PeriAnesthesia Nurses

What a Knockout: Working as a Perianesthesia Nurse

by Michele Wojciechowski | Feb 9, 2018 | Blog, Career Advice | 0 comments

When patients need surgery or any other procedures that require anesthesia, they need a good health care team working with them to ensure their safety. Perianesthesia nurses are a crucial part of this team. And in honor of PeriAnesthesia Nurse Awareness Week, Regina Hoefner-Notz, MS, RN, CPAN, CPN, answers our questions about working as a perianesthesia nurse.

Hoefner-Notz is the Clinical Manager for Phase I & II PACUs (Post-Anesthesia Care Units) at Children’s Hospital Colorado as well as the Vice President/President-Elect for the American Society of PeriAnesthesia Nurses (ASPAN). An edited version of the interview follows.

As a perianesthesia nurse, what does the job entail on a daily basis?

Perianesthesia nursing encompasses all the care an individual might need around (Peri from the Greek for “around”) the administration of anesthesia—hence the practice name perianesthesia. Most people think in terms of recovery rooms and surgery, but this practice has evolved into so much more.

Nurses in perianesthesia guide and care for individuals through some of the most traumatic times of their lives. Surgery and procedures are nerve-racking for everyone. Anytime a patient receives anesthesia, there are nurses who prepare them, educate them and their family members, vigilantly assess and intervene as they recover from anesthesia, as well as continuing to prepare them for returning home safely. These nurses are specially educated and knowledgeable about many aspects of care, and various surgeries and procedures.

When I discuss this with nurses with whom I work, I acknowledge that they accomplish in 1-2 hours what it may take other nurses an entire shift to figure out. Perianesthesia nurses deal with multiple patients throughout a shift, each requiring care compassion and spot-on assessments.

I have the great fortune of managing our Phase I and II postanesthesia care areas. These nurses specialize in the immediate needs of their patients as well as collaborate with our anesthesia colleagues to determine when a patient is well enough and safe enough to leave the hospital after his surgery or procedure.

Why did you choose this field of nursing?

I was searching for a new nursing venue after 20 years in pediatric critical care. I had heard of the PACU as a great place to work and, in 2000, I took the leap to try this practice area. It has been one of the best career decisions I have ever made. After orienting and learning new skills, I remember thinking, “This is why I went into nursing, to see the whole picture.” It is extremely gratifying to be able to see a patient and family come into a hospital, successfully have surgery, reunite with loved ones, and be comfortable enough to go home to continue their recuperation in familiar surroundings. I love it!

What are the biggest challenges of your job?

My challenges are a little different right now as a nursing manager and leader. I want every nurse to see this as an amazing practice area and to reach their greatest potentials through education and participation. I try to encourage ongoing professional education and involvement. It has been extremely rewarding to see nurses reach professional places they never thought possible, knowing I have a small hand in some of that. Other challenges evolve around the changing face of health care and trying to determine how we continue to give exceptional care to our patients, while always being mindful and good stewards of our financial resources.

What are the greatest rewards?

I have been a pediatric nurse for 37 years. The greatest reward of this job is to see families breathe that sigh of relief as we reunite children with their parents after surgery. The reward is seeing a child well cared for, and not as afraid as they might have been if they had not been in a pediatric hospital with perianesthesia nurses providing very specific care for them. My practice area combines two great loves—perianesthesia nursing and pediatrics.

What would you say to someone considering this type of nursing work?

This is an incredible practice area with something for everyone. Some nurses want to be front and center, always part of the action, and there is a place for them in PACU. Some nurses want to educate patients and spend meaningful time making sure everyone knows what to expect and what to do—there is a place for them in the pre-op areas and Phase II discharging areas. Some nurses want a little bit of everything, and they can do that too. Perianesthesia nursing can be found in hospital settings, surgery centers, outpatient centers, GI clinics, dental clinics, and anywhere there is a need for anesthesia and excellent nursing care.

Is there anything I haven’t asked you about being a perianesthesia nurse that is important for people to know?

Perianesthesia nursing is so privileged to have a professional organization exclusively dedicated to this practice area. ASPAN is the organization whose core purpose is to “Advance and promote the unique specialty of perianesthesia nursing.” ASPAN sets standards of care by promoting evidence-based practice for all nurses practicing in this area. This organization encourages networking, as well as professional growth and development, for all its members and I am a perfect example of someone who has been able to expand my professional horizons by being actively engaged in ASPAN. I would encourage every nurse to seek out his or her specialty organization and get involved.

Insight from a Perianesthesia Nurse

by Michele Wojciechowski | Feb 10, 2017 | Blog, Career Advice, Perioperative Nursing | 0 comments

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.