emain86

I currently have a full time night shift job and a PRN job. I work about 50-60 hours a week and take home approx 2200$ biweekly. I'm looking at traveling nurse jobs and have a concern about positions and pay. I feel like I can do pretty much anything but I am certified in Post Anesthesia Care and would like to stay in that area as its pretty much similer across the board. My concern is the consistency with assignments. Its not like I can just be like oh here let me take that ICU job right quick because no PACU jobs are open up. I get that you can take three month assignments and I have nothing tieing me down. I love what I do but the place I'm working out is draining me and possibly looking for some changes. Just scared to move away from the consistentcy I have here.

Im a big fan of the whole recovering a patient in the ICU isntead of calling someone in. I work nights and really the standards say one PACU Phase 1 RN and a RN. ICU nurses are more than capable of helping with a PACU patient if things go south. Makes everyone happy and saves the hospital money. What I'm not okay with is that as a nightshift PACU nurse every responsiblity is on me. I'd rather have the on call person come in because then I get a second set of hands; get the patient out early and can get back to my other duties ( mainly making sure things in same day are good and the unit is in good order for the next day.)

For the same reason you send a thank you card after a job interview? To achieve a goal, to look good, to make them think good things about you. Something like " thank you for choosing ___ it was our pleasure to take care of you and we wish you a speedy recovery" studies have shown that people who send thank you cards get more positive feedback. When my dad was a car sales person he had me type out this data base and we mailed out christmas cards to everyone who ever leased a car from him because it helps to put an idea in people's heads. To the person who talked about fluff, patient satisfaction is as one co-worker described it a mystique. It's all fluff.. or a lot of it. At the end of the day I tell people fake it until you make it because you only have to deal with surgical patient's & and their families for a 12 hour day. However, that list of 8 things is a good list that people should be doing strictly based on common sense. I guess the question is how are we going to get all those points across in a scripted manor.

As Satan ( A.K.A) Press Ganey knocks on our doors we are looking for ways to improve our patient satisfaction scores. One of the things that was suggested and I think is an excellent idea is for every outpatient surgery patient to receive a thank you card, hand signed by every person who helped to take care of them. I know it sounds like just one more thing to do, but I really think that patients would appreciate that. On the topic of patient satifaction what are some of the things you guys do to increase patient satisfaction. Our scores are horrible!! I do feel like we do a good job though, and everyone is being pushed to the max but we are still bottom of the barrell. Not all of our patient's get Xanax because its PRN and the stupid same day nurses always ask " would you like a xanax"? Whereas I say "heres the medicine the doctor ordered it wont make you loopy or sleepy just help you relax". How do you guys give information about delays to the patients? Sometimes we are so short staffed we barely have time to think and the OR ends up on hold. Some people find it not feasible to update family thoroughly.

I just did tons of practice questions. I did no review courses. I'll admit I found the test to be harder then the NCLEX. I went in there did the 175 questions in about an hour or so,prob had half of them marked as i don't know and passed. I've only been an RN for a little over a year now but did PACU in the military. My advice for anyone doing any test is practice questions/practice questions. I wouldn't bother going over stuff you already know like trying to read a chapter and then do questions. Overall, not a bad test at all. Also purchase the practice test off of the ASPAN website for a decent representation of the test questions ( types not exact). Its usually 2 test for 50 $. I did 2 test before I started studying and 2 test before I actually took the test.

I work nights so I hate calling people in the middle of the night just to recover a simple patient. On top of that it would literally save thousands of dollars doing it that way. Like thousands. My manager on the other hand wants nothing to do with any change. We don't say what would jesus do we say WW ( insert name) do. Thanks for the response though. I'm over it. Actually about to head over to the travel nurse forums and was totally gonna find out about travel nursing in PACU . That really would be a fabulous way to recover patients and save thousands of dollars a year.literally thousands.

Here comes a bunch of us playing doctor! My first thought wouldn't be UTI, but infection is more than likely the issue. Actually those symptoms all fall in line with sepsis ( ER has a sepsis flowchart/algorythm). They'd still do a UA. Blood cultures x2. Lactic Acid for sure! ABG's.BMP, H&H. (Basically a full sepsis workup). The patient would probably end up in ICU. They'd figure that out based on labs/what not.

