Like everything else there is good and bad things in being a PACU RN.
The bad news: PACUs aren't staffed like a normal nursing unit. Shifts overlap, nurses come in usually starting around 730 with the last ones around 3. Call starts by 1130 pm. Call is a mandatory thing, usually 4 nights and 1 weekend a month. Usually, you can give away or take more call if you want more or less call.
You aren't guaranteed hours or 40 hours per week. Some days you need to start late or early depending on the surgery schedule. Other days you might be sent home early or even cancelled for the same reasons. Then again you might need to stay late so you don't leave your peers in the lurch when complicated or too many surgeries come out at the end of your shift. In other words, you need to be flexible. You aren't remembered by many of your patients so there won't be many if any accolades. Those that do remember are due to a perceived wrong.
The good news: Your pay scale is usually on par with ER and ICU nurses, so you are at the upper levels within your hospital. Once you establish yourself as a good competent PACU nurse you gain a lot of independence. The surgeons, CRNAs, and anesthesiologists will listen to your recommendations and suggestions. Staff ratio to patients is 1:2 based on national standards. ICU and pediatric patients are 1:1.
There is less paperwork (computer charting), than other places. Patients with difficulty personalities can be tolerated better, because you know they are leaving your care soon. You don't have to care for them your entire shift or days at a time.
I hope this helps
I worked in PACU for 10 years and it was great most of the time. However, we got pulled to the ICU, cardiac cath, special procedure and the floor if we were not busy or until we receive our first patient. If ICU could not accept patient from the OR, the patient would come to the PACU awaiting for bed availability. Unfortunately, if we were short-staffed, no one ever came from those other units to help us.
Depends if it's an outpatient surgery center or a hospital.
Surgery Center- Mon thru Friday, no call and weekends off. Length of shifts are dependent on the patient load so if the last patient leaves at 2pm and you didn't get to work until 8a you'll be short some hours in a 40hr week. Usually not a lot of pto is offered when compared to a hospital.
Hospital-depending on how large or busy that hospital is you may work long hours and mandatory on call which means you will on many occasions have to work weekends and holidays. You may not get a full 40hr work week here either for the same reason. And remember hospitals are open 24hrs a day.
Personally I work at an outpatient surgery center and have no desire to work in a hospital setting.
PACU is critical care nursing. Every PACU is different. Our PACU does 50-60 cases a day. It’s fast and busy. Everything from appys to lap choles to thoracotomies to TAVRs. Collaboration with anesthesiologists and surgeons and medicine is satisfying and rewarding. After being an ICU RN, I appreciate that we don’t have to fix these patients. We stabilize them and transfer them to the unit. Best area of nursing I have ever worked.
In contrast to the other RNs response: we seldom get sent home early (maybe 30-60 min but not half a day.) Our call requirement is typically 3-4 four-hour shifts in 6 weeks. Our weekend rotation is one every 10(?) weeks (alternating 7a-7p and 7p-7a).
You do not need to take care the same patients for 12 hrs like floor RN. They will go home or admitted to the hospital.
The best kept secret In nursing besides work from home
If you have to be a nurse, this is THE job to have. Manage O2, BP, pain, and airway while the patient wakes up. When they are ready they go home or go to the room. No dealing with families, friends, etc. it’s GREAT
26 yrs PACU. Pacu us not for anyone with children, you never have set tine to go home. I missed a lot of my kids activities. One day the were 6 then all of a sudden they are 30 and 35 and have children. You don't have guaranteed hours, you may work 4 hrs or 20 in 1 day. You never get help from other departments. Hold admits for multiple hrs waiting on beds. Call is part of the deal. May go home at 8 pm and get called back 30 min later and not get home til 1 am. PACU is now used as Icu holding. Also you will also do 30 pts a day and at a fast pace!. Pacu is NOT for a person looking for a cush job!
If you want a “soft nurse life” then PACU is the way to go. I must say there’s a lot of down time. Gets boring most times. The dark side of PACUis that there’s a lot of “gate keepers”. Very few blacks work in that area. Good gig to make money 💰.
Thanks for sharing your experience and honest perspective. You gave a good overview of this specialty !
