NewRN starting in pre-op & pacu surgery center; expectations??!!

ocean waves · Dec 31, 2010

Hello. Congratulations on your job at a surgery center for orthopedic pain! Regarding your question of "prepare for what", here are some good ideas to prepare for this new job: (1)ask for opportunities to carefully read the policy and procedures book which should be available at your center; (2)ask fellow nursing employees about the most common medications administered for pain at your center and carefully review tips in a good nursing medication reference about giving those meds(plus keep a small drug reference book in your supplies at work) Best wishes!

nurse1109 · Dec 31, 2010

My first job as a new grad was in outpatient surgery pacu and it was rough. This was because the nurses idea of training was to let you take all the patients and watch you struggle. We all floated between inpt and outpatient and these same nurses stood by watching while another new hire's pt going bad and they did not step up to help, they sat behind the nurses station until anesthesia was there giving orders. The pt later died in ICU. This is wrong on so many levels. You should always treat your patients as you would your own family member. If that persons family had been standing in pacu what would they have thought? The nurses all justified this by saying this is how they were trained.

So my advice is don't let anyone take advantage of you. You should always be willing to step up and take as many patients as you can (variety) this is how you learn but if you are not comfortable or not experienced someone should be willing to help and offer advice. I hope you have a good group of nurses to work with. It took me about a year to be fully comfortable (with inpt and outpt). Deciding how much medication to give in pacu was challenging at first, every patient is different. Once I had a young gyn pt who had never had surgery before. A pevlviscopy is very painful with uterine cramping and the gases they use for the scope. This patients was crying like crazy so I kept giving her meds. Well her pain never went away but she became very pale, nauseated, and bp was too low to release her so she had to stay all day. So sometimes you can only medicate someone so much before you are doing them more harm than good.

At my facility we uses mainly Fentanyl, Morphine, and Dilaudid. A good nurse told me to start with Fentanyl because it has least side effects. You can also give this to someone who has lower BP. Morphine and Dilaudid will decrease the BP. Dilaudid makes a lot of patients very sick, but does a better job for your chronic pain patient.

Good luck and congratulations on your new job! Where I live ambulatory surgery is a good job and turn over is low (especially if there is no on-call).