PACU Nursing

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I'm suspicious of the working conditions of any unit that needs to recruit students who won't have a license for a year. I'm even more suspicious here because most hospitals fill their PACU slots with experienced ICU and ER nurses that want out of those units or to move to day shift.

Might be OK, but it sounds fishy to me. This is an old argument that I do NOT want to start again, but I also don't think new grads should go right into critical care areas- it can be very overwhelming unless you have a very supportive staff. A PACU that is recruiting a student who can't work for a year is either VERY pro-education or they can't get people to work there.

What I like about PACU: patient contact without being overwhelmed by multiple consultants, family members, and days of conflicting orders. My duties: 1:2 patient care, monitoring respiratory status, managing pain, monitoring hemodynamics. Making sure the patient has a bed to go to and that it's an appropriate bed. (Here is where working somewhere else first might help you- what kind of pt goes to he floor? To tele? Stepdown? ICU? If you haven't worked any of those floors, will you know if your pt's assignment is appropriate?)

What I don't like: call. WAY too much call. Getting stuck late because patients were discharged from floors late and then no one called housekeeping and then it's almost shift change and then I'm stuck staying late because the evening or night nurse doesn't want to take report right away... I've been on the other end of that and sometimes it's legit. (NOT starting a PACU/ICU/Floor flame war here!!!) But getting stuck at work 3-4 hours late every blessed day gets VERY old. VERY old indeed.

It all depends upon what YOU want in a nursing position. Where do your preferences lie? I personally think that you should have more experience working as an RN to be hired to work in PACU. I, for one, work in PACU (among ten other positions) the one day a week that the surgeon comes here. But it is a requirement that the PACU nurse be ACLS certified (which I am). I would not want a new graduate/brand new RN taking care of me or my loved one in PACU with no prior experience or adequate training for the position.

Ideally, the PACU will have experience in assessing patient's and intervening appropriately, but we have not always had an exp. nurse applying for the job. If we put a grad in there they are not allowed to take call for 6 mo or longer and work closely with preceptor. All our nurses are ACLS or PALS certified, but critical care nurses have special competencies to demonstrate. My preference is to put an experienced nurse there, but then I believe ALL grads should do med-surg for a while. Of course, my preference is not practical.

watch out, PACU can be tough, as can any dept. But PACU usually recruits seasoned ICU nurses who are used to intubated/sedated pt's. Beware, many times you will work alone, everyone is busy with their own wake ups, & they can go bad with little notice. I know 'cuz I 've done it!!!

Thanks for your replies and advice. I still haven't decided if PACU is where I want to go after graduation or not but, the experience as a CNA/student nurse could be invaluable in making that decision. Around here, new grads are hired in virtually every department and are with a preceptor at least 6 months or more. I feel that this is also a MUST.

The one thing that I do know is that I do not want to work in med/surg, maternity, or pediatric floors.