Tips for New PACU Nurses

nurse offering tips for others working in PACU

You did it. You landed your dream job as a nurse in the post-anesthesia care unit (PACU), supporting patients in the recovery room as they wake up after anesthesia. Now what? While PACU nursing is a highly sought-after specialty for several reasons, including that PACU nurses are likely to only care for one or two patients simultaneously, nurses in this specialty carry a tremendous responsibility. 

If you're new to PACU nursing, it's normal to feel overwhelmed and anxious as you settle into your new role. To support you with the learning curve of joining a PACU team, we've compiled our best tips for new PACU nurses. 

Know What to Expect

To become PACU nurses, registered nurses often need at least one or two years of work experience and certifications to qualify to work in a post-anesthesia care unit. While you may not be new to nursing, you may need to learn what to expect while working in a PACU. To ease into your new role, find as much information as possible before starting your first shift. While you're likely to get an orientation, your colleagues expect you to jump in by caring for your patients on your first day in the PACU. 

Knowing what to expect in the role is crucial to feeling confident that you'll be able to handle any issue that may arise or that you'll at least know who to lean on when you need support or have questions. Speak with other nurses in the PACU to get an idea of how the team works and what challenges you may face. Over coffee or lunch with a PACU nurse, ask as many questions as possible and find out what they wish they knew when starting as a PACU nurse. 

In addition to familiarizing yourself with the team, workflow, and systems, find out what cases you'll see most often as a PACU nurse. "Depending on the type of cases you're seeing daily, it's important to get an idea of what's "normal" in the immediate postoperative period. Where I work, I would say 40% of our cases are ENT. Tonsils and adenoids, septoplasties, turbinate resections, etc," writes one PACU nurse on Reddit


Familiarize Yourself with Common Medicines

Floor nurses working in hospitals or medical clinics are typically familiar with dozens, if not hundreds, of medications. PACU nurses, on the other hand, typically deal with only a handful of pain management medications. 

On the job, you'll learn everything there is to know about these medications as you adminster them day in and day out and see their impact on patients. In the meantime, please take the opportunity to learn as much as possible about these medicines and their uses. 

Learn as Much as Possible about Surgeries 

"If you get an opportunity to observe surgery in the OR [operating room] itself, I highly, highly, highly recommend that you do it. You'll learn a lot, and you'll be able to see exactly how the procedure [unfolds]. You'll also understand why patients experience pain the way that they do because of the techniques involved, the way they're positioned and the manipulation of their tissues to achieve the surgical outcome," advises one nurse on Reddit. 

Another PACU nurse, Natalie Numi, who shares her experiences on her nursing YouTube channel, highly recommends purchasing a copy of the book Surgical Care Made Incredibly Visual

According to the book's description, it "offers an innovative visual approach to mastering perioperative nursing [with] hundreds of detailed and colorful photographs, diagrams, charts, and other visual aids guide nurses through each task in surgical care, including perianesthesia management, infection control, wound care, and nursing interventions for specific surgical procedures."

While sharing her tips for new PACU nurses, Natalie said: "It's the only book I purchased, and I look back at it even now even though I've been there [working in the PACU] for two years … This should be like your Bible."

Manage Your Patients' Expectations

Since there is no guarantee that recovering from surgery will be a pain-free process, even with painkillers, it's your role as a PACU nurse to set your patient's expectations accordingly.

"I never tell patients I can make the post-op period 'pain free.' Typically I say something to the effect of: '[We] will try and get you as comfortable as we can before we get you home, but we can't make it pain-free.' Surgery is gonna hurt, there's no way around it," writes one nurse in a 

Reddit thread

The nurse suggests that, at times, what appears to be pain management can be about managing a patient's anxiety instead. Surgery can be an incredibly stressful time, and as a nurse, you can expect this will create anxiety among patients. 

"If you're having trouble with controlling a patient's pain, consider if they're displaying symptoms of anxiety. I've taken care of people before that were having issues with pain control, and not only were they hurting, but they were anxious. I'd offer a small dose of [medication name redacted], and every patient I've done that for has thanked me, telling me they felt way better," the nurse wrote, offering advice to new PACU nurses. 

Final Thoughts on Tips for PACU Nurses

As with any life or work transition, stepping into a new role as a PACU nurse can leave you feeling anxious. It will take time to settle in and feel confident with the responsibilities you'll shoulder in this position. However, researching and asking the right questions will help you know what to expect before your first shift as a PACU nurse. We're here to support you along the way, as is Nursa's online community. 

Want more tips on PACU nursing from the experts? Join the Nursa community today to connect with other PRN nursing professionals. This free online community provides a safe space for nurses to learn and connect.

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