Become a PACU Nurse in 3 Steps

Nurse Types / PACU Nurse

Nursing is one of those healthcare careers that offers so much variety you’ll never be bored. Among the nursing specialties from which you can choose is the lesser-known PACU nurse.

PACU is short for post-anesthesia care unit. Every PACU includes highly trained nurses who provide specialized care for patients who have just had surgery or are recovering from procedures requiring anesthesia.

In this article, you’ll learn:

• What is a PACU nurse?
• What do PACU nurses do?
• Where do PACU nurses work?
• What are closely related fields?
• How do you become a PACU nurse in 3 steps?
• What are additional requirements of PACU nurses?
• What are the salary and career outlooks for PACU nurses?
• FAQs

What is a PACU nurse?

Every year, millions of people have surgery in the U.S. Post-op, patients can find PACU nurses at their sides as part of their healthcare teams. Sometimes patients aren’t aware they receive this kind of help because they can be groggy for quite a while thanks to the effects of anesthesia.

PACU nurses receive special training to help patients recover from anesthesia. In this specialty, you’ll also learn how to spot the signs a patient is experiencing negative side effects from anesthesia.

Qualities of a successful PACU nurse

If you want to be successful in your career as a PACU nurse, you’ll need some of the following qualities:

• Compassion and empathy. PACU nurses deal with people at their worst. Their patients can include those who have had life-saving surgeries and are frightened when they wake up. They also might have patients experiencing unpleasant side effects from sedation. Your compassion and empathy play a large part in their recovery.
• Observant. Anesthesia affects every patient differently. You’ll need to understand the risks and how to spot the warning signs in your patients to ensure their full and recovery.
• Detail-oriented. It’s essential to keep tabs on crucial details when taking care of multiple patients simultaneously. Remembering dosage levels for different patients and keeping things organized can be very helpful. 
• Critical thinking. PACU nurses need to have necessary solid thinking skills to solve any complications when a patient undergoes anesthesia. They need to know how to help patients with their various needs properly.

What do PACU nurses do?

PACU nurses oversee care for patients who are waking up from anesthesia. Most PACU nurses work in the post-anesthesia care units of hospitals.

As a PACU nurse, it’s your job to reduce the turnaround time for your patients. You want to make sure they’re stable after receiving anesthesia before they can be transferred to an intensive care unit (ICU) or other recovery area.

If you pursue a career in PACU nursing, some of your responsibilities include:

• Checking your patient’s level of consciousness
• Monitoring your patient’s vital signs
• Watching for signs of post-anesthesia complications

A day in the life of a PACU nurse

As a PACU nurse, you’ll get to work with a variety of patients from all walks of life. You may be responsible for one or more patients at a time depending on nurse-to-patient ratios where you work.

During a typical day in the life of a PACU nurse, you can expect to engage in the following duties:

• Administering pain treatments for patients having adverse side effects from anesthesia
• Coordinating with your patients and their caregivers about post-op care
• Educating patients and their caregivers about which medications to take and how often to take them
• Keeping dressings and bandages clean and dry
• Updating charts, medical records, and patient files

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Common conditions treated by PACU nurses

PACU nurses must be vigilant in watching for signs of anesthesia complications in their patients. It’s not uncommon for patients to experience side effects from anesthesia. Some are mild while others require additional medical intervention.

Some of the conditions you can expect to treat post-anesthesia include:

• Dry mouth
• Itching
• Nausea and vomiting
• Muscle aches
• Shivering
• Sleepiness
• Sore throat

Where do PACU nurses work?

Most PACU nurses work in the post-anesthesia care units of hospitals. They also can work in surgery centers and trauma units where anesthesia frequently is used with patients. 

What are closely related fields?

Two closely related fields to PACU nursing are ICU nursing and operating room nurses.

• ICU nurses care for patients with a variety of conditions and illnesses who need specialized care. Some of those patients may be recovering from surgeries. As an ICU nurse, you may have patients struggling to shake the effects of anesthesia. They’ll need close monitoring.
• Operating room nurses monitor patients during surgeries to keep them safe. Part of their duties can be watching for signs a patient isn’t responding well to anesthesia and alerting the rest of the surgical team.

