Whether it's a simple outpatient procedure or invasive inpatient operation, undergoing surgery can be scary and overwhelming for a patient. When patients come out of surgery, they are in the care of post-anesthesia care unit --or PACU -- nurses, who must possess specialized skills along with general nursing skills.
Education and Certifications
Along with an associate or bachelor's degree in nursing, many employers require PACU nurses to possess a Certified Post-Anesthesia Nurse or Certified Ambulatory Perianesthesia Nurse designation from the American Society of Perianesthesia Nurses and American Board of Perianesthesia Nursing. Because PACU nurses deal with patients with life-threatening conditions, they must also have certification in advanced cardiac life support. Nurses working in pediatric units may be required to hold pediatric advanced life support certification. All PACU nurses must take specialized ECG classes to be able to read ECGs.
PACU nurses monitor patients' post-surgical vital signs, including blood pressure, heart rate, pulse and oxygen levels, arterial lines and central venous lines. He or she must be able to hook the patient up to and operate equipment such as a cardiac monitor, pulse oximeter and blood pressure cuff. If a patient's vital signs indicate a problem the nurse must be able to quickly diagnose the problem and respond quickly and appropriately. In addition, it's generally the responsibility of the PACU nurse to keep friends and family members current on the patient's condition.
Another responsibility of a PACU nurse is pain management, which requires a thorough understanding of pain medications and how to administer those medications safely and effectively, as well as familiarity with patient-controlled analgesia pumps and I.V. or epidural infusions. PACU nurses monitor patients for adverse reactions to both pain medications and anesthesia, such as vomiting, headaches and nausea. This requires an educational background in anesthesia and how it affects the body.
Typically, a patient remains under the PACU nurse's care until he or she regains consciousness. If a patient can be discharged, the PACU nurse is responsible for ensuring he or she is able to drink fluids, use the bathroom and move around well enough to get into and out of a car. Explanations of post-surgical care , including medication and wound care and the responsibility of the PACU nurse, so good communication skills and the ability to relay instructions clearly are important. A PACU nurse should possess critical-thinking skills and the ability to make decisions in a high-pressure environment and react quickly to changing situations.
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