Post-Anesthesia Care Unit PACU

Upon observation of the circulating nurse, I noticed that she was very interactive and involved in the surgery. One of the responsibilities of the circulating nurse is to retrieve any surgical supplies that are not available in the operating room and to make or receive any calls for the surgeon. During the surgery, I noticed the nurse call for an x-ray for the surgeon, the laboratory for biopsy samples, and the operating room floor front desk to inform them that the surgery would be later than expected. This is her responsibility as the surgeon cannot break sterility by touching the phone and it is easier for him to communicate through her and not leave the surgical site. Also in the operating room, I observed the scrub nurses’ roles. Before the operation, the scrub nurse opened all of the sterile packages, arranged them on the sterile field, and took count of what was there along with the circulating nurse. The scrub nurse did this because she is sterile during the entire procedure, and once the sterile packs are opened, the contents can only be handled by sterile personnel. The scrub nurse also was ready and waiting at the sterile field at all times to get the surgeon any equipment needed from the sterile field. This is helpful to the surgeon because it enables the surgeon to stay at the surgical site and convenient for when

The CRNA has deeper understanding of disease processes, pharmacological treatment and technological interventions when caring for patients. Advance practice comes with a high level of responsibility; furthermore, increased autonomy is why I aspire to advance my nursing practice. I want to be the nurse that eases my patient’s way through what may be the most stressful time in their life. During my anesthesia shadowing experience I witnessed the complexity and compassionate care that the CRNA provided safely and efficiently. Most importantly I observed clear communication that was vital to all involved in the care of the patient’s unique needs. My shadowing experience fueled my drive to continue to pursuing CRNA School and extend my knowledge at the

They also take care of patients anesthesia before, during, and after surgery. They even give mothers epidurals during child birth for pain management. A CRNA can also perform physical assessments, participate in preoperative teaching, administer anesthesia to keep patients pain free, oversee recovery from anesthesia, prepare for anesthetic management, and follow the patients postoperative course from recovery to the patient care unit. These types of nurses are the only certified personnel to deliver anesthesia in most rural hospitals in the United States (Lippincott Williams & Wilkins 42).

When I arrive to the Trauma ICU 4800 unit, all of the nurses were already being followed by other students. The nurse in charge had me follow several different nurses, so I was able to observed several different patient cases. The first patient had received a triple bypass open-heart surgery. The patient had received a creatinine blood test. The patient had a dialysis machine next to them, which was used to function as the kidneys since the patient’s kidneys were not functioning correctly. Also, the patient’s body temperature was lowered from having a taken cool liquids so the nurses were keeping him warm with a bair hugger, which was a machine that helped regulate the patient's’ body temperatures.

Anywhere anesthesia is delivered, CRNAs can be found, from hospital operating rooms, to outpatient settings, to military healthcare facilities. In many situations, such as hospitals in rural areas, where physician anesthesiologists are not available, nurse anesthetists are the sole providers of anesthesia to patients (“Nurse anesthetist,” 2012).

This essay discusses and reflects upon patient care in the post anaesthetic care unit (PACU) and is linked to my experiences on placement. It discusses how my approach to patient care has been challenged and analyses how evidence based practice can create a change in the way patients are cared for. It reviews the processes of managing the perioperative environment and evaluates the implications for practice when applying a change in healthcare. Wicker and O’Neill (2010) state that “The lack of immediate medical support in the recovery room means that practitioners work in a more autonomous role than any other area of the operating department” (p.379). By reflecting upon my experiences I am able to link practical and theoretical aspects of the operating department practitioner (ODP) job role. This will provide me with a greater understanding of professional practice and it will develop my personal knowledge and self-awareness (Forrest, 2008). Using a model of reflection is important as it provides a framework that can be systematically followed and acts as a guide through the process of reflection. For this essay I have chosen to use the Gibbs’ Reflective Cycle (1988) as it provides a methodical guide to reflection using a series of ordered questions that each lead to the next stage of the cycle (Forrest, 2008).

While there was a policy in place for conscious sedation, even good policies rely on the vigilance of staff to adhere to them. Often times, working conditions allow for distractions, and even the best of practitioners, with the best of intentions, make errors. There were several areas presented in this scenario that require examination and improvement.

Traditionally nurses delivered clinical information about the patient, the clinical events on their shift and the plan of care to the oncoming shift to ensure continuity of care and to make sure that their colleagues were informed about tasks or instructions that needed to be completed by the next shift. This process had a variety of names; report, handover or handoff. The format was often different from unit to unit. It usually took place in an off stage room or office or at a charting station from away from the

This Anaesthetic case study would describes and discussed the scenario of a patient through the anaesthetic role of their surgical procedure. It will include and discuss the anaesthetic safety procedures equipment and drug interventions used to ensure this particular patients maximum safety and comfort before and during the procedure. The case study will include pre and peri-operative assessment in order to describe the involvement contribution of various specialties in the holistic care of the critical care patient. This assignment will focus only on the anaesthetics side of the procedure but will also highlight the importance of the triad of anaesthesia and discuss the administration, maintenance and reversal of

(History of Nurse Anesthesia Practice. 2010, May), (Koch, E., Downey, P., Kelly, J. W., & Wilson, W. 2001).

Effective communication during a patient handoff is critical in ensuring patient-care quality and safety and bedside shift reports have been found to increase patient involvement and satisfaction (Wakefield, Ragan, Brandt, and Tregnago, 2012). Bedside shift report is viewed as an opportunity to reduce errors and ensure improved communication between nurses (Gregory, Tan, Tilrico, Edwardson, and Gamm, 2014). Improved communication between nurses can be beneficial for all involved. In response to the Joint Commission’s National Patient Safety Goals, bedside report has been supported as improving patient safety, patient-centered care, and nurse communication as well as reducing medical errors (Gregory, et al., 2014). Ofori-Atta, Biniend, and Chalupka’s (2015) article examines statistics regarding hospital care and shows that according to the Inspector General Office, Health and Human Services

sedation have continuous BP, ECG, & Pox monitoring done. Nurse J. who was trained in the

I help the nurse hold down the patient, while the nurse was maintaining her airway. I was able to see LMA and a endotracheal tube extubation. I really like the environment in the PACU. There were a few times when out of nowhere patients start to desaturate and the nurse had to respond quickly.

Overall, the knowledge and expertise an anesthesiologist acquired allows them conduct preoperative procedures and evaluations of patients before undergoing an operation to ensure the best possible operational safety for the patient. The evaluation of patients is important because of numerous factors that can could possibly lower the effectiveness of the anesthetics being used or severely endanger a patient. Before an operation an anesthesiologist must evaluate a healthy patient with a systems approach. This procedure usually evaluates the airway, pulmonary system, neurologic system, cardiovascular system, and endocrine system(Hata p.585-588). Each of the systems that need to be evaluated have different methods or procedures to ensure the best

A surgical nurse is responsible for monitoring and ensuring quality healthcare for a patient following surgery. Assessment, diagnosis, planning, intervention, and outcome evaluation are inherent in the post operative nurse’s role with the aim of a successful recovery for the patient. The appropriate provision of care is integral for prevention of complications that can arise from the anaesthesia or the surgical procedure. Whilst complications are common at least half of all complications are preventable (Haynes et al., 2009). The foundations of Mrs Hilton’s nursing plan are to ensure that any post surgery complications are circumvented. My role as Mrs Hilton’s surgical nurse will involve coupling my knowledge and the professional