Surgeries often involve a number of nurses, all with specific duties to perform in order to ensure the safety and care of each patient. Theresa Clifford, MSN, RN, CPAN, CAPA, is the perioperative nurse manager at Mercy Hospital in Portland, Maine. In honor of PeriAnesthesia Nurse Awareness Week, she shares a little information about what it’s like to be a perianesthesia nurse.
As a perianesthesia nurse, what does your job entail? What do you do on a daily basis?
For the past 26 years, I have been privileged to call the PACU my “home” and have functioned in a variety of perianesthesia roles, including a clinical bedside nurse, a clinical resource nurse and most recently as a perianesthesia nurse manager.
As the manager for perioperative services, I am responsible for the staff and the quality of care that the staff provide throughout all phases of perianesthesia care. First, I manage the staff in a preoperative clinic. This unit is responsible for the preanesthesia assessment of all surgical patients. As soon as a surgery is booked, the work of putting together the preoperative story of the patient begins by a gathering of relevant patient data and calling the patient for an extensive nursing history. The workflow includes an algorithm that helps to identify patients at high risk for surgical or anesthesia-related complications. The main objective throughout this process is to help optimize the patient’s baseline status for the safest perianesthesia experience.
I also manage the staff in the same-day “Ambulatory Care Unit.” Here, we greet the patients on the day of their surgery and continue the process of providing high-quality preoperative care that includes verifying patient information, confirming surgical consents and procedures, and initiating the IV and preoperative therapies. Some of the preoperative interventions are aimed at preemptive pain management and include the provision of preoperative nerve blocks. This is also the unit where patients returning home on the same day of their procedure will be brought for discharge preparation and teaching following recovery from anesthesia (the Phase II unit).
The last unit I manage is the post-anesthesia care unit (PACU) where patients receive Phase I level of care. In the 1960s, the courts deemed the PACU as “the most important room in the hospital,” and I could not agree more! During this phase of care, the nurse is responsible for monitoring patients for airway, ventilation, and hemodynamic stability. In addition, the ongoing management of pain and comfort is actively carried out by the PACU nurses. Once the criteria for safely moving the patient from this intensive level of care has been met, the perianesthesia nurse will hand off care of the patient to the next level of care required.
Why did you choose this field of nursing?
“Curious indeed how these things happen. The wand chooses the wizard!” (J.K. Rowling). I always knew that I would be a nurse. My mother was an incredible nurse, and while I knew I didn’t want to work in her specialty field, I knew I wanted to grow up to be able to help people and touch their lives the way she did.
What are the biggest challenges of your job?
Honestly, the most difficult part of my job in health care today is remaining current with constant external and internal pressures to provide high quality, safe patient-oriented care within restrictive budgetary rules.
What are the greatest rewards?
The surgical experience for most patients is at the least, a memorable event, and at the most, life changing. It is a privilege to be able to participate in the experience as a guide, a knowledgeable professional, and as a source of compassion and care during a time when an individual can be most vulnerable.
What would you say to someone considering this type of nursing work?
I think perianesthesia nursing is a well-kept secret within the profession of nursing. There is a saying—do what you love, love what you do. There are a wide variety of opportunities within the perianesthesia practice to find a niche, a chance to “do what you love!”
Is there anything I haven’t asked you about being a perianesthesia nurse that is important for people to know?
It’s also important, as it is within any nursing specialty, to become aware of your specialty practice organization and to be an active member of your local and institutional work teams. The network built among specialty practice nurses, like perianesthesia nurses, allows for the opportunity to share knowledge and experiences and to participate in best practice and educational programs. The American Society of PeriAnesthesia Nurses (ASPAN), is the premiere organization for this specialty and provides an incredible source of information and support for the practice.
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