I work PACU, new job. How can I work safe but increase my speed working. Director says I need to work faster or they are going to let me go. Frustrated but want to be a safe RN
I If you have a nurse you trust that works with you, ask her to give you some ideas of where you can prioritize your time. When I first started I was repeating a lot of unnecessary tasks that took up time. As I got further into the day I became increasingly overwhelmed. One day I just asked the team where I was going wrong ause I can't seem to keep up. They critiqued my time and it was a game changer! No problem after that.
make yourself checklist of 'to do' lists items and times they were completed....
Well , do u do just phase one or do you have to do phase 2 also? As soon as they come out do your initial assessment of wounds , foley s vs . After ten minutes start waking them up if they are not already awake . Get that airway out assess for pain medicate if needed . Assess for nausea Medicate if needed . That’s probably 20 to 30 minutes . Reassess for pain once pain gets to 3 or 4 that’s ur sweet spot . As long as vitals are stable pain in control . An hour has probably passed . It’s time to transfer to phase 2 or if u have to discharge get the family and start discharge process . Keep chit chat down tell them they can sleep more comfortable at home . If they have to per before they leave keep that iv fluid going . If they handled the ice chips start giving them water or juice put the idea of urinating in their head . If they wake up with no pain vitals stable they only have to stay in phase one by law for 30 minutes . After 30 minutes and they are still pain and nausea transfer to phase 2 or go get family and start the discharge . If u do endo cases u need about 20 minutes of vitals . Wake them up after 10 minutes get water clothes and the family do the discharge so after the doctor gives results it’s bye bye. U cannot let them sleep for like an hour 10 minutes at the most the clock is ticking . Unless u have someone crashing u need to be able to turn these people over in an hour to 90 minutes after that it’s time to call anesthesia for pain control or ask ur charge. For help!!
Make sure you are prepared and ready for the patient to arrive at your bedside. Get as much documenting done while the patient is still asleep from the surgery after you do your initial assessment
Hi! I have experience as a Pacu Rn for 16 years. I am curious as to the setting you are working in (inpatient vs outpatient pacu). I have worked in a variety of different units. Each unit has their own type of surgeries or procedures and knowing how to recover a patient from the specific surgery will help you determine how quickly you can recover them . Knowing what type of anesthesia the patient received is also helpful. Make sure you are discharging your patient according to the Aldrete score and that will maintain a safe recovery. I was a CAPA (Certified Ambulatory PeriAnesthesia) Nurse and followed the ASPAN standards.
Also, when given report at handover,ask for po Zofran and po pain medication and give it early in recovery by using your best judgment. Ask a trusted colleague to help you get organized with your paperwork and charting to improve your recovery speed. I found this to be the best time saver. Be proactive regarding medication orders from your anesthesiologist/surgeon. Make sure you ask for what you feel your patient may need before the doctors walk away from bedside. It’s difficult to get an order after the fact and wastes time.
I hope I have answered your question. There is so much more I could add. And I bet we have all been told we are slow when learning a new nursing specialty. My best to you.
Did you tell your director that you are the patient advocate and you are doing everything
to keep the patient safe? You are administering
the best care possible and avoiding any mishaps.
