PCU interview... but what exactly is PCU?

Nurse Kyles, BSN, RN · Oct 26, 2013

Progressive care is classified as a critical care area by the AACN, but not as critical as CCU or a SICU. In my hospital the nurse patient ratios for PCU are strictly capped at 3:1. We take open heart surgery patients as soon as post op day one. We run drip medications such as dopamine, dobutamine, amiodarone, nicardipine, cardizem, nitro, insulin, integrillin, angiomax, and heparin. There are others but those are the most common medications. We do not run vassopressors; they can only be ran in CCU. My unit does not take ventilators, but patients can be on bipap continuously. Patients are hardwired to bedside monitors, and we do assessments Q4H. We take post angiogram patients that have intervention, and manage the femoral arterial lines when they were unable to pull the sheath in cath lab. We do much more than what I am writing, but it is hard to list everything (especially when typing on my phone)

It is a really interesting unit to work on, and I am very glad I started in PCU as a new grad. It has made me into a meticulous nurse.

My advice for the interview is to express enthusiasm for learning and continuing education. Come with questions for the interviewer. Ask them what the PCU criteria is? What type of patients do they accommodate in their PCU? What are the nurse patient ratios? Having criteria for PCU is important, because it helps prevent (not always) getting dumped with a patient that should really be sent to CCU. Not all PCUs are created equal, so asking these questions will provide a better idea of what the unit is really like. This is just my two cents. Good luck in your interview! Let us know how it goes.

tarotale · Oct 26, 2013

wow! that was some awesome input. I don't know yet what kind of PCU the unit I am being interviewed for, but from what you describe, PCU patients sound like pretty critical (well, heck lot more critical than floor pts because I am med/surg nurse right now:(...) and I enjoy critical pts, love codes etc. I love the description of pts in PCU too. to be honest i am pretty bored with the overall stable, non-sick medsurg pts, and I feel like medsurg is kind of dead end job with tons of meaningless charting, endless dumb misc activities like fluffing pillows or calling house keeping to wipe the floor so they can calm their butts down from dirty floor ha! I am also seeing how much the PCU will pay me b/c the area is bigger city compared to where I live, and bigger cities give more dinero as we all know... more money and more learning opportunities... I am loving the sound of it so far. Thank you!

Lev, MSN, RN, NP · Oct 27, 2013

I know it stands for Progressive Care Unit most of times, and probably equivalent of a stepdown unit? I thought that cardiac nurses can relate to PCU also, so I will post here.
So I got an interview next week at PCU, and am trying to figure out exactly what a nurse does at PCU, what to expect, what kind of environment it is, etc. Also, any strategy, info on how to land the job would be appreciated.

Hmmmm I also have an interview in PCU this week...I think the ratio is 1:3-4.

Nursing_Mamacita · Oct 27, 2013

I work on a cardiac respiratory PCU! We do all of the things mentioned in the first replys post but we DO take vent and trach pts.

Our unit merged with the lower acuity portion of the CCU, so we are a critical floor. Our preferred ratio is 4:1 BUT the limit is 5:1.

It's a GREAT place to start and if you truly love it, a place to stay (though every PCU differs)!

For your interview, I would just be prepared to give answers that make you stand out. Be formal, but not so formal that the nurse manager doesn't see you as a human, if that makes sense. I know in order to stand out, when asked what my strengths were and what I could bring to the team, I avoided the cliche "ohh, my communication skills etc etc blah blah" and went with "Well, I am a new grad, so I am still learning, but I am a whiz with pharm/drug recall and I have a memory made for nursing. I may not have experience, but I have the foundation ready to become a great nurse." ...I got the call for the job offer an HOUR after leaving my interview.

Dress sharp and look confident (this is a critical position and confidence is key to survival). I wouldn't ask TOO many questions, because then it appears that you have no idea what you have applied for. When asked about your skill set, I would maybe focus on your multi-tasking/stress handling because if your medsurg floor is anything like my hospitals, you are busy (even though it may be doing silly things like fluffing pillows like you mentioned above...you are still meeting needs of multiple pts). Know your prioritization of pts and what to do when you do not have enough nurses and extra admissions coming from the ED.

