whats less stress.... pacu or OR?

adio412 · Feb 6, 2010

I have been a Trauma/ER nurse for 14 years and last November I decided to make a change. I figured I was getting burned out or a bad attitude or was already so crispy I wouldn't know the difference anyway. So, a friend who already punched out (from the ER) to PACU suggested I try it. A night position had just opened up and so hesitantly I took it.
The hospital's orientation to PACU took me through the three of the surgical experience. My thoughts are as follows and reflect my own personal tastes, experiences, and observations since last Nov.:
1. PREOP-- Wouldn't have that job even if you threw in complimentary booze and guest pass to the Mustang Ranch all inclusive. HIGH stress getting people ready to be cut open. Paperwork out the ass! Nervous patients, even more nervous family members. People have been NPO since before midnight. They are thirsty, hungry, and anxious. Did I mention the paperwork? Consents for just about everything short of taking a dump. Labs to draw, results to be reported, surgeons and anesthesiologists to find, etc. etc. and all the while that clock is ticking down to go to OR.
2. INTRAOP (OR)-- In a word, BORING. (my opinion OR nurses, not an insult!:)) Put on your hat, booties, gloves, and in this hospital, what I can only describe as a Bio-HAZARD SUIT. Which I guess is exactly what it is. Now, stand there from 1-6 hours depending on the case and sometimes longer. If you're lucky the surgeon's musical taste and yours are somewhere in the same ballpark. Otherwise you are stuck in audio hell.
3. PACU--It's a GRIND. You can recover most run of the mill surgery patients in about hour or so. I mean they are scheduling on just that, the pt. being gone in about an hour. You can hold up the OR if too many patients are in PACU longer than that. OR HELD UP= NEXT SURGERY HAS TO WAIT= THAT MONEY IS NOT BEING MADE. So, You roll one out and they roll one right back in. On a busy day this can go on NON-STOP ALL DAY. And I am serious about that money part. The OR brings the hospital $$$$$ and they don't like that cash cow sitting idle for ****.
Bottom line
:redlight::banghead:PREOP-- most stressful related to responsibility of paperwork and getting pt to cutting board on time.:barf01:
:grn:OR-- you will die of boredom or kill yourself because you have heard this same Inglebert Humperdink song 6 times today.
:hpygrp:PACU not much stress but pace is monotonous/repetitious.
JUST MY OPINION AND YOU KNOW WHAT THEY SAY ABOUT OPINIONS....
GOMERNATOR

i love this post!!!!!!!!!!

adio412 · Feb 6, 2010

I agree. If you're looking for low stress, how about the endoscopy suite or clinic nursing?

tell me more about these:)

adio412 · Feb 6, 2010

I agree that each area has its stressors.
It also depends on the setting, are we talking outpatient surgery center, or inpatient hospital? Trauma center or community hospital?
I have worked preop/post op and OR in an outpatient surgery center, PACU in a hospital trauma center.
To me, Pacu had more advantages related to varying acuity of patients meant that you had to keep your critical care skills, and be able to quickly identify changes.
Yes it was stressful, but on normal workdays (not on call), there was a real team effort and team support, especially if a patient was going downhill. On call is a different story- very stressful.
I loved it.
Now as a manager over all of the above areas- I am the most comfortable stepping in during short staffing in the PACU.

thinking this. i had several ppl tell me that working for a government hospital is the way to go i.e. the VA

Nurseinator · Feb 6, 2010

What are the hours like in OR? Anyone know.

GadgetRN71, ASN, RN · Feb 7, 2010

What are the hours like in OR? Anyone know.

The hours are usually as such: you have day shift, which is usually 7am to 3pm or 5pm if you do tens, I work evenings, 3p to 12a. You do have to take call. for me it works out that I take a weekend call about every 6-7 weeks. Other than that, I don't work weekends. Holidays work out where I have to take two 4 hour blocks of call on a major holiday(we sign up, you don't have to work all of them)-I usually take this on New Years, because I don't really care about that holiday. Really not that bad at all compared to the floors, where you do every other weekend, and every other holiday.

I work 8 hour shifts, but we also have 10s and 12s

PostOpPrincess, BSN, RN · Feb 7, 2010

I have been a Trauma/ER nurse for 14 years and last November I decided to make a change. I figured I was getting burned out or a bad attitude or was already so crispy I wouldn't know the difference anyway. So, a friend who already punched out (from the ER) to PACU suggested I try it. A night position had just opened up and so hesitantly I took it.
The hospital's orientation to PACU took me through the three of the surgical experience. My thoughts are as follows and reflect my own personal tastes, experiences, and observations since last Nov.:
1. PREOP-- Wouldn't have that job even if you threw in complimentary booze and guest pass to the Mustang Ranch all inclusive. HIGH stress getting people ready to be cut open. Paperwork out the ass! Nervous patients, even more nervous family members. People have been NPO since before midnight. They are thirsty, hungry, and anxious. Did I mention the paperwork? Consents for just about everything short of taking a dump. Labs to draw, results to be reported, surgeons and anesthesiologists to find, etc. etc. and all the while that clock is ticking down to go to OR.
2. INTRAOP (OR)-- In a word, BORING. (my opinion OR nurses, not an insult!:)) Put on your hat, booties, gloves, and in this hospital, what I can only describe as a Bio-HAZARD SUIT. Which I guess is exactly what it is. Now, stand there from 1-6 hours depending on the case and sometimes longer. If you're lucky the surgeon's musical taste and yours are somewhere in the same ballpark. Otherwise you are stuck in audio hell.
3. PACU--It's a GRIND. You can recover most run of the mill surgery patients in about hour or so. I mean they are scheduling on just that, the pt. being gone in about an hour. You can hold up the OR if too many patients are in PACU longer than that. OR HELD UP= NEXT SURGERY HAS TO WAIT= THAT MONEY IS NOT BEING MADE. So, You roll one out and they roll one right back in. On a busy day this can go on NON-STOP ALL DAY. And I am serious about that money part. The OR brings the hospital $$$$$ and they don't like that cash cow sitting idle for ****.
Bottom line
:redlight::banghead:PREOP-- most stressful related to responsibility of paperwork and getting pt to cutting board on time.:barf01:
:grn:OR-- you will die of boredom or kill yourself because you have heard this same Inglebert Humperdink song 6 times today.
:hpygrp:PACU not much stress but pace is monotonous/repetitious.
JUST MY OPINION AND YOU KNOW WHAT THEY SAY ABOUT OPINIONS....
GOMERNATOR

Night shift in a PACU is not the same as day shift. Also depends on the acuity of your patients, and the co-morbids. Our PACU hops, but it is super stressful at times. We've had three codes in the past week alone.

I like when the patients leave and I love the pace. You have to also be very good at airway control, as sometimes they come out so snowed with all the airways still in place.

So..I think it would highly depend on the types of patients you have coming through your OR.

adio412 · Feb 10, 2010

anybody else??

calmcool1 · Mar 6, 2010

Iv'e worked in both and I would have to say PACU.

TakeTwoAspirin, MSN, RN, APRN · Mar 7, 2010

In the OR you will certainly be "runnin around" as you put it. Certainly less running with PACU, but as far as stress is concerned, I would say they are about the same.