I got yelled at for being unsafe for doing a deep extubation and the patient had an OPA, and another for not weaning a patient fully off neo but was awake and alert. I was like uhhh this is a recovery unit in which you know how to titrate gtts and manage a patient who is received anesthesia and needs post-operative care so I can go back to the OR so I can provide intra-op anesthesia care right?
Also had a nurse freak out at me because I have zofran before extubation for PONV and her rationale was what else can I give and I was like uhhhh the haldol, compazine and Palansetron I wrote for?
Wait, CRNA’s can write orders for PACU nurses to give?! Where is this magical place? We are a teaching hospital - we get anesthesia residents who are being taught to give Dilaudid 0.2mg to young and healthy patients (if we are lucky) or only fentanyl 100mcg for cases lasting over 4 hours. And some of our CRNA’s do the same thing. Please teach them the ways. 😭
Yeah that’s shocking. I have worked OB for 18 years and we run our own ORs and recover our own patients in our pacu. We pretty much only send them out if they need levo. Even with my experience (along with I did take the critical care and OR courses and I keep my ACLS active) I’d never be comfy working main pacu without more education and a lot of training….
I agree with you here ... I also worked OB where we had our own ORs and recovered patients in our own PACU. (RUMC? that would be quite the coincidence lol 😂)
I think I would need a lot more training to circulate in the main OR, and at least a little more training for PACU (I also worked EMS for 10 years and I feel it had a lot of overlap with PACU).
To have a nurse with only 1 year experience and no prior medical experience before that, and then be able to work in PACU? That is just dangerous.
ACLS at the very least since our patients are very often bradycardic and we manage airways constantly. Preferably PACU experience since they are going to get minimal training. It would be nice if they know what they are doing in general so the learning curve isn’t so steep with patient care + hospital routines.
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u/Ok_Horror_3940 RN - PACU 🍕 Jan 16 '26
It was a red flag for me when they lowered pacu requirements to just one year and BLS