Night Watch

In many hospitals, the postanesthesia care unit (PACU) functions 24 hours per day. Nurses “on-call” often cover nights, weekends, and holidays. It has been a struggle for some facilities to meet the American Society of PeriAnesthesia Nurses (ASPAN) standard of care that recommends 2 nurses be present whenever an anesthetized patient recovers in Phase I PACU. Recent practice issues of “holding” patients for inpatient beds, not transferring ICU patients, and admission of patients from the ER to the PACU has complicated staff coverage for the overnight hours in PACU. ASPAN has crafted position statements in response to these issues to guide nurses. This author chronicles one hospital's use of a night nurse to provide staffing stability and care for PACU patients after hours.