PACU'er

You don't sound like you are in a safe situation, with being by yourself. You should have at least one other nurse with you, according to ASPAN standards, not to mention patient safety (and yours). Besides coding, what if the patient woke up with emergence syndrome or something and you where the only one there to wrestle them and medicate them, etc? Sometimes it's not about skill, but an extra hand. Our OR staff is required to stay with the nurse if there is no other nurse (rare). Once I had an OR circulater that refused to stay because the other RN had transported her patient and was to return within 5 minutes. The OR circulater left, the patient became wild, but thankfully the other nurse returned and could run for meds, etc. I wrote the OR circulater up and she got in huge trouble.

Mama d, I know it is frustrating (from personal experience) to wait and not see family in the recovery room. We try to get family in as soon as we can, especially with kids. Sometimes the patient wakes (or doesn't wake) with issues. Family can either hinder or help a situation, but we don't know what we'll get and during a crisis, we don't have time to deal with an extra situation. People (and kids) can and do crash on arrival to PACU. For example, recently I received a young ped patient with an oral airway. He was breathing fine and his O2 was good. After 10 minutes, he just stopped breathing and went blue. I had been listening to his breath sounds with my stethascope and happen to hear the respirations cease. We started bagging and the anesthesiologist came. There was a good outcome. The mother wondered what had taken so long. I, and the doctor explained there was a little incident (we down-played it), but the mother was so alarmed and panicked. I was glad she hadn't been there.

Hey PACUJennifer, I agree with your post. The decision for family visits are up to the nurse. The doctor sometimes tells the family that they will be able to visit in a specified time, and when that doesn't happen, they get upset. I tell them that the doctor shouldn't have made that promise.

We discharge patients at all hours. If it's late then the phase 1 nurse is the one who discharges. We interchange as phase 1 and phase 2 nurses.

It drives me crazy when my report is interrupted with questions. I'll say something like "if you will allow me to continue, I will probably answer your questions". It also drives me crazy when the staff nurse asks if the patient has bowel sounds--uh, no! The patient (including their body) was put to sleep. Yes, we give the patient ice or something to drink, especially phase 2 because they are required to be able to hold fluid before discharge. We only give ice chips sparingly to abdominal surgeries, if ordered. We assess the readiness of the patient before giving ice or fluid. the only problem they may have will be with nausea, not a bowel obstruction. Other questions that drive me crazy (since I get to vent) include "did you ambulate the patient?" or "they haven't voided yet, why not?". I kindly tell them that we worry about bigger issues like breathing.

I work in a Phoenix area hospital, and we do not float our PACU staff. It is never a concern (thankfully) for us. We sometimes have qualified resource staff come to us, but we never go anywhere else. The only thing that would be close, is when a PACU nurse goes to ICU to help recover a patient because the ICU nurses feel overwhelmed when a patient goes "direct", and demands help.

I came from a Med/Surg background (not ICU) and have worked in PACU for 2 years. In fact, we have many nurses that have the same background. Those who weren't capable enough, were weeded out. We have so many excellent PACU nurses in our unit, I am sometimes amazed. They are on top of their game. We are also a busy PACU in a large Phoenix hospital. We have all kinds of patients day and night, including ICU, peds, etc. I have never seen a nurse respond inappropriately to any situation. The Med/Surg background nurses have proven to be as capable as the ICU background nurses. ICU experience is awesome, but a nurse with a Med/Surg background can be just as efficient, have excellent critical thinking and be able to respond to emergent (or otherwise) situations. I think the key is preparation. Just my thought. Thanks.:redbeathe

Well, I wonder how things are going, it's been a month since your last post. We also introduced computer charting and EMAR to our unit. It was quite a transition, and I am fluent with it. However, it does take more time to chart than with paper charting which management needs to realize it. This is even more true when you have an ICU patient, because there is obviously more care that occurs, and more charting in different screens. I hope all is well with you.

Here in Az, all peds patients are transported with at least one RN.

I'm with you on the treatment part. Sometimes we are treated like step-children. We are a critical care area that keeps people alive. I find it interesting that some ICU nurses (FYI: I love and respect ICU nurses) don't feel we measure up until a patient is supposed to go direct, then they want them recovered in PACU because we are better at it!

I am so sorry that you had to experience such dissapointment after all of your hard work. Don't let it get you down (I know, it's hard to do). What me and my classmates did was to study up until a couple of days before the test and then put the books away! We then made sure we were rested and as relaxed as we could be on the big day. You know the information, don't doubt or confuse yourself. I always had trouble with tests. All of us that tried this approach, passed. I hope this helps. I'll hold positive thoughts for your landslide test passing! Good luck to you.

I live in the Phoenix, Arizona area and couldn't agree with the fellow Arizonians more! There are jobs aplenty here. There are also new hospitals being built, so those will also need to be staffed.

Well, I am out here in Phoenix, Arizona. There are so many opportunities in the hospitals and medical places, that are just waiting for applicants. This doesn't include the facilities that are in the process of being built. The "suburbs" are combined with it's neighboring suburb, creating a hugh area. You are definately not alone here. Just a thought. By the way, you can't beat the winters, they are perfect.

I think it depends on where you want to go. I have never been interested in pediatrics (although I think kids are great), so I never pursued that type of nursing. I started in Med/Surg because I believed that it would offer me a strong foundation. In fact, nurses used to feel that new nurses should begin there. Opportunities had stayed limited, not allowing new grads into many areas. Today, that thinking has changed. New grads are seen in the ICU, OB, ER, etc. We even have a new grad in the recovery room, and he is doing fine. Everyone is different. I think the sky is the limit on today's nursing possibilities. I think that you should focus on the area that you are interested in. You may love what you choose, and never leave it. Or, you may decide later to change into another area and love that. Either way, the future is yours to shape.

I remember as a kid, the painful growth spurts I had to endure. I would hurt straight down into the core of my bones. At the time, I didn't realize the significance of the growth spurt upon my future development. Sometimes, it is the same with nursing. I also began in Med/Surg. I would endure days that were downright awful, leaving me with the desire to pack up and change jobs. I remember being nervous of every decision, wondering if it was the right one. The stress would exhaust me. However, I realized that this was a huge growth spurt for me. I gained valuable experience that I would not trade away. I left Med/Surg and currently work in the PACU (recovery room). It is a very different environment where I am much happier. I actually have an edge over some of the other nurses because I have "floor experience". Know that it will get easier. One day you'll realize self-pride because you handled your day efficiently. Just know that you are entering into a wonderful field that has an abundance of possibilities and opportunities, especially if you are young. You can try different areas, as they can vary greatly. In fact, I envy nurses who do have a broad base of experience. Good luck.