Postanesthesia nursing: past, present, and future

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)