RN MNA, PACU, Per Diem

The Registered Nurse assumes full and ultimate responsibility for the quality of nursing care she/he provides to individuals and groups. Included in such responsibility is health maintenance, teaching, counseling, collaborative planning and restoration of optimal functioning and comfort or for the dignified death of those they serve. The registered nurse, within the parameters of his/her generic and continuing education experience, may delegate nursing activities to other registered nurses and/or health care personnel, provided that the delegating registered nurse shall bear full and ultimate responsibility for the patient outcomes. Performs other duties as assigned.

PACU Primary Responsibilities

• The PACU nurse is clinically and administratively responsible for the care of the post-operative patient.
• Receive an oral report from the anesthesia provider on the patient’s condition to include the operative procedure, allergies, medications administered, estimated blood loss, any complications that occurred and any other pertinent information.
• Perform an initial assessment with the anesthesia provider to include the evaluations of:
  • Vital signs
  • Respiratory status (respiratory rate and competency); type of artificial airway, if applicable and oxygen saturation
  • Blood pressure
  • Pulse, apical or peripheral
  • Temperature
  • ECG rhythm interpretation and documentation
  • Level of consciousness
  • Position of patient
  • Condition and color of skin
  • Patient safety needs
  • Condition of dressing/s
  • Condition of suture line, if dressing absent
  • Type, patency and securement of drainage tubes, catheter and drainage collection devices.
  • Amount and type of drainage
  • Fluid therapy, location and condition of IV site, securement and amount of solution infusing
  • Level of comfort
• Evaluate continually the condition of each patient and maintain an accurate written report of the patient’s vital signs. The ongoing assessment includes:
  • Records periodically ECG rhythm interpretation and vital signs as indicated above. As a routine, vital signs are to be taken every five minutes for 15 minutes or until stable, and then every 15 minutes for the duration of the patient’s stay in PACU.
  • Monitors, maintains and/or improves respiratory function.
  • Monitors temperature every 30 minutes if below 96 degrees F, appropriate measures are taken to provide the patient with warmth and comfort.
  • Documents nursing action and/or intervention with outcome.
  • Monitors surgical site and drain.
  • Monitors and documents intake and output.
  • Evaluates the need for administration of analgesics and/or antiemetics.
  • Includes parent/guardian in the care of the patient as indicated.
• Maintain the medical record for each patient in the post anesthesia care unit.
  • The record will include at least such postoperative data as the patient’s general condition, respiration, consciousness, circulation, and special problems or precautions, summary of fluids received during surgery, oxygen saturation.
  • The record will include at least such postoperative data as allergies, physical and mental impairments, prostheses, electrocardiogram, vital signs, radiological findings, laboratory values, drug use and mobility limitations.
• Discharge patients from the post anesthesia care unit using discharge criteria, including authority to discharge, which have been developed through the post anesthesia policies and procedures.
• Confirms patient ride home and home assistance before discharge.
• Handoff report given to staff nurse prior to admission to the inpatient setting.
• Collect prescriptions for the surgical patient prior discharge
• Formulates a teaching plan/discharge plan based on identified patient learning/care needs and evaluates its effectiveness; family is included as appropriate in teaching/evaluation process.
• Checks daily crash-cart and emergency medications, supplies and equipment at the beginning of each day’s surgery.
  • Charges defibrillator per manufacturer’s instructions and ensures that it is in working order will all connections tightly secured and proper accessories available on the cart.
  • Checks par levels of emergency medications in the crash cart as per schedule.
  • Ensures that all items on crash cart are presented in correct quantity.
  • Ascertains that the oxygen tank is full and functioning properly.
• Maintains par level of other supplies and medications. Checks for expiration dates of medications and supplies on a monthly basis.
• Cleans routinely after each patient.
• Checks all suction outlets and monitors to ensure that they are all functioning properly.
• Ensures that stretchers and recovery chairs are in a locked position.
• Ensures that all equipment is clean (i.e., suction canisters, stretchers, recovery chairs, monitoring equipment).
• Conducts narcotics count in the specified manner with another RN. This is performed weekly and reported to pharmacy.
• Renews BLS, ACLS, and PALS, TNCC or TCAR certification per GSMC requirements.

Education: Baccalaureate Degree in Nursing or related field preferrred. Graduate of an approved School of nursing. Must be a licensed Registered Nurse in the Commonwealth of Massachusetts. Basic life support, ACLS required,Trauma care after resuscitation or Trauma nursing care course required PALs preferred

Experience: Requires 1-2 years previous PACU RN experience or 1-2 years previous critical care unit RN Experience