Post Anesthesia Care Unit (PACU) Nurse Guide

PACU nurses are responsible for observing and treating post-op patients. PACU nurses monitor vital signs and signs of consciousness to ensure their patients safely wake from anesthesia.

They also treat patients who have trouble regaining consciousness or experience side effects from the anesthesia. These types of patients may experience pain, nausea, difficulty breathing, fear, or agitation that requires the attention and expertise of a PACU nurse. They may also help patients stand, change dressings, and complete the discharge process.

PACU Nurse Skills

PACU nurses are often the first people a patient sees after a major surgery. This specialty nursing career requires the ability to comfort and reassure worried patients and family members. Additionally, they should be skilled and patient communicators as they must answer many questions and adequately convey patient care information.

PACU Nurses vs. Operating Room Nurses

While both nurses are important to the entire surgical process, operating room nurses are responsible for preparing patients for surgery and taking care of them during surgery. An OR nurse also assists the surgeon and may be called on to control bleeding, insert sutures, and administer medication. A PACU nurse takes over patient care once they have left the operating room.

OR and PACU nurses also have different salary ranges. Though both are high-earning registered nurse specialties, on average, PACU nurses make more than OR nurses. Check out our comprehensive guide to learn more about OR nurse salary expectations.

The U.S. Bureau of Labor Statistics reports the median annual RN salary at $81,220 per year or $39.05 per hour in 2022. However, this figure doesn't differentiate between specialties.

ZipRecruiter found that PACU nurses earn $120,888 per year or $58 per hour, which is significantly higher than the average of all RNs.

Top 5 Highest Paying States for PACU Nurses 

The states with the highest PACU nurse salaries are as follows:

1. New York - $141,110
2. Vermont - $139,173
3. Pennsylvania - $129,219
4. New Hampshire - $126,283
5. New Jersey - $124,920

*Data retrieved from ZipRecruiter.com 12/12/2023

The BLS predicts that registered nurse employment will grow by 6% from 2022 to 2032, much faster than the average career growth rate. PACU nurses should experience the same level of growth, making it an attractive field that offers both job security and lucrative salaries.

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1. Become a Registered Nurse

The first step to becoming a PACU nurse is earning your registered nurse (RN) license. In the US, you can pursue RN licensure via three pathways:

1. RN Diploma Program
2. Associate Degree in Nursing (ADN)
3. Bachelor of Science in Nursing (BSN)

Each track will prepare you for the National Council Licensure Examination (NCLEX), which qualifies you to begin practicing as an RN.

2. Gain Experience

Once you're an RN, you should gain 1-2 years of bedside nursing experience. Then, start looking for opportunities to work on the recovery unit to learn PACU nursing skills. At some facilities, the on-the-job experience you gain will be enough to qualify you as a PACU nurse. 

3. Become Certified

Certifications help verify your skills as a PACU nurse to potential employers. The industry standard certification for PACU nurses is CPAN or certified post-anesthesia nurse.

To apply for CPAN certification, you must be a licensed RN with at least 1,800 hours of clinical experience. Once you pass the exam, you will be qualified to practice as a PACU nurse.

Methodology

We analyze several factors in our ranking methodology to choose the best nursing programs for PACU nurses. These factors include:

• Reputation
• NCLEX pass rate
• Tuition
• Acceptance rate, when available
• Only ACEN or CCNE-accredited schools are eligible

Because PACU nurses must become RNs and earn professional experience, this list also takes into account clinical experience and BSN outcomes. 

Nurse Panel

Our selection panel is made up of 3 Registered Nurses with years of experience and multiple degrees:

• Tracy Everhart, MSN, RN, CNS
• Tyler Faust, MSN, RN
• Kathleen Gaines, MSN, BSN, RN, BA, CBC

Since individual nursing pathways and careers take various forms, our panel ranked the top 10 programs for PACU nurses in no particular order.

1. Oregon Health and Science University- Portland

• Tuition Per Term: Resident - $5,112.00 | Nonresident - $9,372
• Online: No
• Program Length: 3-4 years

OHSU focuses entirely on healthcare and related fields and ranks among the top nurse anesthesiology universities. Though undergraduates don't take anesthesiology courses, they will gain clinical experience, which may expose them to the PACU. 

