New nurse to PACU

brownbook · Mar 23, 2015

Geeze.....no one has replied....apply to ANY job you want......just getting the interview experience is good....just hearing/learning what kind of experience they want, expect, is helpful for your future aspirations. Getting your face and name known to charge nurses, human resources, is good.

It really depends on the type of surgeries they do. I work in in out patient surgical center. Honestly it is really easy.....we are doing relatively minor surgeries on relatively healthy patients. We pass off many patients to our LVN's after a nursing (60 second) assessment.

I don't know if they would take someone with your experience, but just be "agressive, be the squeaking wheel, show any charge nurse, hospital, you are gung ho and really want the job, counts for a lot.

Mavrick, BSN, RN · Mar 25, 2015

I agree with brownbook that it depends on the type of surgeries and patient selection.

I work in a hospital setting where we recover patients from outpatient cystos to unstable ICU patients with bowel perforations. All our nurses have at least a year med-surg background. Most have multiple years in ICU. We work very independently in collaboration with our Anesthesiologists but frequently get orders like "...and whatever else you want" or "Will that be enough?"

I do a lot of predicting how much medication to give and when to stop based on my years of experience and still get fooled watching an undiagnosed OSA patient stop breathing after 25mcg of Fentanyl. The Doc is in another surgical case and not readily available so you are expected to manage extubation, hypotention, bronchospasm with little to no immediate support. Better yet you really need to be preventing the little events that will turn a routine procedure into a legal case.

I do not believe an acute care PACU is any place for a new grad.

In your case based on what you have said and assuming you are not talking about an outpatient surgery center, I would suggest a year ICU experience.

gizmopacurn · Mar 25, 2015

If you can get into an internship in pacu that would be better. I went straight from nursing school to being hired in pacu after doing my 6 week clinicals in pacu. I did a 6 month internship that was very intense. I learned so much. I am also a self motivated person and was always reading and studying everything I could get my hands on. Then after my internship I took the CPAN certification and passed first try. I think it is possible that you could do it but you would need support from the staff to teach and you would have to be highly motivated as well. There are some very easy days in pacu and almost feel guilty that I am getting paid for working there and then the very next day every pt you get is a train wreck and a lot of work or an ICU pt on 2 or 3 drips, no bp hemorrhaging out or someone that you have to re-intubate etc etc. You do have to be prepared for the worst and it makes a huge difference if you have support or not. You are also required to do call/standby so during the night there are only 2 nurses and sometimes that can be quite scary.

I think if I were you I would try to get into ICU and learn learn learn if they ever offer an internship and then try to get into pacu. It might be easier, not sure.

All the best to you.

wannabecnl · Mar 27, 2015

I was a new grad in PACU, and for me (and probably my boss) the jury is still out on whether it was a good thing. Now, after 2.5 years, I'm in pretty decent shape. I've often heard of ICU being the best way to come to the PACU, but I'm not sure; we have hired nurses with 1 year of med-surg and others with 6-7 years of ICU. It depends on whether it's a good fit or not. Have you shadowed in a PACU at the level of where you would be working? I mention that because all PACUs are not created equal.

BTW, I'd resist the urge to go to an outpatient facility before working acute care PACU. Those pts can go south in a hurry, too, and I wouldn't trade the critical ones for anything in terms of experience and practice staying calm!

BoyNamedSue · Mar 30, 2015

Yeah, I've shadowed my preceptor during my final year of nursing school in the PACU where I'm applying. They do mostly routine surgeries, but when I was shadowing, we did get the occasional shock patient/emergency patient.