What is a PACU Travel Nurse?

Nursing specialties vary immensely, each with its own unique nuances relating to duties, training, education, and more. Here, we cover the fundamentals of PACU nursing, including life as a travel PACU nurse. The first question to answer is, "What is a PACU nurse?"

PACU stands for post-anesthesia care unit; these types of nurses are highly specialized critical care RNs.

Amy Hebenstreit, MBA, BS, RN, CCRN, manager, ICU/house supervisors/float pool at Adventist Health Castle in Kailua, Hawaii, summarized the role: "A PACU nurse recovers patients who have just come out of surgery (or any procedure requiring anesthesia)".

What does a PACU nurse do?

PACU nurses perform a variety of duties on a day-to-day basis, caring for patients with varying degrees of acuity. Since these patients have just undergone surgery and are emerging from anesthesia, this is a specialty where anything can happen.

Because of the nature of their duties, a PACU nurse must be knowledgeable, nimble, proactive, empathetic, and detail-oriented.

"There are two phases to PACU," Hebenstreit said. "Phase 1 is the most critical time when a patient may need help controlling their airway, may have low respirations, has difficulty waking up, may be hypotensive, etc." "Once the patient is arousable to voice, opening eyes, moves all extremities, has stable vital signs, and an Aldrete score of 9-10, they move into phase 2. At this time, the patient does not have to be on the monitor and vital signs can be checked every 30 min to 1 hour until they are ready to go home. If they have been admitted, they can go to their room."

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Some of the typical duties of a PACU nurse include the following:

Monitoring Post-Operative Patients

"A PACU nurse watches the patient, monitors vital signs (q5min X3, then q15min until the patient is out of the critical window), gives meds for pain and/or nausea, and monitors any bleeding until they are stabilized. We also monitor the Aldrete score which assigns a number from 0-2 for five variables: activity, respiration, circulation, consciousness, and color," Hebenstreit said.

"Patients who are coming out of anesthesia are at very high risk for apnea (not breathing, or blocking their own airway with their tongue), so a PACU nurse needs to be very vigilant about staying by the bedside to closely monitor the patient. Doing simple things like inserting an artificial airway (oral or nasal) or holding the patient's jaw open with a tongue jaw lift is the difference between life and death. That's very satisfying," Hebenstreit added.

Managing Pain and Other Side Effects

Pain management is a significant component of PACU nursing care since many patients are in a world of pain following their procedures. PACU nurses need to help evaluate the patient's pain level, follow the physician's orders, and create a nursing care plan tailored around that. They are also tasked with treating nausea and other post-operative symptoms of anesthesia and administering medication as prescribed.

PACU nurses are privileged to comfort, teach and support their patients through the recovery process.

Educating Patients

Educating patients and their family members and caretakers is another important facet of PACU nursing, including providing at-home instructions and answering any questions that may arise.

The rise in same-day surgeries means that patients are more frequently discharged directly from the PACU unit recovery room, and effective education and communication have become even more vital to ensure favorable post-op outcomes.

Updating Patient Records

Keeping accurate and timely notes, including updating charts and digital patient records, is also a critical component in the daily life of a PACU nurse. Drug interactions, updates, vital signs, and other data points are a central part of PACU nursing and are vital for sharing with the medical team.

How to become a PACU nurse

"Education and licensure as a registered nurse are the first steps to becoming a PACU nurse, typically followed by a few years of experience in the hospital. PACU nurses need a background in critical care, most commonly the ICU (intensive care unit)," Hebenstreit said.

Nursing Education Required

The education and training required to become a PACU nurse is more extensive than some other specialties. Although the basic requirements can vary depending on the state and facility, PACU nurses will need to earn a nursing diploma, associate's degree (ADN), or a bachelor's of science in nursing (BSN) degree, with the BSN degree strongly preferred by employers.

PACU nurses will also need to obtain their registered nursing (RN) license by passing the NCLEX, building up clinical experience, and obtaining the necessary certifications.

PACU Nurse Certifications

PACU nurses need Basic Life Support (BLS) certification, Advanced Cardiac Life Support (ACLS) certification, and Pediatric Advanced Life Support (PALS) certification if they care for children.

In order to apply for the Certified Post-Anesthesia Nurse (CPAN) certification or the Certified Ambulatory Perianesthesia Nurse (CAPA) certification, nurses must have an unrestricted RN license and at least 1,200 hours of direct clinical experience obtained within the two years prior to applying for initial certification.

These certifications may be required by some hospitals and surgery centers before one can secure a job as a PACU nurse.

The American Board of Perianesthesia Nursing Certification, Inc., provides all the details on the CPAN and CAPA certifications, including requirements, exam preparations, and more.

How to become a travel PACU nurse

A typical travel PACU nurse will need a minimum of 8-10 months of experience in a post-anesthesia care unit, depending on the travel nurse agency and the type of contract or assignment.

At Onward Healthcare, we recommend that new nurse graduates reach out to us after clocking in about 6 months of clinical experience to get the ball rolling on their travel nursing adventure.

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