OHSU offers a quick, affordable BSN pathway students can complete in just three years. The school also partners with community colleges across the state to offer flexibility and transfer options.

2. University of Pennsylvania

• Annual Tuition: $58,620
• Online: No
• Program Length: 4 years

UPenn's emphasis on clinical practice and mentorship could help aspiring PACU nurses get early exposure to the field. This excellent four-year BSN option has students work in team settings, have study abroad opportunities, and have internship options. Additionally, many graduates get the privilege of working at some of the best hospitals in the nation.

3. University of Michigan

• Tuition Per Term: Resident - $8,448 | Nonresident - $28,870
• Online: No
• Program Length: 4 years

Nurses and healthcare professionals may know the University of Michigan for its top-ranked hospital and facilities. Undergraduate students enjoy clinicals at the esteemed hospital, getting exposure to a variety of fields. UM also boasts an extensive alumni network of over 13,000 nurses who could connect graduates with PACU nursing opportunities.

4. University of Minnesota

• Tuition Per Credit: $557.55
• Online: No
• Program Length: 3-4 years

Located in the Twin Cities, students can enter the University of Minnesota's BSN program as direct admits from high school or transfer students. Transfer students study at the Rochester campus, which is also home to one of the best hospitals in the world -- the Mayo Clinic.

To enter the program as a transfer, applicants must first complete one year of prerequisite courses at UM or another accredited university. Then, they may apply to and attend the three-year nursing program. Students complete clinicals during the final two years of the program, earning valuable experience at the Mayo Clinic.

5. Johns Hopkins University

• Tuition Per Credit: $1,881
• Online: No
• Program Length: 5 semesters

Johns Hopkins is home to one of the best hospitals in the nation and offers top-ranked nursing programs like its direct-entry MSN. Specially curated for applicants with non-nursing bachelor's degrees, this program satisfies the requirements to sit for the NCLEX and prepares graduates for APRN education. This prestigious MSN also helps graduates compete with BSN-holding nurses for some of the top positions -- including PACU nurse jobs.

6. University of Washington

• Quarterly Tuition: Resident - $4,215 | Nonresident - $13,999
• Online: No
• Program Length: 2 years

The University of Washington requires students to complete two years of pre-nursing courses before attending its BSN program. Students may complete their nursing school prerequisites at UW or another accredited university. 

UW's program is outstanding because it necessitates over 1,000 clinical hours at excellent facilities state-wide for graduation. Students earn real-world experience working with a diverse patient population at sites like the UW Medical Center and Seattle Children's Hospital.  Graduates often find positions in the region, and nurses can begin gaining PACU nurse experience quickly after. 

7. University of California Los Angeles

• Annual Tuition: Resident - $12,522 | Nonresident - $45,096
• Online: No
• Program Length: 4 years

Another excellent school with its own world-class hospital, UCLA also boasts one of the nation's best BSN programs. This program is an excellent choice for nurses who plan on continuing their education or finding a specialty area like PACU nursing.

The BSN blends clinical learning and theory, providing a more academic-minded education than nurses might find elsewhere. UCLA uses a quarter system, and students begin taking nursing courses during their first year.

8. University of Wisconsin

• Annual Tuition: Resident - $6,102.98 | Nonresident - $20,801.54
• Online: No
• Program Length: 4 years

Nursing students at the University of Wisconsin get to complete their clinical rotations at several great area hospitals. The university has stellar nursing graduate outcomes, with a 93% first-time NCLEX pass rate. 

Students complete a two-year pre-nursing program before attending an additional two years of nursing school. In those final years, they gain 720 hours of clinical experience. UW nursing graduates find work in various roles nationwide at respected hospitals.

9. University of Maryland

• Semesterly Tuition: Resident - $4,913.50 | Nonresident - $20,194.50
• Online: No
• Program Length: 4 years

Baltimore's University of Maryland has an unbeatable location near some of the most important cities in the nation. Like many other traditional BSNs, the University of Maryland requires two years of nursing prerequisites before accepting students into the two-year nursing program. The university's excellent academics and clinical partners help it stand out and prepare RNs to gain PACU experience. 

