This week in PACU area I have been at the pre-operative ward. There is also a pre-operative area for patients who come directly from home. The first 2 hours in the morning we were there, we do all the pre-operative questions like: name and birth date, fasting, which is the operation that will take place today, fake teeth that can be removed, then we put the identification bracelet, we take vital signs including Temperature, we put an IV and also take blood test and do the procedure for blood bank in case the surgery requires, then we ask them to dress for the surgery and wait to be picked up. This area is new it had been opened 2 weeks ago. Before all the procedure were done at the pre-operative PACU ward.
After the first 2 hours of the shift we move to the pre-operative PACU ward. There we welcome patients that come from the pre-operative area and other wards, we do once again the pre-operative questions and review that the whole documentation is ready for operation. Later the circulant nurse together with the anesthetist will pick the patient and bring him/her to the surgery room.
When the surgery is ready we put the patient either in the 24h section of the PACU or in the pre-operative area as they will stay maximum for 4 hours. From there on we follow the doctors post-operative orders write in the anesthesia paper. These orders are pretty the same for all patients, but of course depending of the surgery type might be different, they include but not limited to: VS constant monitoring. O2 with nasal cannula or mask, head of bed at 30 degrees, Fluid therapy and infusion time, Pain therapy (this may include infusion pain pumps and rescue pain killer like morphine). Rescue medication depending on patient’s condition.
Part of the job it also to “find beds” for patients at the wards. I don’t really understand this mess with the beds. If they come from home they should have a bed assigned at the moment of the pre-operative procedure. If they come from ward the bed and room should be the same. It also physically mean that when patients enter to surgical area they are move to stretchers. They wait a lot of time in these uncomfortable beds, plus all the logistic work we do and new blankets every time…In Germany patients are move from their bed to OR table at clean pre-operative area, then bed is cleaned for OR area and when surgery is ready the patient is picked up with his/her bed at the OR. I find this much more easy and cost saving. In Spain they really spent tons of time doing this secretary work finding lost beds all around causing that patient stays at PACU more time than necessary.
Let’s see how is next week.