That's all I can really think of atm. Sorry, I get so frazzled when giving advice via comments...I just get so excited and get lost in my thoughts! Hah. I love my PCU so much. You will probably love yours too!

:cheeky:

cardiacfreak, ADN · Oct 27, 2013

My PCU does the same as the first reply and we are also the certified stroke unit. We get all TIA/CVAs that are not candidates for TPA. We are not allowed to titrate cardiac gtts except for Nitro and then only to pain up to 20 mcg. Our ratio is 1:3,4 on days and 1:4,5 on nights.

I have been on this unit for 14 years and absolutely love it. We also respond to all codes in house.

tarotale · Oct 27, 2013

1:5 on critical pts? yikes... well at our medsurg, we get upto 6 pts, and everyone hates this floor including the ones working lol b/c the amount of work required by manager is tremendous yet we get no compensation, plus our manager is... not sided with nurses... i would rather get to place that not only pay good but also where i feel like i am actually doing something important other than running around passing meds, countless meaningless charting and picking up extra crap that other nurses forgot to do.

anyways mamacita, thanks for the advice. i will reflect on that!

Do-over, ASN, RN · Oct 28, 2013

It depends on the unit. Where I used to be, it was really telemetry with a few drips, bi-pap. 1:5 days, 1:6 nights.

tarotale · Oct 28, 2013

yuck, im really not thinking about going into another 1:5, 1:6 ratio since I am about at that ratio with my medsurg unit. I got another interview with ICU at other hospital later, so unless the pay is attractive in PCU, I might go for ICU since I do LOVE ICU as well; but really, I like all critical pts, so PCU will be a strong choice if the pts are critical as well as low pt ratio.

cardiacfreak, ADN · Oct 29, 2013

yuck, im really not thinking about going into another 1:5, 1:6 ratio since I am about at that ratio with my medsurg unit. I got another interview with ICU at other hospital later, so unless the pay is attractive in PCU, I might go for ICU since I do LOVE ICU as well; but really, I like all critical pts, so PCU will be a strong choice if the pts are critical as well as low pt ratio.

We don't get more pay for PCU or ICU at my hospital. If you are really considering PCU check with the nurses to see what their patient ratio is. Our ICU is 1:2 which I think is very common around the country.

Do-over, ASN, RN · Oct 29, 2013

The pay at my place is not based on unit. I got paid the same in step down as I do in ICU.

turnforthenurse, MSN, NP · Oct 29, 2013

meaningless charting, endless dumb misc activities like fluffing pillows or calling house keeping to wipe the floor so they can calm their butts down from dirty floor ha!

You'll get that on PCU, too! Actually, I think that's everywhere.

I worked PCU for 2 years, including filling the charge nurse role. PCU stands for progressive care unit and it is recognized by the AACN as a critical care area; however, these patients are on the less-acute end of the critical care spectrum compared to other areas such as ICU. Not all PCUs are created equal as some previous posters mentioned. Some PCUs do in fact take patients on ventilators whereas others do not. The PCU I worked on did not take patients on ventilators but we did have patients that needed continuous BiPAP. Most of our admitting diagnoses were cardiorespiratory problems - chest pain, CHF exacerbation, atrial fibrillation, bradycardia, pneumonia, acute respiratory failure, asthma/COPD exacerbation, pulmonary embolism, etc. We also had patients presenting with electrolyte imbalances (hyponatremia, hyper/hypokalemia being the most frequent diagnoses), acute/chronic renal failure, DKA/HHNKS, altered mental status, CVA/TIA, sepsis, GI bleed, ETOH intoxication as well as other diagnoses. We would prepare patients for heart caths and stress tests and we would also recover patients from those areas. Sometimes patients will come back from the cath lab with the sheath still in place so we would have to pull it. Everybody was on continuous telemetry monitoring.

As far as drips: NTG (titrate for chest pain only, not for BP), dopamine (only up to 5mcg/kg/min, otherwise they had to go to ICU), cardizem, Lasix, heparin, Integrillin, octreotide. We would occasionally get an insulin gtt. We could push cardiac medications whereas the med-surg floors could not. Our nurse-to-patient ratio was always 1:4. If we were short, we were expected to take 5 patients each.

PCU nurses at my hospital actually get paid more than med-surg nurses because PCU is considered a specialty area.