Advances in technology and the health care industry have influenced the rapid growth of ambulatory surgery since the 1990s. These changes are at the core of the evolution of the nursing specialty of perianesthesia – and these nurses are increasingly central to ensuring safe patient care delivery and continuous quality improvement in surgical settings, including pre- and post-anesthesia care and pain management.
In honor of Perianesthesia Nurse Awareness Week 2019, University at Buffalo School of Nursing Associate Professor Carla Jungquist answers some common questions about this important nursing specialty you may not have considered.
Perianesthesia nurses care for patients that are going to have or have had a surgical procedure under anesthesia. These nurses are specialists in pre-operative assessment, post-anesthesia recovery, ambulatory surgical care and pain management. They are a member of the perioperative team and work beside surgeons, anesthesiologist, nurse anesthetists, surgical nurses, gastroenterologists, pulmonologists, and other specialists that perform in-patient and out-patient procedures.
When working with patients that are going to have surgery, it is the job of the nurse to ensure the patient is fully prepared to undergo the procedure with utmost safety. The nurse is responsible for reviewing the patients’ medical history, medications, and previous surgery experiences, and ensuring the patient is prepared to undergo the procedure. The nurse works directly with the anesthesia and surgical team to double check all potential safety issues such as ensuring the correct surgical location and that the patient has withheld all the pertinent medications. Perianesthesia nurses spend time calming and relaxing patients and provide patient education.
My area of research is about how perianesthesia nurses assess for opioid-induced respiratory depression. In the post-anesthesia recovery room, the nurse is responsible for assisting the patient maintain adequate respiration while balancing good control of their pain. There is a real art to balancing adequate pain control with potential negative effects of the medications, especially while the patient is recovering from anesthesia. Most nurses will depend on electronic respiratory monitoring equipment as well as their past experiences with assessing level of sedation.
Post-anesthesia care nurses are in the perfect position to identify patients that are sensitive to the respiratory depressive effects of opioids. Once identified, the PACU nurse will take lead in informing the rest of the health care team during hand-off that this patient is sensitive and opioid sparing pain management and aggressive monitoring of the patients breathing is necessary. PACU nurses are key in promoting safe patient care.
You will find perianesthesia nurses at every location where in-patient or out-patient surgical procedures are being performed.
Student nurses will spend time in the surgical suite during their education. If they find this area of nursing interesting, the student can speak with his/her instructor about spending more clinical time in the perianesthesia suite.
Most perianesthesia nursing positions will require a few years of experience on the general care or critical care units. Once hired to work on the perianesthesia team, the nurse will be trained and mentored by the senior nursing staff. New nurses should join and attend their professional organization conferences. The conferences are great ways to network with other nurses, learn about policies and procedures of other hospital systems, and learn about national standards of care.
Certification options include Certified Post-Anesthesia Nurse (CPAN®) and Certified Ambulatory Perianesthesia Nurse (CAPA®). Although certification is not required, it is strongly recommended by Magnet hospitals.
By Carla Jungquist, PhD, ANP-BC, FAAN, associate professor, University at Buffalo School of Nursing