Leaving the ED for the PACU

Specialties PACU

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Specializes in Pediatric Emergency and Trauma, PACU.

Does anyone have any good information on acclimating to the new environment? I'm curious on specific skills, important assessment knowledge, and any other great tips. If it makes any difference it is an all peds PACU that see anyone who is not going to require prolonged intubation or drips beyond renal dosed dopamine. My background is 5 years of pediatric trauma/ED. Thank you for any and all posts!

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I am also interested in the PACU, I am in Med/Surg now, I cant wait to read the responses.

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I feel like ED and PACU are probably the most similar jobs in the hospital. Only exception is you always have docs right there in the ER. You have many of the same stressors, some different too. The best part is generally dealing with family less and the second best part is most of your patient's don't die.

Surgery in general seems to have a lot less BS to do with computers and making sure you do this or that. It seems more patient care oriented.

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Specializes in ER, SCTU, PACU.

In a similar situation currently. Looking at 3 PACU jobs, 1 full-time at a level I trauma 90 minutes away, 1 40 minutes away at a level II trauma, 1 25 minutes away at a level II that's only PRN. Nervous about a PRN position because I haven't done PACU before, only ED and Critical Care Transport. Want to get out of the ED, tired of being dumped on & being told we're not doing anything right. I do enjoy the fast-pace of the ED & the fairly rapid turn-over (2-4hr stays for the most, unless we're boarding in-patients, which I dread), but I don't enjoy the patient load 1:4-5 patient ratio (once had 1 intubated patient and 4 other ED patients to care for, and the other trauma room nurse had the same, 1 intubated, 4 others). Very little support from management when it comes to proper staffing. What's your average patient load in the PACU? How long do they stay with you? How often do you board admits?

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Specializes in PACU, presurgical testing.

If you like turnover and a fast pace, then PACU could be a really good fit! We keep our patients anywhere from 30 minutes to 3 hours; the kiddos tend to move out quickly unless they have post-op issues or need a consult. At my hospital, we are always 1-to-1 ratio with pedi patients. Common surgeries are ORIFs, hernia repairs, T&A, ear tubes, and appys. Had one kid get a stomach monitor placed and another got a central line put in. I've had 2 kids in spica casts and a good number in full emergence delirium requiring medication and prolonged observation in PACU. Had to call cardiology in for one little guy with a very strange rhythm, but that's unusual.

If you've worked pedi ED, I think you'd be well-prepared. You'll need to learn the PACU "stuff," but you'll do better with the nursing tasks than I do, since we don't have a lot of pedi cases (on a busy pedi day we might have 4-5 kids out of 25-30 cases) so it is never really that familiar, especially med dosing (which is always cross-checked with another RN).

My favorite part of pedi cases is that the kids tend to do really well; I always think of my pedi professor reminding us that most of the time, kids don't have a bunch of underlying comorbidities like the vast majority of my adults--if they broke an arm, that's usually the worst thing that's wrong with them! My least favorite part is dealing with their parents. Mom is usually the best medicine, but not always, and my "flow" gets thrown off when there are a million questions coming at me while I'm trying to assess the kid! But you're used to that from the ED.

Good luck; I think you'd be a real asset!

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Went from ED to PACU also. Airway management skills and autonomy are a must. Different doses of narcotics are given, (much smaller), because the patient is already sedated. The evenings were stressful as our only doctor was in surgery and available only by phone. So you really have to be on your toes. It's a different kind of stress, a different kind of busy.

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Specializes in ER, PACU, ICU.

Well I kinda have the same question. Any suggestions on good resources or books to read? I too am an ER nurse switching over to PACU. Ive worked in rural ERs as well as trauma, stroke, and STEMI receiving centers. I guess there isn't much to do to prepare other then jumping in and learning. I hope any of the bad habits I may have picked up working in the ER wont get in the way.

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I have the same question but this is not peds I don't mean to sound geeky but I am sooo psyched and learn different so any good resources , books , YouTube sites etc(;thank you

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