Need help from experience PACU nurses!

MsBruiser · Nov 4, 2008

I graduate in DEC '08 . I currently work as a surgical technologist in the OR and have done this job for the last 6 years. My boss of 5 years has recommended me for a job in PACU. The PACU nurse manager says that there would be an intense training for about 6 months,not even then would the throw me to the wolves; but do you think that's enough time for the basics to build my PACU nursing career as a new grad. I have alot of people that I work with that really believe that I can do, I believe I can do it, just don't know if 6 months will be enough time, and I don't want to seem like a failure with my first nursing job. I am up for the challenge though. What do you think?

Well - from the perspective of a "new" PACU RN (one year ICU experience before moving to PACU).

If you can find a PACU that you like where they are willing to give you 6 months of intense training - jump on it. 6 months should work - you will be exposed to lots of different surgeries but will eventually gain a nice mastery in 6 months - especially if they will keep working with you. Anything less than such an intense orientation, I would say no way. PACU is way different than ICU and I have had quite the learning curve...I personally think it is the best type of hospital nursing. So if someone is willing to take you on...go for it!

FlGaNurse · Nov 5, 2008

Thanks alot for your insight, I think it will be a great experience. I'm going to try it out.

PaKuRN · Nov 26, 2008

Well... PACU and OR nursing are quite different. "Intense" six month training should include time on ICU, Vents and drips (and peds if your hospital does pedi cases). These things, among others are learned by doing... not text books. We recently had a med-surg RN orient to PACU and we tried to expose her to as much as possible, but the unit was too busy and fast paced and at the end of orientation she was not ready to work independently, she requested a transfer. Sooo, as an experienced PACU nurse, I suggest critical care training. I like to work with nurses who have a background in ICU/ER nursing. I feel PACU nursing is the best RN hospital job. If you have this oppurtunity in the begining of your nursing career, your very lucky. So GRAB IT, and take this intense training, learn and do as much as you can

FlGaNurse · Dec 1, 2008

Thanks alot, I'm so excited about the learning experience!!!

cully24 · Dec 9, 2008

As an educator for a large PACU, we will only take RN's with ICU experience. 6 months of orientation will not prepare you for the critical thinking that you will need to take care of a crashing AAA on the midnight shift when it's just you and another co worker. Go to ICU first, get the experience and then come to PACU.

CaliRN29 · Dec 31, 2008

There are a lot of nurses that say you need ICU experience prior to starting PACU however, I think an intelligent nurse with a strong drive to learn can do it. I did ICU a little over a year and when I came to PACU, there was a big learning curve. Not every patient is critical like they are in ICU so you need to learn which ones are and which ones aren't. Although I have had outpatient surgery patients semi-code so you need to always be on your feet. You will do great. You have access to doctors within a few minutes if you need them and your co-workers are in the same room so they can't run and hide from helping like in ICU and M/S. Be prepared for some high stress for awhile but you will be great! Good luck!

MsBruiser · Dec 31, 2008

There are a lot of nurses that say you need ICU experience prior to starting PACU however, I think an intelligent nurse with a strong drive to learn can do it. I did ICU a little over a year and when I came to PACU, there was a big learning curve. Not every patient is critical like they are in ICU so you need to learn which ones are and which ones aren't. Although I have had outpatient surgery patients semi-code so you need to always be on your feet. You will do great. You have access to doctors within a few minutes if you need them and your co-workers are in the same room so they can't run and hide from helping like in ICU and M/S. Be prepared for some high stress for awhile but you will be great! Good luck!

Very, very well put. ICU helps but if you can't learn to be fairly competent after an intense 16 week orientation, you will never learn...

SUNURSALA · Dec 31, 2008

Go for it! You will love it! I have primarily been an OR Circulating nurse for many years and have been in the PACU almost a year now. I didn't get 6mo. training, and I'm still learning everyday, but I have great support and ask questions all the time. You have a great opportunity. Enjoy your new position and learn all you can from those around you. Don't be afraid to ask what may seem like the most trivial question because you will more than likely learn other things you didn't expect in the process. I'm excited for you!

Southern Fried RN · Jan 2, 2009

Not every patient is critical like they are in ICU so you need to learn which ones are and which ones aren't.

Personally, I think my ER experience better prepared me for PACU. Not to say that ICU did not contribute, which it did quite a lot, BUT when there are a lot of cases coming out you've got to keep up with the pace. Knowing who's really critical, who's not, and who's got about 15 minutes before going critical is the key. I learned that quickly in the ER. Some ICU nurses are so book smart and can get bogged down in the details of every little thing about a patient. I've seen some ICU nurses stumble with that aspect in PACU, because they are not used to that pace. Not that ICU isn't busy, but when there are cases coming from the OR, you have to know who's ready for Phase 2 and who isn't.

I think ICU is great for learning your skills, like IV insertion, foley insertion, intubations, vent, drips, a-line/swans. It's nice to hit the ground running already having learned how to zero an a-line, run a CBI, or manage a chest tube. I saw most of those things in the ER but ICU is where I learned them backwards and forwards.

Good Luck!!

azhiker96, BSN, RN · Jan 23, 2009

I volunteered in PACU while taking my pre-req courses. I worked as a tech in PACU while attending nursing school. After graduation and the nclex they took me in and I worked 5 months with a preceptor. The program was intense, they sent me every tough patient they could find. I even had to give report on phase 1 pt's so I could get the fresh vent that had just called out. It was tough and often tiring but well worth it. PACU is a great place to work. Good luck to you.