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Discussion

PACU on call

Hi all!

I was just offered two jobs at a new hospital. One for CV Stepdown unit, and one for PACU.

The PACU is 9a-730p 4 days mon-fri, with 2:1 pt ratio. Seems awesome. The only downfall is that they require 4-6 on call shifts (11p-7a) a month!! (Is this normal??) It just makes me nervous having an unsteady work schedule, with the potential of being called in at night. I would like the change of pace and critical care experience of PACU because I've been a nurse for 3 yrs on a Progressive Care Unit.

The CV Stepdown is day shift 7a-7p, with 4-5:1 pt ratio. Having worked on a progressive care unit, I know kind of what I'm getting into with step-down, but adding the focused cardiac care. Downfall of this is the patient ratio seems like a lot! I'm used to 3-4:1 on pcu.

Any thoughts? Suggestions????

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    • Author

    Its the same pay rate by the way, and I have a couple days to make a decision.

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    • Admin

    Call with a PACU job is quite common. I'd say that 4-6 shifts per month isn't bad- it's most likely 1 day per week plus one weekend. How often you would get called in depends a lot on the facility- is there staff 24 hours and the call person is backup for multiple cases or critical patients? Is it a trauma facility that will do surgery at all hours of the night? There are so many variable that go into what makes call an okay thing vs an every time working thing.

    Not really PACU, but how call works for the open heart surgery team I work with: We take call pretty much every other DAY. About 99.9% of the time, we stay late when on call to finish scheduled cases, plus have the risk of being called in whenever. (I've been called in at 2am for a stabbing to the chest, 9pm for a return to OR for bleeding, and pretty much any other hour between leaving and starting my next shift for whatever the surgeons deem necessary- including weekend "scheduled" cases that come in on Friday, need anticoagulation reversal, but are too unstable to wait until Monday for surgery). I have to say, in comparison, what the PACU position you're referring to requires is nothing. Put it into perspective- extra money, possible overtime (I get paid time and a half for coming in on call whether I've hit 40 hours or not), and it's really not all that frequent. Depending on the facility, it may only mean staying close to the phone and on a rare occasion having to go in.

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    Wrap it up at 1930 ... say, 2000 by the time you punch out. Settle into bed at 2300. 0100 *RING!*. Get there by 0145, finish the case by 0400? Back in bed by 0500, 'rest' until 0730 then start up for a new day! Hope they pay well. I was reading about someone doing acute dialysis who had a peak week of 108 hours - scheduled and on call. It can add up! :wacky:

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    • Author

    The pacu closes at 11p, so there is no staff from 11p-6a. They said if you do get called in, 2 RNs go in together every time. They made it sound like it wasn't a big deal and you don't get called in very time you are on call.

    I guess it just makes me nervous bc I definitely like my off time, and don't want to be driving into the city at odd hrs in the night. With that being said, I may wait to pursue pacu a little whole longer and just go with the stepdown unit.... :-/

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    I've been on call for the ICU. (They hate giving people off completely.) "We're low on census ... do you want to stay home on call?" ($2/hr) ... Ummmm, okay. Yup, 1am - *RING!* "They're doing a heart transplant ... come on in! " Oh ... yippie!" :facepalm:

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    I really enjoyed working in a PACU. It was a lovely break from ICU and tele nursing. So if you're burned out in your area, the PACU is really nice. It is still busy but it's different and a nice change of pace.

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    • Author

    Thanks for all your input! & Nice username @ flexiseal Lol:D I'm hoping I can pursue PACU again soon, I can definitely see myself there. Possibly when I won't be commuting 45 min to work.

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    I was in the PACU for my preceptorship, I loved perioperative care. My only concern with it was what happens if you want to change and go back to a floor? I felt it was its own specialty in which you lose the basic nursing skills (like those lovely foley insertions).

    Personally I would love to be in the OR, but there are a lot of other stuff I want to do first. I am a new nurse (no job yet) and I would like to know what sick looks like before being in the PACU. A lot of nurses told me I would be pigeon holing myself if I went straight into perioperative care.

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