New Grads in the PACU - page 2

I know this topic has been bopped around in here a few times, but here it goes... I am a 35 year old, second-career, NEW grad RN with a license so new (7 days) that the ink is still wet! I'm... Read More

  1. by   gentle_ben_RN
    The biggest issue for me about new grads in the PACU is that during off hours like nights and weekends, there is often only a skeleton crew in the PACU and/or they are working on call. So if only two nurses are working in the PACU, then it is very important IMHO that both nurses be experienced.

    I agree 100% with RN34TX on this subject. I work 11A-11P and there is one nurse that I work with sometimes who is 3P-11P. She is an experienced RN (in L&D) but has issues with taking the more critical cases (thoracotomy, craniotomy, AAA repair, ect) There have been times in working with her that she would totally refuse to take a post op that was still intubated and have a complete fit about it. This has been an ongoing issue that I and others have brought to the NM. She has been in PACU for a year now, part-time BTW. I just can't work PACU with someone I can't count on.
  2. by   RN Zeke
    I am a new grad, also interested in PACU, so am glad to hear all the valuable information shared. I have a back ground in surgery as a tech. so will go back to surgery as that seems to be my home.
    Once again thanks for sharing the information with the new grads., we don't get all the needed skills information in the job sites for hospitals.
  3. by   hlfpnt
    Is long term acute care experience with ACLS certification an acceptable back ground for PACU?
  4. by   RN34TX
    Quote from hlfpnt
    Is long term acute care experience with ACLS certification an acceptable back ground for PACU?
    In my opinion, no.
    And I'd like to throw in that the bulk of my nursing experience has been in long term acute care so I know what that setting is all about.

    However, that is only my opinion. There are new grads with no experience at all, some of whom are my current co-workers, who were hired straight into PACU right out of nursing school. This practice is not very common at most hospitals and my co-workers who were hired straight into PACU as new grads had done so 10-15 years ago.
  5. by   macfran
    all messages in this forum is very interesting for me...i appreciate all who posted.
    i'm actually a nurse who is now working for almost 2 yrs now in a med/surge unit here in the us but has been a pacu nurse for 6 yrs abroad before i came here. i'm very eager to go back to pacu. so, would i be considered for the position if they require previous experience. would my experience from abroad be significant? by the way i also have 4 yrs of experience in er.
    thanks for any replies.
  6. by   gentle_ben_RN
    macfran, you shouldn't have a problem.
  7. by   SeaTracer75
    i would have to say i am in the minority here... i am a new grad, got hired into the pacu, and apparently am the first new grad to get through orientation there... one other was hired, but fired during the orientation was 13 weeks with 2 of them in the classroom and a 5 day critical care course squeezed in... also pals and acls....

    i surely wouldnt recommend it unless u are really up for a challenge...i spent many a day in tears during those 13 weeks and believe me I still do not feel anywhere near fully qualified...every day i still learn something new... even though i didnt choose that route the icu first suggestion (if possible) would make for a great transition into pacu... my weaknesses include vented patients (of which there are many) and multiple "drip" patients... i have tons of experience yet to gain but fortunately i work with a bunch of great nurses who want to help "groom me," (and also a bunch of hobbible ones who couldnt care less!)