10. University of North Carolina Chapel Hill

• Total Tuition: Resident - $32,255 | Nonresident - $91,120
• Online: No
• Program Length: 2 years

A Public Ivy located in Chapel Hill, the University of North Carolina prepares RNs to work in several environments. UNC-Chapel Hill grads work in nearly every field of healthcare, including PACU nursing. Nursing students in this program thrive thanks to UNC's day-one application of knowledge, which requires students to attend hands-on clinical courses in the first semester.

PACU nurses work in fast-paced environments making quick and critical decisions to provide optimal patient care. Here are a few examples of what it's like to work as a PACU nurse:

PACU Nurses are Keen Observers

PACU nursing is a unique position because the patients may not be able to articulate their discomfort. It is up to the nurse to make observations and act. They must be diligent and vigilant monitors as post-surgical patients come out of sedation. If there are any complications, the PACU nurse should be prepared to take immediate action.

PACU Nurses are Compassionate

A big part of being a PACU nurse is comforting post-surgical patients. They may be scared and confused once they wake up, and the anesthesia can exacerbate those feelings. A successful PACU nurse will be able to soothe these fears with care and compassion so that the patient can comfortably resume their recovery. 

PACU Nurses are Concise Communicators

PACU nurses also serve as points of contact for patients and families. They must be able to communicate care instructions and answer any questions. Being able to work with the public and effectively communicate during stressful times is a vital PACU nurse skill.

PACU nurses must maintain an RN license in their state of practice and any relevant certifications, like CPAN. Below are some continuing education requirements you may need to maintain as a PACU Nurse.

RN Licensure

Each state has different standards for RN continuing education, and some have no CEs at all. Additionally, your state may require HIV/AIDs or mandatory child abuse education as part of its licensure maintenance.

You can find your requirements in our Nursing Continuing Education Requirements by State guide or by checking your state's Board of Nursing website.

CPAN Certification

The American Board of Perianesthesia Nursing Certification (ABPANC) oversees CPAN certification and renewal. Eligible nurses must complete 1,800 hours of relevant clinical experience in two years to apply for this certification. After applying, you'll pay an examination fee, take the exam, and earn your CPAN credential.

You must renew the CPAN certification every three years. The ABPANC requires 90 contact hours or reexamination to qualify for CPAN renewal.

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You can work as a PACU nurse without the CPAN certification. However, earning it will showcase your skillset to employers and help you compete for better positions. It may also help you negotiate a higher nursing salary. You may consider holding both a CPAN and CAPA certification, expanding your skills to care for both pre and post-surgery patients.

Advanced Nursing Education

A natural progression for PACU nurses is becoming a Certified Registered Nurse Anesthetist (CRNA) by pursuing a Doctor of Nursing Practice degree from an accredited program. CRNAs are highly specialized advanced practice registered nurses (APRNs) who perform many of the same duties as anesthesiologists. They're also the highest-paid nursing specialty, which can be enticing for nurses who want to increase their salaries.

Nurses are part of a tight-knit community that offers a wide variety of professional associations that keep you abreast of changes and opportunities in the profession, including national conferences. Professional associations for PACU nurses include:

• American Association Colleges of Nursing
• Johnson & Johnson Discover Nursing
• American Society of PeriAnesthesia Nurses
• American Academy of Ambulatory Care Nurse
• American Academy of Nursing

Nurses are a vital component of our healthcare system, and many facilities are suffering from nursing shortages. With the right educational background, you can secure a lucrative and fulfilling position that will also offer opportunities for professional development and advancement. Use our job board to find the best PACU nursing jobs near you.

• What does a nurse do in PACU?

  • PACU nurses are responsible for post-surgical patient care. This care includes monitoring vital signs, administering medication, and updating the patient's family. They also take care of patient transfers and discharges. 

• What makes a good PACU nurse?

  • PACU nurses should be well-versed in the surgical care of patients. They must have good judgment and assessment skills to treat patients in pain properly. Additionally, PACU nurses should be compassionate, good educators, and team-players. 

• How many patients does a PACU nurse have?

  • PACU nurses will generally have between 1 and 2 patients at a time. Once a patient is transferred to a unit or discharged, the nurse will receive another patient from the OR.

• What does PACU mean in a hospital?

  • The PACU is a post-anesthesia care unit. This unit is for the post-surgical care of patients who do not need the ICU.

• Is PACU nursing considered critical care?

  • The PACU is considered critical care, and most units will require critical care experience before hiring nurses in this role.

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