MakeItRain

While there is technically no distinction between the actual or potential needs of an outpatient vs inpatient postoperative patient, there is however a huge difference between anesthesia techniques. For example, you wouldn't need to worry about residual or reoccurrence of paralysis in a patient post MAC, because the patient never received any paralyzing agents, nor would you be expecting a laryngospasm if the patient was never intubated (unless of course they were post-bronchoscopy) which is why there is a distinction between phase one and two care. The vast majority of outpatient ambulatory centers use MAC and/or regional anesthetics with occasional general requiring phase one level of care. Yes two weeks is a very short orientation, but given that the OP will likely be recovering low acuity patients and doing mostly pre-op/phase II, this could be a very good opportunity for them to break into what I believe to be one of the best fields of nursing there is.

I've travelled all across the western half of the US for PACU and the vast majority are the way I describe. Also, the OP is talking about an ambulatory surgery center which means 99% of their patients will be MAC. In many inpatient facilities MAC patients don't even stop in the recovery, instead they go straight back to their rooms after 10 or 15 minutes of monitoring prior to leaving the OR. In which case, the OP has probably cared for many of these patients I described already.

I'm a travel PACU nurse and have never had an issue with finding contracts, but I'm also willing to travel just about anywhere. Like GirlOnPfizer said, case loads wax and wane on a normal basis which does encourage the use of temp staff and this need has only been amplified with the complexities of covid. Also, typical orientation times for staff nurses in the PACUs I've worked are anywhere from 4 to 12 weeks, which makes for a common practice for travelers to come in a week or two before someone quits and a new hire begins orientation. Also many times I've worked in place of a nurse that goes on fmla or maternity leave.

Yes, this is correct. Phase II standards of care are generally less, but do still require a second staff member capable of at least BLS

I've worked inpatient and outpatient PACU in various settings ranging from surgery centers to level one trauma and peds. I think you'll be fine. One of the great things about PACU is that it's a highly team oriented environment, unlike what you've probably experienced on the floor. In PACU, if there is ever an assignment or type of case you're uncomfortable with, there are always nurses available to help. I know this, because I too was a medsurg nurse with a year of experience when I made the transfer to an inpatient PACU and I do not regret it!

I may be going out on a limb, but if you only have eight PACU bays, then there's a good chance that your facility is small enough that PreOP and PACU are staffed by the same nurses in a rotating basis, in which case the PreOp nurses ought to be "competent" in Phase I care, which would then deem them appropriate for PreOp of ICU level patients, but that's just my thoughts. I've worked in eight different PACUs (and preops) from outpatient surgery to very large level one trauma centers and I've never heard anyone making this argument, but it does kind of make sense... but then again, I've always said that if I'm getting called in in the middle of the night for an "emergent" life-or-limb case then don't expect me to monitor said emergently ill preoperative patient on one side of the PACU while I recovery another emergently ill patient on the opposite side.

Usually the age is around 8 years old. That beings said, it's not strictly an age related practice, more so it's dependent on the pt's size/weight. Some anesthesia providers will not induce a patient without IV access because they have no means of mitigating cardiovascular compromise that can occur early in induction, which is more profound in "larger" patients, as in; bigger than a small child. I've see some rather large children as young as 6 that required IV access prior to rolling to OR.

Just curious to see what your facilities do to handle late phase II patients. Some places I've worked pre-op closes at 1600 and anything after that was handled by PACU staff, granted the day usually was winding down so there was time for this and the place I'm at now will keep pre-op nurses late for one phase II patient while PACU may spend 1.5-2 hours waiting for the last phase I patient. What is your protocol for this situation?

Just so you know, I put this in general nursing forum because you don’t need to be a PACU nurse to be familiar with how these assignments work... also, my thread is completely dead now because the PACU forum on here is completely stagnant... so thanks for that

Thanks for the info guys! I’m actually a traveling PACU nurse and in my six years of experience, I’ve almost always worked under some kind of turn based assignment, but my current facility is just completely set on trying to plan the entire day out and it NEVER works. There will be times when one nurse has three patients in preop while another has one, but for some reason they just don’t see the benefit to taking turns. So I was hoping to take a poll here so I could have something to show them other than just my experience alone.

Hi! I’m a PACU nurse, and for the sake of gathering data, I’m reaching out to any perioperative nurses about assignments/staffing specifically for pre-op/PACU. How do you guys do it? What works best? Big and small, preop and pacu. I’ve worked places that did turn based assignments, as in nurse 1 takes the first patient, nurse 2 takes the second, and so on and so forth without really have a predetermined “assignment” so to say. I’ve also worked places where at the beginning of the day they have a nurse’s name next to each patient for the entire day (and it never works as planned). Do your charge nurses take patients? Also, how many cases do you have a day and with how many ORs? Thanks in advance for the info!

Hello Everyone, I'm new to this site and I was wondering if anyone in the Austin area could give me some advice. I'm a student enrolled in a BSN program in my hometown. My wife is an LVN and is also currently enrolled in an ADN program. We both have talked about our future and where we want to go with our careers. She is undecided on how much further she is willing to take her education after her Associate's degree. My ultimate goal is to obtain my MSN and I am currently looking into UT Austin. My question is; does Austin currently have a moderate amount of job opportunities for BSN's and ADN's? If so, what type of schedules will be expected from us? Do you think it would be too difficult for a full-time student to work as a full-time nurse, especially while obtaining a Master's? If it became necessary, would the average pay for ADN's be adequate for my wife to support both of us in the Austin area? If anyone could help me out, I would greatly appreciate it. P.S. I will be graduating in the Spring '13