Which unit is an overall better to work on...Pre-Op/PACU or SICU??

linearthinker, DNP, RN · Apr 14, 2011

My general area of choice would be SICU, but I'd have to make the decision you face by assessing the people I'd be working with. People are the main issue, people being colleagues, not so much patients, lol. Patients come and go, presumably you would be working alongside the same people for years. Better if you actually like them.

emeraldcity · Apr 14, 2011

I would think Pre-Op/PACU: Monday through Friday, no weekends, no holidays. You have patients for a short time so if they're nice you enjoy them and if they're not, they're gone soon. No turning bariatric patients every 2 hours and injuring your back. :up:

j621d · Apr 14, 2011

I would suggest SICU if you are early in your career. The reason being the knowledge base you will develop. You can then move into Pre-op/PACU with confidence, not to mention the solid knowledge you will have acquired from SICU.

meandragonbrett · Apr 14, 2011

PACU most likely will require on call and lots of late nights that run beyond your scheduled time off.

sungrl01 · Apr 14, 2011

Oh I didnt mention..I am a relatively new nurse with an OR background..oh and the Pre-Op/PACU is in an Ambulatory Surgery Center.

Rabid Response · Apr 14, 2011

From what I've observed in my hospital, PACU is where experienced ICU nurses go to retire while still collecting a paycheck. When I talked to a co-worker who had recently transferred to PACU, he said that he was very happy there but was often bored. That said, I am sure that the only reason the job seems easy-breezy to him is that he has more than 20 years experience as a nurse, most of it in ICUs. PACU doesn't seem the sort of place to start your critical care training. While the workflow might be kind of routine and predictable, when something does go wrong with a patient, it can go very wrong, and I think you need to be able to call on mad critical care skills to deal with that.

In short I think that, unless you have heard awful stories about the working conditions in that particular SICU, you should take the job there to develop a broad critical care skills base.

Congrats on having two job offers!

Annaiya, NP · Apr 14, 2011

From what I've observed in my hospital, PACU is where experienced ICU nurses go to retire while still collecting a paycheck.

I couldn't agree more. I found pre-op to be the most boring place on earth, it was almost all paperwork. And while I liked PACU a little better, it is very routine. But it depends what you are looking for. If you want very little patient care and "normal" hours, go with the pre-op/PACU job. If you want stress and excitement, tons of learning and patient care, go with the SICU.

DutchRN09 · Apr 14, 2011

I work pre-op and post-op recovery, Ambulatory surgery in a hospital, and I love it. The patients are mostly healthy, the staff is great, the surgeons and OR staff are fun, and no holidays and no weekends. Plus it it good experience, and I believe that Ambulatory srugery will continue to grow

sungrl01 · Apr 15, 2011

Yeah it is a tough decision...both offers sounded good...but I have no Critical Care experience except from nursing school with a few clinicals I did in the ICU.

j621d · Apr 15, 2011

...but I have no Critical Care experience except from nursing school with a few clinicals I did in the ICU.

I think I would go with SICU, again to gain the experience and knowledge. If the position is in an ambulatory center you may not have the resources available to you should something happen. You will need to rely on your knowledge base to react to emergency situations.

Perpetual Student · Apr 15, 2011

I agree that the SICU job will likely give you more and better experience early in your career than the ASC job.

That said, I want to point out that PACU RNs are far from "retired" on the job. While it often is routine that routine requires careful individualization to each patient. Pain medication titration for outpatient surgery is an art that has to be mastered. Not only do you need the patient to keep breathing, you need him to saturate well enough on RA to meet the DC criteria yet also be reasonably comfortable. When things go wrong (which they certainly do) you need to recognize the problem, then act immediately and decisively.

Many of the long term ICU RNs I have encountered in the PACU are not there to retire, but to get away from some of the undesirable aspects of ICU practice: the drug addicts who come in again & again, the hostile families, etc.