Preceptorship in PACU

[brit.pz]

Hello, everyone! I have just started my final semester of nursing school and along with our regular classes we are also required to complete our precepting hours during this time.

I found out today that I will be in the PACU. I am pretty nervous because I have basically zero PACU experience. The most I've spent on a PACU unit was maybe 30 minutes.

So, I was hoping to get some advice from some of you on what things I should brush up on or anything that you wish you would have known before starting on your unit. I really want to do a great job so I am open to any and all advice you have. :)

(Also how many patients do you typically have assigned to you?)

Thank you all!

[BellionRN]

Typically I have two patients, or one if it is an ICU, a sick stepdown patient or otherwise someone who is requiring more of my time (pain management problems including q5min drug Adm, confused/aggressive, etc.).

I would recommend reviewing post op main management and airway management to start! :)

Good luck, I love PACU :)

[Rose_Queen, BSN, MSN, RN]

I also completed my senior preceptorship in the PACU. The biggest issues we dealt with were airway management, pain management, and PONV. I work in the OR now, and our PACU's ratios are 1:2 for regular patients (non-critical care, non-peds) and 1:1 for critical care and peds patients.

[wannabecnl]

I did my immersion and final capstone project in PACU (and work there now).

I bought Cecil Drain's book "PeriAnesthesia Nursing: A critical care approach." I didn't read the whole thing, but it is an excellent reference.

Keep track of the meds your hospital uses, and don't be afraid to ask the anesthesia staff what something is so you can look it up later. They'll be using IV pain meds, antinausea meds (IV plus scop patches and po marinol), drugs to raise and lower BP and HR, and anesthetic agents. You probably already have a good drug reference guide (I like my Davis). Use it to see the various dosages, cross reactions, etc.

It's impossible to learn every possible surgery beforehand, so see if your unit has a copy of the Core Curriculum (they should know what this is). If you can take 5 minutes when you know what patient you and your preceptor are getting, look up the surgery and familiarize yourself with the issues, terminology, risks, and outcomes. VERY useful.

Ask your preceptor if you can follow the same patient through the whole process, maybe one outpatient and one inpatient coming from/going to the floor. It is useful to see the whole continuum of perianesthesia nursing care (preop, surgery, phase I recover, phase II recovery or inpatient admission), which starts before the patient even gets undressed and continues until they are discharged.

Where do you work? You should visit the ASPAN website, which is Home (I don't know why AN makes this into a hyperlink called "home", sorry), and find the local component close to you. Attend a conference. You won't get CEs, but you'll learn something new and meet other PACU nurses. Some of the nurses in your unit may be ASPAN members and/or active with the local components. That ASPAN website is a great resource for practice guidelines, too.

I love my job and learn something new every day. I hope you will enjoy it as well!