How do you become a PACU nurse in 3 steps?

PACU nurses are RNs who specialize in post-anesthesia care. To become a PACU nurse, you must follow these three steps.

Step 1 – Become a registered nurse

Becoming a registered nurse is the first crucial step to starting your career as a PACU nurse. There are several ways you can get your RN licensure.

Earn a BSN degree

You can become an RN with an Associate Degree in Nursing (ADN) and passing the NCLEX-RN exam. However, most PACU units prefer RNs with advanced degrees like a Bachelor of Science in Nursing (BSN).

If you already have as associate’s degree and are a licensed RN, you can enroll in an RN-to-BSN program. This allows you to work as a nurse and earn your bachelor’s degree. Another option is the Accelerated BSN program. It applies to individuals who hold a bachelor’s degree in an unrelated field who want to switch to nursing.

Pass the NCLEX-RN exam

Passing the NCLEX-RN exam follows the completion of your degree. You can practice before taking the exam using any of the preparation tools offered on the NCLEX website.

The main purpose of the NCLEX-RN is to ensure you’re well-trained enough to begin practicing as an RN. Test questions are application- and analysis-based, requiring you to use all the knowledge gained during your BSN degree program and clinicals. 

Step 2 – Accumulate experience

Once you have your degree and RN license, the next step is to gain valuable experience in your nursing field. You can work anywhere RNs are needed to build your skills. After a few years, you can apply for RN positions in ICUs or other recovery units. There, you can get a feel for PACU nursing. 

Helpful skills and experience

PACU nurses must be observant and diligent in monitoring patients post-anesthesia. Everyone reacts to anesthesia differently. It’s your job to know when a reaction rises to the level of an emergency.

You can get that kind of experience by:

• Working as an RN in a surgery or trauma center, where patients often require anesthesia
• Working as a critical-care RN in any setting where this level of care is provided
• Working as an RN in an emergency room, where patient care is fast-paced and precise

Changing specialty to a PACU nurse

Changing your nursing specialty to a PACU nurse isn’t difficult. You may even prefer the change of pace. Since you already have experience in an acute care setting, those skills transfer to your new role as a PACU nurse.

Step 3 – Obtain certifications

PACU nurses can become certified to take care of patients under anesthesia. Two of the most popular certifications include:

•  Certified Post-Anesthesia Nurse (CPAN). This PACU nursing certification is ideal if you work with patients who are waking up from anesthesia. You’ll also be skilled in identifying and treating any issues patients experience during the wake-up process.
• Certified Ambulatory Perianesthesia Nurse (CAPA). Like CPAN, this certification allows PACU nurses to determine when patients are ready for discharge. It signals you can give aftercare instructions and ensure the patient has safe transport home.

What are additional requirements of PACU nurses?

PACU nurses must stay current on best practices for post-anesthesia care. You can do this by fulfilling continuing education requirements for your state of practice. Every state handles it a bit differently, so it’s best to check with your state’s licensing body.

If you have any certifications, some require periodic renewals. Usually, that means retaking the competency exams.

What are the salary and career outlooks for PACU nurses?

PACU nurses make an average annual salary of $87,396. This is higher than the average RN salary of $82,750. Some PACU nurses earn as much as $104,000, while others may be on the lower end of the pay scale at $71,000. How much you earn depends on your level of education and experience, plus your location.

According to the Bureau of Labor Statistics, the job outlook for PACU nurses is good. Like most RNs, the growth rate for PACU nurses is 6% between 2021 and 2031.

Job satisfaction

PACU nurses work in fast-paced environments that can be stressful. Most PACU nurses care for one to two patients at a time. You can expect a high rate of turnover among your patients.

You’ll want to be careful working as a PACU nurse because, like any nursing job, you can experience burnout. 

Next Steps

PACU nurses have many opportunities for advancement. One possible path includes becoming a certified registered nurse anesthetist. You’ll need significantly more education. However, the return on your investment is high in the form of a significant pay bump and more autonomy.

No matter what path you choose for career advancement, you can keep current on your nursing skills with free nursing CEUs. Have questions about your options? You can ask other nurses working in those specialties to help guide you through the process.

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