L&D to PACU

[eaRNdit, BSN, RN]

Hi all! For the past year I've been working in Labor & Delivery at a large, tertiary care teaching facility. In my first year as a nurse, I realized that even though I thought this was the specialty for me, it's really not.

I am going to be starting a new position in the PACU next month and I'm really excited! During nursing school I did a summer internship in the MICU at this hospital and really enjoyed critical care. My only concern is that for the past year I have not been working in med surg. In L&D I circulate in the OR and follow my patients to the L&D PACU until they are transferred to the postpartum floor, so I do have some post-op experience and feel that I have a good general sense of what to assess for immediately after surgery. There are just so many types of procedures and critically ill patients at my hospital that I'm worried I'll look dumb!

I've been reading AACN's Essentials of Critical Care Nursing to prepare. Anyone have any tips or advice on how to make my transition smooth?

Thanks!!

[HeySis, BSN, RN]

Have you already started?

In my facility the L&D recovery is very different from what we do in PACU, since most of their c-sections are done with a spinal. IF there's a real emergency, and the patient has to under general, they'll bring them down to the OR or we go up there and we recover them.

I hope you are still getting a full orientation, that will be vital in your transition.

Other then that, read your units policies, look at ASPANs website ASPAN.org and you can find information about some clinical guidelines and position statements. They're good information.

[peaches88]

Having worked PACU and having friends that are L&D nurses, my biggest recommendation would be to study up on cardiac monitoring, airway management, and medications. Try to see if your facility has a PACU med order sheet and then focus on studying those. Get comfortable with OPAs and NPAs. Make sure your orientation includes information over the aforementioned areas, malignant hyperthermia, and invasive hemodynamic monitoring. The majority of facilities require ICU experience before PACU, so don't let them screw you out of a good, thorough orientation. Also, don't be afraid to ask anesthesia providers questions about the medications they gave to put the patient to sleep and the rationales behind their choices.

[Marlaina S]

On 10/25/2016 at 8:57 PM, eaRNdit said:

Hi all! For the past year I've been working in Labor & Delivery at a large, tertiary care teaching facility. In my first year as a nurse, I realized that even though I thought this was the specialty for me, it's really not.

I am going to be starting a new position in the PACU next month and I'm really excited! During nursing school I did a Summer internship in the MICU at this hospital and really enjoyed critical care. My only concern is that for the past year I have not been working in med surg. In L&D I circulate in the OR and follow my patients to the L&D PACU until they are transferred to the postpartum floor, so I do have some post-op experience and feel that I have a good general sense of what to assess for immediately after surgery. There are just so many types of procedures and critically ill patients at my hospital that I'm worried I'll look dumb!

I've been reading AACN's Essentials of Critical Care Nursing to prepare. Anyone have any tips or advice on how to make my transition smooth?

Thanks!!

Hey there! Just wanted to see how you’re liking PACU/ how the stress level compares to L&D. I’m in a similar situation that you were in. I’m in my first year of L&D and think it might not be for me.  We’re you in a nurse residency for L&D? Most PACU jobs I am looking at are requiring that I finish my 2 year nurse residency contract .