    anyway ill stop for now i could go on and on and on......
  8. by   azhiker96
    I am also a new grad who hired into PACU. I am the first new grad that has been hired by my department. If I had not worked there for 3 years as a tech, I wouldn't be there now. They have given me an extra long orientation to help ensure I am successful. It's a great place to work but I would not recommend it to most new grads. Chin lifts, extubations, wrestling patients, ventilators, labetalol, versed, morphine, dilaudid, and patients from 1 month to 90 yrs old are all part of a normal day. One hour into my very first shift I was doing chest compressions on a pt who had an anaphalactic reaction to a med. (He was discharged from ICU 5 days later.) Any patient could be a breeze or scary. Without a good orientation (16 weeks in my case) I wouldn't be able to take any but the easiest patients. Anyway, I love my job and look forward to recovering people tomorrow.
  9. by   BonnieSc
    Hi, I'm a new grad with an interview for PACU coming up... this thread has definitely given me food for thought. I did my senior internship in the ER of a big trauma center, but I don't know whether that background will be enough... I'll definitely want to ask some questions about the orientation. Obviously the unit is welcoming new grads, because this job was posted specifically for new grads and they're hiring a couple of them.
  10. by   akowens
    I saw that there are a few of you that are new or newer grads that are interested in PACU. Just to let you know, I am just graduating nursing school this week and have already secured a job in the PACU at a Level 1 trauma hospital. It can be done. I just set myself up an interview, capstoned at a PACU, and they hired me! Now, just have to tackle that NCLEX! Wish me luck.

  11. by   ava'smomRN
    After following this thread, I think I will chime in.

    I did an externship in the PACU last year and was offered an RN position upon graduation and offered to stay on as a CNA. I accepted of course.

    As I got closer to graduation, I got nervous and started interviewing other places.

    My manger offered me 6months of orientation, critical care course, RN residency program, and excellent preceptor and very supportive, educated staff. My manager told me that she wouldn't hire new grads but I am the exception because i have been there and she thinks that I am well beyond capable.

    so I will be starting in Feb 2008....
  12. by   nickola
    Quote from MoriahRoseRN
    Can you believe I interviewed for a PACU job, & I was told the orientation was usually 2 weeks. The manager said it is a little longer if you are a new grad, but she did not specify. I don't think they will be calling me back, as I have no acute care experience, only just about one yr in LTC as an LPN (I don't know why they didn't look more closely at my resume). I'm shocked this is all the orientation they would provide, but it is a day surgery position. Would that make any difference?
    Someone on these boards once said that "PACU seems like an easy place to work until it's not" I think this is especially true in day surgery PACU. If you have learned PACU only in a day surgery setting you are not prepared for all that can go wrong. For one thing, day surgery is much faster paced, and if you can't spot problems quickly & know what to do, you are putting your patients at great risk. If anything, it is even more important to have a good solid HOSPITAL PACU background to work day surgery. Part of what makes one a good PACU nurse is quick assessments for spotting potential problems, and having been in situations where you learned this b/c things DID go wrong. My manager will not hire new grads or anyone for PACU w/out previous PACU experience. With more and more cases being done in an outpatient/ day surgery setting the potential for problems is higher. And you will be alone many evenings w/a support person - LPN or Tech- so you have to be able to function independently & act quickly in an emergency. A couple years in a good solid hospital PACU w/call & all that it entails will prepare you well & give you the needed skills & confidence for day surgery. Good luck!
  13. by   Rojo33
    I see this thread is fairly dated but hoping someone might still check up on it. So I'm a new BSN grad that was hired straight into PACU and I'm the 1st new grad to ever be hired at my hospital for PACU. I have military exp as a surgical tech and got ACLS/PALS certified shortly after NCLEX but am still as green as they come as far as nursing is concerned. I'm 2 months into my 3 month orientation, 1st month was a mix of classes and hands on alongside my preceptor. 2nd month I've been mainly solo but my preceptor was (and I'm sure always will be) available. My last month will be starting call rotations with her and than I'm on my own. I've had all positive feedback about my progress but I'm honestly a little hesitant about getting off orientation next month. I'm generally ok 1:1 but more than that and I get swamped fast. I don't want to jeopardize my position by asking for a longer orientation but I definitely don't want to harm a pt! The other nurses I work with have between 5-30 yrs experience in ICU or ER so I feel incompetent just standing near them lol. But seriously, I want to ask for more time but my hiring manager apparently ruffled a few feathers hiring me and I don't want her to regret her decision or be a burden to my co-workers. However, after reading about orientation at some hospitals being as long as a year, I'm thinking my hesitancy is justified.

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