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Postoperative pain management continues to be a challenge to health care professionals. To address this, hospitals across the country are developing Acute Pain Services. It is fast becoming a specialty area and is being incorporated into the realm of practice of anesthesiologists. As postanesthesia nurses, we are in a unique position to enter this new field.
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The 10th anniversary of ASPAN it is a time to appraise past accomplishments while simultaneously identifying future goals as we approach a new decade and new century. Historical aspects of PACU nursing care demonstrate the manner in which this specialty evolved. The scope of practice included the acquisition of critical care skills from its very inception. Inherent in these skills, and representative of the core of this nursing specialty, is the PACU element that sets its nurses apart from all other critical care specialists. The ability to render knowledgeable PACU care within a critical care setting constitutes the integral and unique professional identity of PACU nurses. This identity has survived the test of time in light of rapidly accelerating technology. Can it survive in light of other more subtle changes taking place within the health profession? Guarding and preserving the specialty's identity will be the chief challenge for PACU nurses in the 1990s. The critical care skills of these nurses render them vulnerable to exploitation by other critical care units whenever these units are understaffed. Exploitation can also occur when the PACU becomes a resevoir for critical care patients, ie, from the emergency room, due to overcrowded conditions in the ICUs and CCUs. The present nursing shortage is yet another serious problem that administrators may seek to alleviate by consolidating critical care areas. PACU policy will need to reflect sound admission criteria coupled with the absolute support of the department of anesthesia and nursing administration. PACU nurses are encouraged to be alert to patterns of patient admission that do not conform to the policy.(ABSTRACT TRUNCATED AT 250 WORDS)
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Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Evaluating each patient's return to an acceptable state after surgical and anesthetic intervention is the responsibility of the postanesthesia nurse. Postanesthesia nurses use criteria to determine ambulatory surgical patient readiness to be discharged from phase I recovery to phase II recovery and from phase II recovery to home. Temperature is one indicator of postanesthesia recovery. Temperature discharge criteria from phase I postanesthesia recovery have been reported. However, temperature discharge criteria for phase II postanesthesia recovery have been adapted from phase I standards and nursing traditions. This study sought to describe the postoperative temperatures of ambulatory surgical patients from admission to phase II postanesthesia recovery to discharge home. A convenience sample of 101 adult patients undergoing surgery at a hospital-based ambulatory surgical unit (ASU) participated. Tympanic temperature was measured preoperatively on admission to the ASU, postoperatively, at the beginning of phase II postanesthesia recovery, and at the end of phase II postanesthesia recovery immediately before discharge home. All subjects were normothermic during phase II postanesthesia recovery, with temperatures ranging from 36.0 degrees C (96.8 degrees F) to 38.3 degrees C (101 degrees F). Paired Student's t Test showed significant differences (P < .0001) between temperature means. There was a 0.38 degrees C (0.7 degree F) decrease between preoperative admission temperature and temperature on admission to phase II postanesthesia recovery. During phase II postanesthesia recovery the mean temperature increased 0.16 degree C (0.3 degree F) before discharge home. However, the clinical and practical implications of these findings is questionable.(ABSTRACT TRUNCATED AT 250 WORDS)
The postanesthesia clinical nurse specialist (CNS) is a relatively new and developed role, one that is needed and that can be justified in the specialty of postanesthesia care nursing. This article describes a model with components of expert practitioner, educator, researcher, consultant, and liaison. The sub-role of change agent pervades all other roles of the postanesthesia CNS. Establishment of the role is examined using change theory. Fitting this specialty CNS into the organization is briefly examined through systems theory. Integrating the role into the system requires role making, role taking, and steps to reduce the stress associated with establishing a new role. Communication with involved subsystems, such as postanesthesia staff nurses, management, anesthesia staff, and physicians, is vital to the success of the role. Through education and interaction, significance of the role can be demonstrated to establish the postanesthesia CNS as a vital partner in postanesthesia nursing practice.
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The postanesthesia nurse encounters patients with pain daily in nursing practice. The intensity of patients' acute postsurgical pain varies from mild to very severe. Currently, the treatment of choice for postsurgical pain is administration of a narcotic, usually in titrated intravenous doses. When the pain is mild and the patient is able to cope until the narcotic reduces the intensity of the pain, narcotics alone are satisfactory. However, the patient with severe pain may not be able to cope with the length of time required for the narcotic administered to produce pain relief. For those patients additional measures are needed to assist them in coping with the pain. Nursing interventions may benefit the adult postanesthesia patient who is experiencing acute pain upon emergence from anesthesia. Physiology of pain transmission and nursing research in the area of acute pain control are the basis for interventions. Preoperative education and sensory preparation, distraction, deep breathing, and progressive muscle relaxation are additional interventions with potential to enhance acute pain control in the PACU.