Who is taking this patient!?!? ::crickets::

brownbook · Sep 22, 2014

Actually we have some kind of system but I often don't follow it very well. Kind of just, first pt. goes to nurse A, second pt goes to nurse B, 3rd to nurse C.....then 4th (if no more nurses without patient) goes back to nurse A, etc. It is written on an assignment board who got which and the nurse who is up next will have a empty circle by their name indicating they are next.

However you cannot expect to simply assign pts by number.....pt. 1 may be sicker, needier; patient 2 may have been easy and already discharged so nurse b gets another patient instead of nurse A.

It just sounds like your experienced nurses are being childish....however maybe you don't realize their patients are sicker so they can't easily or safely take another patient and the newer nurses may be getting easier patients who are discharged quicker?

I know just because the patient is easier and discharged sooner, that still leaves the paper work, charting, etc. Not like the nurse with the easy patients is having an easy day! A lot of easy patients can be as hard as a few sicker ones!

Tarawr158 · Sep 29, 2014

I am current in PACU as a student on my last placement. Here they work in teams. There are two teams and there are usually three nurses in each team. When a patient comes in they will go to team 1, the next will go to team 2, the next team 1 and so on. Then in the teams nurse 1 will get the first patient of their lot, nurse 2 will get their 2nd patient and so on. Team work is great here and it works very well.

wanderlustnurse88, RN · Sep 29, 2014

When I volunteered in the PACU when I was a student, each nurse was assigned a set of beds and then they had cards with the bed numbers on it. They would put them in a rotating order so when a pt came in, they went to the first bed on the list. Once a pt was discharged the bed number went back into rotation.

summeroflov · Feb 1, 2015

Basically in our PACU if the older nurses were "holding" patients, our charge RNs would be on to it. One of their responsibilities is to kind of 'round' on the unit (more or less the RNs) and ensure that the flow is smooth. If a patient who came in fairly stable with no adverse events in the PACU course is still with us after 1.5 or 2 hrs, red flags go up. The charge RN has the final say in calling for a bed or calling for phase 2 transport, and our (seasoned) charge RNs wouldn't put up with any of that BS.

But basically our rotation is determined by a)Nurse and Teams, as some above posters have said. No nurse gets 2 patients if one Nurse doesn't have ANY patients yet. b) Acuity- If there are two patients from minor procedures and two patients from major, high acuity procedures we mix them up. The RN shouldn't have two heavy acuity while the other gets the "easier" patients. 3) Children under the age of 2 are always 1:1.

wannabecnl · Feb 17, 2015

We have the nurses' names on a white board, and the charge nurse keeps track of numbering us so we know who is up next. They will also come around to check on our progress and let us know when we are next up or after the next one, etc. I find that check-in more helpful than the numbers, which don't always get updated.

When a nurse comes onto her/his shift, he/she is always up next unless someone is almost ready to go home (i.e., the 7-3:30 person may take a patient at 1 to make sure she can get them out before she goes home). We also will "settle" patients for someone who is up next but on their way back from the floor or lunch or just coming on. Thus I would take report, hook the pt up to the monitor, and do the first assessment, then give report to the PACU nurse who really was next in line. Again, this is usually overseen and assigned by the charge nurse.

gizmopacurn · Mar 22, 2015

Our charge nurse organizes who is up next for pt's. They have a clipboard at the charge desk and keeps track of who is next to get a pt. On a white board is a list of RN names and what hours their shift is and whether or not they have had lunch. Is someone is "boarding" a pt in order to not receive another one, the charge nurse keeps track of how long the pt is in pacu and then checks the charting to see any reflection as to why the pt is taking longer or just asks to RN why has the patient been here for 2 hrs. I think personally a PACU can run smoothly or poorly depending on how good your charge nurse is and what support they have in the unit. Teamwork is so very important for a unit.