New RN just hired into PACU

[RN-767]

Hello everyone,

Sorry if my post is a bit lengthy. I guess first I should say that I am relatively new to the forum and so far I have found tons of great information here. This is my first post but I have been reading others for for a while now. I know their are several posts about new grads going straight into PACU and I just wanted to post my own situation and get any feedback that might be helpful.

I graduated Nursing school (RN) back in May of 2011 and passed the Nclex about a month later. Much to my surprise finding a job has been very difficult at best. I think we have so many nursing schools in my area graduating students that the market is just saturated right now. After many applications and months of waiting and only a couple of interviews I applied for a PRN PACU position at a large hospital and somewhat to my surprise I was offered and accepted the job. The job was advertised with new grads considered and considering how hard it's been to even get an interview I couldn't turn down the offer.

The good thing about this job is that I am very familiar with that particular unit in that hospital because I worked there as a tech before I went to nursing school. I know all the nurses in the unit well and work very well with them. They were all very excited to find out that I would be coming on board as an RN in the unit. I think job satisfaction there is very good because the turnover is almost none. I guess my question comes as to what advice would anyone have for a new grad working in pacu? I know it is a very high acuity environment and know first hand how busy and hectic it can get sometimes. I have read a lot about how CCU experience really helps a lot if you have it. I was assured by the nurses working there that they would all be there to help me. I do know for a fact that they all work together as a team very very well and nobody has to ask for help, they just pitch in and help. Even with all that, I'm very nervous about starting my new job but I think that knowing the people I'm working with and knowing the hospital and department is already a major stumbling block that I do not have to worry about so that I can just focus on doing my job to the best of my ability and learning as much as I can. I am not the type of person that breaks under pressure. I might bend a little but I am very persistent and always love a challenge. I know the initial orientation will last about a month but beyond that I'm not real sure what to expect. I will find out more details pretty soon as I have not yet started. Looking forward but at the same time wishing I could just move ahead a couple of years and be settled comfortably with my job.

Any advice, tips, or pointers would really be appreciated. Thank's everyone.

[brownbook]

Try to relax, new employee jitters are to be expected. At the same time "what could go wrong here" should always be in the back of your mind.

Just think, airway, airway, airway. Get comfortable with jaw or chin lift, for the patient a little slow to wake up. Get used to inserting or having readily available oral airways, nasal trumpets (and surgilube), and ambu bags. I rarely have to use them, but when I do I want to know exactly where they are and be comfortable with them.

Have ready and be comfortable with suctioning equipment.

[GHGoonette, BSN, RN]

Here's an old thread that appeared in the OR forum, from a nurse who was doing a practical exam in PACU. Read through it, Canesdukesgirl (AN guide) posted a brilliant response about aspects of patient recovery, while I focused on what might be expected from a daily routine/basic knowledge POV. Hope you find it helpful!

https://allnurses.com/operating-room-nursing/scrub-nurse-recovery-509419.html

[RN-767]

Thanks brownbook & GHGoonette for the tips and information. The article by Canesdukesgirl was really informative. I think getting a routine down and then dealing with the variations of each individual case as they arise is a big part of it. Still nervous as the day draws closer but at the same time looking forward and excited about the experience.

[Rayray15]

I was kinda in the same situation as you. I worked as a RN though for 3 months on a medical floor and then transferred to PACU. I was still considered a new grad, but you can definitely do it! After 2 months of orientation my manager made me pm charge nurse. Do not be afraid to ask questions to your nurses, crna's, and doctors. I was hired to work in main and outpatient recovery, however I also asked if I could be trained in assessment. In assessment, I learned to admit patients, brushed up on my iv skills, and learned how to do blocks. I also tried to take the more complicated patients while I was still in orientation, it made me more comfortable once I was on my own because I knew what to do. The good thing about PACU is that you will never be by yourself! You will always have other nurses there to help and a doctor will always be there! :) I love PACU and I couldn't see myself ever working on the floor. Best of luck to you!

[RN-767]

Wow, that is awesome. Glad to hear that it worked out well for you. That helps me to relax a little more knowing of other new nurses that have been successful starting out in PACU. They hired several new RN's last year and they told me that they have worked out really well. I really think I'm going to like it a lot once I get my routine and comfort level down. I also like that your not alone and have other experienced nurses there beside you, plus the doc is usually just nearby if things start going south. Everyone I have known that worked in PACU always said that they wouldn't work anywhere else and I hope for me it's the same :-)