Should I get experience in the ICU before transferring to the PACU?

Hi there. It depends on the hospital. Typically the answer would be yes, but many facilities are starting to do "bridge" programs where nurses from non-icu settings are able to transfer into PACU by going through a special orientation. By "special" I mean a lot of the ICU stuff is incorporated into the PACU orientation. Vent settings, vasoactive drugs, airway management is a biggie. I've even seen some hospitals with "residency programs" allow new grads to start in PACU. To be honest, I'm anti "you should start in M/S no matter what". But when it comes to PACU, it's not a bad idea to do ICU first. I always tell my orientees "you never know what's gonna come through those doors"! I've had patients come out and actively seize on arrival, sometimes their initial BP in PACU is in the toilet (or through the roof), rapid assessment and intervention of laryngospasm, etc. Sure they can all be learned in PACU, but your comfort level would be a LOT higher if you did ICU first. Especially since many recovery rooms have to take "ICU boarders" due to lack of beds.

Yes, it would be helpful as manybtimescyourb I attention can be critical

Absolutely. ICU will help you recognize trends and stop them before they become urgent/emergency.

Yes. You will have to frequently recover patients that are in critical condition such as GSWs, stabbing, heart caths, or other critical procedures. An ICU background will prepare you and increase your critical thinking skills.

I have been a Perioperative Educator as well as a PACU RN for >30 years. I hear the nurses that believe that you don't need ICU background first, but they have no examples to speak of where a new nurse to PACU without ICU background has faced a situation that demands quick and accurate assessment and actions. All you need is the PACU to be increrdibly busy, all nurses very busy with issues/problems with their patients, and the new nurse needs help. That isn't fair to either the patient, or the other nurses who have to stop their actions with their own sick patients and help the RN who wanted to skip ICU experience. Overall, it is unsafe in my view no matter what level of acuity your PACU is. The reason?? Anything can happen post anesthesia, despite how simple the surgery is. It isn't the surgical procedure that one should use to decide how to assign a patient to the new nurse w/out ICU, but the comorbidities of the patient. Anesthesia has serious implications with sick patients, regardless of the surgery they are having. I have had managers expect me to move patients quickly to discharge to home---- but the patient was clinically a sick ASA 3 PRIOR to outpatient procedure, and due to their comorbidities the patient didn't do well with anesthesia and ended up in the ICU. The "manager" who was in charge had minimal if no ICU background herself. Needless to say, this PACU had problems and I ended up leaving as people were more concerned about having their friends in the hospital work with them in Pacu, than requiring honest to God critical care background for the patient's sake.

I was an ICU nurse before I did recovery room. I was glad that I had the experience before I transferred to PACU. ICU allowed me to fine-tune my skills even more and it came in handy when taking care of critically ill patients in the PACU.

As a PACU nurse and an educator, It is not necessary to have ICU experience prior to joining PACU, however, it is always impactful to have ICU or ER experience when you enter in a unique nursing specialty.

Hospitals should require at least 2-3 years ICU experience in my opinion. I have worked both units. PACU patients are potential time bombs due to the effects surgery and anesthesia on top of their underlying conditions. Frequent administration of IV pain meds complicate things even more Intuition and astute assessment are essential. Way less support from roaming residents and PAs, you are on your own with your patients and need to be ready for anything. It was my favorite unit !

I believe it's a prerequisite. At least it was when I worked in the SICU because we frequently got floated to the PACU. Regardless, I definitely would get critical care experience. It opens many doors down the road

I do

I think it is beneficial depending on the type of PACU experience you will be having. Because mine differs greatly in that patients who are vented or need higher care (pressors, cardiac drips, etc) will go straight to the ICU after surgery. My hospital allows entry-level and new grads in PACU because there is always someone there who is trained either ER or ICU to help, but if I would try to go to another hospital I would probably be considered inexperienced or entry level because I don’t have ICU or ED experience. I would talk to whoever is in charge of there on what they require.

yes in my experience they will not even look at you if you do not have ICU experience I would recomend you do have a few years being to critically think is very important !!!! and the confidence that comes with that is very important when working as a PACU nurse the OR nurses basically only have BLS so they can not help and the CRNA may have time and the anethisia drs are pretty good but you have to be able to be sharp and on your feet b ecause you never know what is coming out of that or as far as in clinics that is different they basically only do surgery on pts in clinics that are stable with very few maedical problems, and as far as someone saying it depends on how desperate a hospital is for a nurse!!! a BULLSHIT that is your licesnse and someones life do not ever fall for that crap you do not ever do a job you are not qualified for those people kill patients!!!

If you are working PACU in an ambulatory surgery center, you don't necessarily
need ICU experience. I never worked in ICU, and I have worked PACU for several years in an ambulatory surgery center

Yes they want critical care nurse

It definitely helps! In my PACU we do prefer ICU experience but it is not required. When I transferred to PACU 15 yrs ago, I did not have ICU experience except for occasional floating to ICU.