Perianesthesia (PACU) Nurse
What is a Perianesthesia (PACU) Nurse?
A perianesthesia nurse works with patients undergoing or recovering from anesthesia or sedation. A perianesthesia nurse may be involved with many levels of care, including preparing patients for surgery or caring for patients who are waking up and recovering from anesthesia. A perianesthesia nurse may also be referred to as a recovery room or post-anesthesia care unit (PACU) nurse.
Anesthetics have been used medicinally since before the 1900s, and these specialized medications make pain-free surgery possible. The ability to use anesthesia during surgery can be lifesaving, though potential side effects and adverse reactions may occur. The job of the perianesthesia nurse is crucial, as they monitor closely for complications and ensure the optimal safety and comfort of patients under anesthesia.
A perianesthesia nurse is one of many medical professionals that work with anesthesia. Here are a few more that work closely with these professionals:
| Role | Responsibilities | Work Environment | Required Education | Certifications |
|---|---|---|---|---|
| Perianesthesia Nurse | Prepares patients for anesthesia, monitors patients during and after anesthesia, provides post-anesthesia care | Hospitals, surgical centers, outpatient clinics | RN (Registered Nurse) license, BSN (Bachelor of Science in Nursing) often preferred | CPAN (Certified Post Anesthesia Nurse), CAPA (Certified Ambulatory Perianesthesia Nurse) |
| Anesthesiologist | Administers anesthesia, monitors patients during surgery, manages pain control | Hospitals, surgical centers | Medical degree, residency in anesthesiology | Board certification in anesthesiology |
| Certified Registered Nurse Anesthetist (CRNA) | Administers anesthesia, monitors patients during procedures, collaborates with surgeons and anesthesiologists | Hospitals, surgical centers, outpatient clinics | RN license, MSN (Master of Science in Nursing), specialized training in anesthesia | National certification as a CRNA (Certified Registered Nurse Anesthetist) |
| Surgical Nurse (Perioperative Nurse) | Assists during surgeries, prepares operating room, provides pre- and post-operative care | Operating rooms, hospitals, surgical centers | RN license, BSN often preferred | CNOR (Certified Nurse Operating Room) |
How Do I Become a Perianesthesia (PACU) Nurse?
Perianesthesia nurses are a mainstay in hospitals as they prep and care for surgery patients. Those looking to enter perianesthesia nursing must have strong assessment skills, as well as a strong foundation in pharmacology, IV skills, a Basic Life Support (BLS) certification as well as Advanced Cardiovascular Life Support (ACLS) certification. Experience in surgical environments and a solid knowledge of anesthesia are excellent foundations for the role.
What Are the Schooling Requirements?
To become a perianesthesia nurse, the first step is to attend an accredited university or college and graduate with a Bachelor's Degree in Nursing (BSN) from an accredited school. To become licensed and start working as a nurse, a passing score is needed on the National Council Licensure Examination (NCLEX-RN).
Many perianesthesia nursing positions require a minimum of two years of experience in a hospital setting working on an acute care floor like an Intensive Care Unit, ER, or another unit that works with complex patients.
Are Any Certifications or Credentials Needed?
There are two types of certifications for a perianesthesia nurse that are awarded by the American Board of Perianesthesia Nursing Certification, Inc. A nurse may obtain either certificate or may complete both certifications.
- Certified Post-Anesthesia Nurse (CPAN): This certification is for nurses who care for patients in post-anesthesia Phase I. The eligibility requirement includes at least 1,800 hours of direct clinical experience within the last two years prior to applying for certification. There is an associated fee, and the exam must be passed to obtain this certification.
- Certified Ambulatory Perianesthesia Nurse (CAPA): This certification is for nurses who care for patients in the pre-anesthesia phase, day of surgery/procedure, post-anesthesia Phase II, and/or extended care. The eligibility requirement includes at least 1,800 hours of direct clinical experience within the last two years prior to applying for certification. There is an associated fee, and the exam must be passed to obtain this certification.
What Does a Perianesthesia Nurse Do?
Aside from helping to prepare patients before a surgical procedure, once the surgery is finished the perianesthesia nurse monitors alertness as patients may be tired or disoriented when the anesthesia wears off and may start to feel the surgical pain as they awaken. The nurse orients the patient and provides direction if needed until the patient is stable. The nurse will also treat pain with medications and non-pharmacologic interventions so that pain is at a manageable level.
The nurse also monitors for the presence of side effects and adverse reactions related to anesthesia. For example, the nurse may treat nausea and vomiting, a potential side effect of anesthesia. He or she also checks for adverse reactions continuously throughout the recovery, as some adverse reactions can be dangerous. Perianesthesia nurses are well informed and prepared to handle emergency situations if needed.
Where Do Perianesthesia/PACU Nurses Work?
Typically, perianesthesia nurses work in hospital settings, where most surgeries are performed. The specific unit they tend to work in is called a Post-Anesthesia Care Unit (PACU). However, outpatient facilities such as same-day surgery clinics will have perianesthesia nurses on staff, as will some dental practices that perform procedures requiring sedation.
What Are the Roles and Duties of a Perianesthesia Nurse?
Perianesthesia nurses may prepare patients for surgery, but their many functions also include assisting patients as they wake up from surgery. After the surgery, the perianesthesia nurse monitors the patient while the anesthesia wears off and the patient starts waking up. The nurse will monitor the patient's vital signs, including:
- Blood pressure
- Temperature
- Respiration Rate
- Heart Rate
Perianesthesia Nurse Salary & Employment
The average salary for an entry-level perianesthesia nursing position is $80,321. For a senior-level perianesthesia nurse with eight or more years of experience, the average salary increases to $118,000. Individual pay increases with certifications and experience.
Perianesthesia nurses are in high demand nationwide. As long as anesthesia is used during surgery, perianesthesia nurses will be needed. Due to an aging population with more chronic conditions along with advancements in surgery and technology, modern medicine is able to keep patients alive longer. Because of this, career opportunities for perianesthesia nurses are favorable and expected to grow.
| Average Yearly Salary | |
| Top 10% of Earners | $118,000 |
| Top 25% of Earners | $90,000 |
| Median | $80,321 |
| Bottom 25% of Earners | $61,500 |
Helpful Organizations, Societies & Agencies
- American Society of Perianesthesia Nurses
- Journal of Perianesthesia Nursing
- American Board of Perianesthesia Nursing Certification, Inc
- Association of periOperative Registered Nurses (AORN)
