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geon's office once surgery is scheduled and continues until the patient is discharged," adds BJ O'Connor, RN, nurse manager of the Palmetto Surgery Center in Columbia, S.C. "Being able to see the big picture is a must for all involved in the patient's care."
Cooley Dickinson Hospital in Northampton, Mass., has a length-ofstay team. "We spend a lot to time trying to enhance our process of getting patients discharged in a safe and efficient manner," says Nurse Manager Shonda Huggins, BSN. "There are many challenges from staff perception, patient perception to actual workflow and case types coming to my PACU and discharge unit. The work is worthwhile, but can be challenging."
It's not uncommon for the same perioperative nurse to follow the patient from pre-op preparation to post-op recovery. "Our circulators will follow patients from beginning to end," says Jeanette Sartain, ADN, surgery coordinator at Box Butte General Hospital in Alliance, Neb. "We've found that will sometimes speed up our whole day."
Nurse-to-patient staffing ratio
What is your nurse-to-patient staffing ratio for Phase I and II recovery? Here's what our survey respondents said:
Ratio Phase I Phase II
1 nurse to 1 patient 50.8% 48.4%
1 nurse to 2 patients 43.9% 35.3%
1 nurse to 3 patients 4.3% 12.0%
1 nurse to 4 patients 1.1% 4.3%
Not all surgical facilities separate PACU into Phase I and II. "We only have Phase II recovery, as all our patients receive conscious sedation," says Tammy White, RN, BSN, MHA, executive director of the Indianapolis Endoscopy Center.