It made me smile that you liked my post . Glad it helped. I'm new to this as well, but like I said did it in military. I try to tell that to every one.

I want a PRN job in a PACU. I work level 1 Trauma Center in PACU so I def see some crazy stuff. I'm talking like you need 2 nurses to handle 1 patient type stuff. ( I mean kind of sometimes haha). But I want the cushy PRN PACU job recovering ortho patient's who get blocks and then get sent home haha. I'll start applying after I get my CPAN.

Wow this is really a good idea! Very inciteful. Using the OR as my secondary nurse isn't always the best because they are basically useless unless I'm calling for a code ( and even still they aren't always an ear shot away. ASPAN standards says 1 phase 1 PACU RN, + an RN at least within earshot). So basically I could look in my bedboard ( our bedding system) and see like oh T2 ( SICU) has 8 empty rooms. Lets just recover the patient up there and when OR calls to say where we putting the patient in room so and so? We actually have a nightshift nurse ( me and one other nurse nightshift) and we work Sun-Friday. Basically we work each others off days and we call in another nurse for patients. So basically since I'm up all night I pick up everyone's call so this could hurt my money haha but its really a great idea. Can you elaborate more on you do your drugs/what not? Do the Anesthesiologist every get mad if they have to walk over to the UNIT? Or maybe I could recover the patient over in SCVICU which is literally right across the hall. This is a good idea. Our drug stuff is funny and I'd have to work on how we'd do that. Overall I really like the idea of doing it that like that. Would really like to discuss this further.

In an ideal world where you have enough Staff those patients can be monitored by 1 nurse on a different side where you allow family to come up and can get them a tray. Once patients are out of phase 1. I usually just do Q4 hr vital signs and 1 full assessment every 4 hours. According to ASPAN standards you can have up to 5 patients. ( its really not bad at all) for 1 nurse. you dont have to do anything for em once they are observation. If/when we don't have a seperate nurse to take the patients.. I've got better things to do than q15 minute vitals so I just put observation whent hey are ready. turn off the light and let them sleep. You can let anyone up out of bed to use bathroom. most of the time its just a hassle. just use your judgement if you think they are going to be fine or not. You can always stay with them in restroom. You are generally worried about fall more than anything. Do you think after that appy was on the floor for 5 hrs they would be okay to get up and go to the bathroom? If so then you could get them up.

I feel like ED and PACU are probably the most similar jobs in the hospital. Only exception is you always have docs right there in the ER. You have many of the same stressors, some different too. The best part is generally dealing with family less and the second best part is most of your patient's don't die. Surgery in general seems to have a lot less BS to do with computers and making sure you do this or that. It seems more patient care oriented.

As much as I want to respond with my thoughts on this subject. It's a can of worms that moderators should probably just close this topic now. Argh but its infuriating. I've sat here for 5 minutes debating wether or not to put my view.. you sign a consent there are risk... could the hospital be at fault yes... and it will come out if they were. We can't just base things on he said/she said. You know when my charting is the very best.. when I have an unstable patient my charting is pristine. And if they did suction the patient ( not typical) they would have suctioned her because the bleeding was so bad it compromised her airway. If your thought process was well "maybe the suctioning caused the bleeding". And we really wont get started on the brain dead topic. got to much stuff to get done.

I have a current ASPAN standards book and am fairly familair with the risk factors for PONV. The problem is Anesthesia here does every single case the same. Zofran, Decadron , Ofirmev ( unless contraindicated), and toradol ( if i'm lucky). Some of the better ones will give some longer lasting narcotics throughout the case but a lot dont. They even localize the port sites. Also I usually dont give reglan and pheneragan together. Lap Chole's to tend to have more PONV than other procedures in my experience. I guess my issue is that we keep getting these patient's returned from Same-Day I give them 12.5-18.75 of phen let them sleep for an hour and then send them on their way. I would like to prevent it more so the patch might be a cheap effective way.

If you ever tried to take my phenergran away I'd probably quit this job. I wish ours didn't have pain issues. I don't know what it is. Some days I feel like all I do is slam people with narcotics and they are still screaming for more. I'll look into the scolpamine thing. I mean nausea is so common in these patient's. They need to try anything.