Senior Preceptorship in Pediatric PACU

Editorial Team / Admin · Dec 20, 2017

I did my senior practicum in the PACU of a hospital. During that time, I had the opportunity to follow a patient from admission to discharge. I can't imagine that you wouldn't also have that opportunity if you request it.

djmatte, ADN, MSN, RN, NP · Dec 29, 2017

Learn all that you can here. It is an excellent opportunity to place on a resume and could catapult you into a similar position sooner than you expect if you find you really like the work environment.

HeySis, BSN, RN · Jan 23, 2018

OP, have you started yet? The PACU is a wonderful environment to learn so much.

Make sure you have set goals and ask your preceptor to look them over, tell you what is reasonable and what other goals to add. For example hoping to get really good aT IV starts might not be a good goal if you stay in phase I, IV's where already placed before surgery. Some ideas for goals: assessing airways, learning about anesthesia medication, reversal agents, malignant hyperthermia, laryngeal spasms (and how to break them) assessing airways, multi modal pain relief, common surgical post op complications, assessing airways oh and did I mention assessing airways??? :) You will come out of this will amazing ability to properly do chin tilts, jaw thrusts and may get to use the ambo bag and learn the C-seal.

Make sure you listen to your preceptor, we had one gal that precepted and thought after a couple of shifts she knew it all... became totally unteachable and a menace. She actually told her preceptor he was lucky to have her because she did all the work. She could not even see all he did to keep the patient safe. So stay humble and learn a lot.

Our preceptees get the opportunity to going the OR, one its good to see the procedures being done so you know what it looks like underneath the dressings, so you can see the positions patients are placed on the table and why their shoulder hurts sooo much, and so you can watch the anesthesiologists work. (they are the ones that bring us the patient and give us report and a lot of our orders, when you see what they and we do you'll understand why)

One word about the OR... just make sure you notice what the RN in there does, you'll notice she is normally not watching the surgery, she's running and grabbing items, placing them on the sterile field and charting everything that happens and who is doing it. So many students "love" the OR because they like watching the surgeries, but that is so different from what the RN circulator does.

And just because this is an ambulatory only surgical center does not mean your patient can't crash in a minute. Little ones can go south so much faster then adults. So remember this is a critical care area and your instructor felt you had the maturity to handle yourself professionally in that atmosphere. Live up to that expectation.

Good Luck!!

meganec17 · Jan 24, 2018

Thank you so much for all that information. I had my "orientation" day yesterday and have my first real day tomorrow, so this came at the perfect time. I'm nervous, but definitely very excited.

I love the ideas of setting goals. Side note, but unfortunately I won't be able to practice IV placements as we are not trained on that during schooling in my program. I've heard (obviously) that airway is the main priority and definitely plan to keep that in mind throughout my caring.

I will absolutely be paying attention to my preceptor; I cannot imagine being pompous enough to think that I know enough already. I know this is a new environment I have very little experience in, so I'm looking forward to being a sponge and learning as much as I can!

I was told that I should have the opportunity to get into the OR frequently, but I completely understand what you're saying. I do think that is part of the reason I enjoy it (being able to watch) but hope that I learn to love being a nurse circulator as well.

This location is a super small, outpatient surgical center facility. It has only four ORs. My preceptor says that surgeries/procedures include endoscopy/colonoscopies, eye surgeries, oral surgeries, and injections for kiddos with CP. This PACU is also attached to an adult outpatient PACU as well... my preceptor says sometimes they help out over there if necessary. I am definitely prepared to stay on my toes, as I know things can happen at any instance.

I'm very happy and honored that I got this placement. Just the hospital name will be a good boost for my resume (or so I hope). I am the only student in the facility, so hopefully I get a lot of opportunities. I definitely am taking this placement with lots of gratitude and looking forward to building professional relationships with the employees.