Do or nurses do pacu after hours?

  1. Any of you OR nurses doing Pacu after hours on call? Our hospital refuses to put Pacu nurses on call. Instead OR nurses are doing surgery then recovery. My training was 1 week in Pacu. Not only is the OR team unavailable for emergency surgery, but we don't do recovery on a day to day basis. I don't feel I am qualified and all the other hospital in the area have Pacu on call. We also cover endo unit which was a 3 day orientation and some of the equipment need for the scopes is up 1 flight of stair in the locked endo unit. Does anyone know if there is any standard of practice that says this is not safe or where to look? I have come in at 7am worked my normal shift till 3pm. Took call at 3pm-7am. Needless to say emergency cases pilled up and I never left. At 11pm I am finishing up surgery only to go onto recovering the patient I had a 20 min. lunch and that was it (maybe 5min here or there to catch my breath). This really doesn't seem right long hours and then changing specialty areas? Imput please!
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  2. Visit emmijay profile page

    About emmijay

    Joined: Jan '05; Posts: 2

    17 Comments

  3. by   sharann
    RED ALERT! This is unsafe and unethical.PACU and Endoscopy are specialty areas just as the OR. They also expect you to work unsafe shifts, overtime etc. I would be outta there before something horrible happens. One week in PACU is not enough orientation by the way. It took me ONE year to feel competent and I still get that fear of the unknown sensation before I get a patient. Things can go real bad. Are you all ACLS certified as well? DO you have anesthesia backup in the house?
  4. by   emmijay
    Quote from sharann
    RED ALERT! This is unsafe and unethical.PACU and Endoscopy are specialty areas just as the OR. They also expect you to work unsafe shifts, overtime etc. I would be outta there before something horrible happens. One week in PACU is not enough orientation by the way. It took me ONE year to feel competent and I still get that fear of the unknown sensation before I get a patient. Things can go real bad. Are you all ACLS certified as well? DO you have anesthesia backup in the house?
    No ACLS no anesthesia in house. I contacted NYSNA (NY state nurses association) rep. and she doesn't think that we will be able to get pacu to take call. Just crazy!!
  5. by   mwbeah
    PACU nurses should take call, ours do.

    Mike
  6. by   shodobe
    NO! I think it is just a cheap way for the hospital to not pay PACU on call money. Two different specialties. I wouldn't work there, but you will find small rural hospitals will do this because of staff restraints. Mike
  7. by   sharann
    How can PACU "refuse" call? This is a part of the job. If they can refuse then so can you right? This is terrible. OR should not be recovering. PACU doesn't circulate the OR do they? A nurse is NOT a nurse.
  8. by   shodobe
    The small hospital I was thinking of going to had this situation. They had a PACU nurse who set her own rules and only worked 8-4 each day and not the weekends. OR people had to recover after hours and on weekends. If more than one case was scheduled the second one had to wait until the first was sent to the floor. This really slowed things down. I just couldn't do it an said no. I told the manager the hospital was working in the dark ages and needed to be brought up to exceptable standards. I just didn't feel comfortable with the situation. PACU and the OR are really two different worlds even though we do help each other out in a pinch. Mike
  9. by   cwazycwissyRN
    God bless rual America. Yup I also did the recovery after hours when I worked in a small hospital. Makes me appreciate the recovery room nurses every time I drop off a patient now.
  10. by   Sarah, RNBScN
    Our PACU nurses are on site until 2000 hrs. then they are on call after that BUT we (OR) have recovered our post op when we know we do not have another case back to back.

    Sarah
  11. by   Marie_LPN, RN
    At 11pm I am finishing up surgery only to go onto recovering the patient
    This is dangerous and it needs stopped.
  12. by   jaquar
    at our hospital OR nurses do recoveries also. A rural hospital with usually under 100 beds can't usually financially survive with OR, PACU, and ENDO nurses all on call. That is why there is cross training, and competencies.
    an orientation is not what determines competency alone, it is also expierence and knowledge.

    it sounds like you were hired with this practice, why did you take the job if you didn't want to recover patients?

    also the OR use to run and do the Endoscopy cases at our hospital. the OR nurses trained the endo nurses which is why they do call. Did your OR ever do endos?

    if your practice now is to do recoveries, yet you say you don't feel qualified, isn't it your professional responsibility to either get qualified or quit. i would think saying your not qualified to do something and than continue to do it would be negligent as a nurse.

    good luck
  13. by   mattsmom81
    Wow. All this switching of gears/wearing of many hats on top of the hours you spend at work is just plain unreasonable..sounds like they're just taking advantage of good hearted OR nurses here to be honest.

    I wouldn't stay in this position personally...and it sounds like you will not be able to make changes, the facility is getting what it wants with their current mode. Good luck to you and I agree with Jaguar this could come back to bite YOU if something should go wrong. Don't count on the hospital to have YOUR backside, they'll be quickly trying to cover their own.
  14. by   MorganO
    I'm with Mattsmom. This OR would not be for me. I guess I'm wondering how you got into this mess. Is this new to your area or something that you agreed to upon accepting this position?

    I work in a rural hospital. As a critical care nurse, I have had to recover after hour cases. It is the policy at our hospital to recover these patients in ICU at the discretion of the shift charge nurse. This is to allow the OR call team to clean up and go home. I never felt that the OR team appreciated the relief. In fact, they challenged the decision made by the charge nurse as to availability of staff.

    As a nurse who needed to recover these cases, I maintained competencies and ACLS. How else do you not feel incompetent in these situations?

    I fear we are losing our capability to make judgements and accept our responsibilities as a professional group at the hands of our piers and other professions.

    I hope you get what your hoping for

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