ICU, than I would suggest getting hands on experience in a unit first. Even though you say you have vented patients with some drips, there is really no substitute for having a good SOLID knowledge base in critical care before PACU. I am glad to hear you are interested in this area of nursing. I really love PACU nursing because of the variety of skills you get to use. Our hospital is a Level One center so we get the sickest of the sick and every day presents with something new and challenging. I have never regretted having ICU experience before my career in PACU. It just made things so much easier in this FAST paced and challenging environment where you have to be able to assess and intervene on a moments notice. Good luck !
YUP! Nursing School!
We were getting the grand tour of how the rooms were set up and I remember my nursing instructer saying " And this is the suction here on the wall and this is how to use it..." Thats it, LIGHTS OUT! Next thing I knew I was the center of attention. Turned out I had a good case of Mono. What an embarassing moment that was!
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