OR vs PACU

[Faith.O]

I've been a bedside nurse (PCU/stepdown) for over 3 years now. I'm looking for a specialty that is more of medical than pt care. I feel I'm not learning as much at bedside since most of my time goes by feeding/changing pts.

Watched tons of videos about PACU and OR nursing and shadowed a nurse for half a shift for both. Now I can't decide which one to apply.
I tend more toward PACU but the fact that pts are in critical condition and the training is like ICU training made me hesitate the specialty.

If you work in OR or PACU please tell me about your experience. which one is less stressful? Why did you choose OR or PACU and what do you like/dislike about your specialty?

[Rose_Queen, BSN, MSN, RN]

Lots of info here from several members with a variety of experiences.

[RN56123]

OR and PACU are both fun areas to work in. If you like assessing patients, giving pain meds, anti-nausea meds, closely monitoring pt and working with pts short term you may like PACU. PACU phase 1 is very short term, the time immediately after the OR. Phase II is when they are more awake and you will spend time helping the pt get dressed and giving the patient and family the discharge instructions. So ask if the PACU job is for phase 1 or phase II, or a phase 1 and II combined PACU. Some PACU's accept patients on ventilators while awaiting ICU bed, some don't. So you may care for an ICU pt for hours waiting for ICU bed to become available. Also in the PACU you encourage pts to deep breathe and cough. You will be sitting close to them while they cough and many places no longer do COVID testing or require masks, some people may care about this, others may not.

In the OR, you will walk even more steps per day than PACU, back and forth to get supplies, go to pre-op to interview patient, bring pt to PACU, lot of heavy lifting of surgical trays (ex. 25 Lbs each), heavy patients being moved to/from OR table, positioning them on the OR table, pushing heavy bed back to ICU, lot more standing time and also sometimes exposed to XRay radiation, fluoroscopy in the OR. So you have to wear a heavy lead apron and also sometimes run and get supplies while wearing that. So if you have back pain, the OR may not be good for you. Also sometimes exposed to lasers and must always wear eye protection specific for that type of laser. In the OR, you don't give any IV meds, anesthesia handles that, no head to toe assessments and shorter charting. OR has a longer orientation time, usually 6 months, because there is equipment and issues specific to the OR and so many different types of supplies used, and different tasks for different case types. Some places have nurses "circulate" and "scrub", hand instruments (lot of standing in one spot for hours, maybe while wearing a heavy lead apron). Some places the nurse only "circulates".

Neither PACU or OR is "easy". It depends what type of tasks you prefer, if you prefer working with patients when they are asleep in the OR, or just waking up in the PACU and if you are OK with the more physical labor and hazards in the OR.

[Faith.O]

RN56123 said:

OR and PACU are both fun areas to work in. If you like assessing patients, giving pain meds, anti-nausea meds, closely monitoring pt and working with pts short term you may like PACU. PACU phase 1 is very short term, the time immediately after the OR. Phase II is when they are more awake and you will spend time helping the pt get dressed and giving the patient and family the discharge instructions. So ask if the PACU job is for phase 1 or phase II, or a phase 1 and II combined PACU. Some PACU's accept patients on ventilators while awaiting ICU bed, some don't. So you may care for an ICU pt for hours waiting for ICU bed to become available. Also in the PACU you encourage pts to deep breathe and cough. You will be sitting close to them while they cough and many places no longer do COVID testing or require masks, some people may care about this, others may not.

In the OR, you will walk even more steps per day than PACU, back and forth to get supplies, go to pre-op to interview patient, bring pt to PACU, lot of heavy lifting of surgical trays (ex. 25 Lbs each), heavy patients being moved to/from OR table, positioning them on the OR table, pushing heavy bed back to ICU, lot more standing time and also sometimes exposed to XRay radiation, fluoroscopy in the OR. So you have to wear a heavy lead apron and also sometimes run and get supplies while wearing that. So if you have back pain, the OR may not be good for you. Also sometimes exposed to lasers and must always wear eye protection specific for that type of laser. In the OR, you don't give any IV meds, anesthesia handles that, no head to toe assessments and shorter charting. OR has a longer orientation time, usually 6 months, because there is equipment and issues specific to the OR and so many different types of supplies used, and different tasks for different case types. Some places have nurses "circulate" and "scrub", hand instruments (lot of standing in one spot for hours, maybe while wearing a heavy lead apron). Some places the nurse only "circulates".

Neither PACU or OR is "easy". It depends what type of tasks you prefer, if you prefer working with patients when they are asleep in the OR, or just waking up in the PACU and if you are OK with the more physical labor and hazards in the OR.

Thank you! Your comment was very helpful 

[emergenceRN17, ASN, BSN, RN]

I work in the OR and I love love love it .. best job ever!!