Question for my perioperative peeps

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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!

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Specializes in PACU, pre/postoperative, ortho.

Small rural hospital, 10 room OR but mostly only using 3-6 rooms at any given time.  We lost some surgeons over the past year (& before that really) & still trying to recover.  Average day has probably 12-15 cases.

For PACU, we take turns.  We have a log book to keep track of pts & it shows who took care of them.  On a busy day, we might get out of order if a nurse is able to discharge someone quickly while someone else has to hold another for an extended period of time.  In other words, we don't make a nurse take a 2nd pt just because it's their turn if there is another nurse without a pt. While we technically have a charge nurse in PACU, we all fill that duty on a rotating basis & everyone takes pts.

For pre-op, the charge assigns a nurse to each surgeon.  That can change as the day moves along, especially if a surgeon is working faster/slower than we expect, cancellations or add ons happen.  A lot of adapting & changes happen along the way.  Prior to covid, our pre-op charge only took pts in a pinch.  We had a lot of staff cuts since & our charge now pre-ops & runs the desk.  Usually by 1100, they are able to solely focus on charge duties & preparation for the next day's schedule, only taking a pt if needed. 

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Specializes in OR, Nursing Professional Development.

PACU assignments are mostly based on turn, with consideration of what else is going on. If the PACU nurse has a peds or critical care, they get skipped for a second patient until the patient was transferred. We have an 18 bay PACU for 20 ORs and a 14 bay PACU for 8 ORs. Facilitator normally does not take a patient unless we get into a crunch. If need be, the OR will have to hold the patient until a nurse is available. 

For preop, we have nurses assigned to the inpatient area and nurses assigned to the same day admit area. They usually take turns, up to 2 patients at a time. It can get hectic for first case starts, but our CNAs do the clipping and prepping plus med techs go through all medication reconciliation. 

Moved to PACU forum

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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.

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On 3/23/2021 at 3:42 PM, Rose_Queen said:

PACU assignments are mostly based on turn, with consideration of what else is going on. If the PACU nurse has a peds or critical care, they get skipped for a second patient until the patient was transferred. We have an 18 bay PACU for 20 ORs and a 14 bay PACU for 8 ORs. Facilitator normally does not take a patient unless we get into a crunch. If need be, the OR will have to hold the patient until a nurse is available. 

For preop, we have nurses assigned to the inpatient area and nurses assigned to the same day admit area. They usually take turns, up to 2 patients at a time. It can get hectic for first case starts, but our CNAs do the clipping and prepping plus med techs go through all medication reconciliation. 

Moved to PACU forum

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

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Specializes in OR, Nursing Professional Development.

Moved to general nursing to generate responses. 

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