Registered Nurse II - Pre-op​/PACU

Job Overview

Under direction, the incumbent is responsible for providing professional direct or indirect nursing care to patients in both the preoperative and post-anesthesia phases.

Preoperative nurses play a critical role in preparing patients for surgery by conducting comprehensive assessments, reviewing medications, coordinating diagnostic testing, and ensuring all necessary consent and documentation are complete. They educate patients about the surgical process and provide emotional support to reduce anxiety, while also confirming physical readiness through proper attire and the removal of personal items to maintain safety and compliance with protocols.

Following surgery, post-anesthesia care unit (PACU) nurses care for patients as they recover from anesthesia, monitoring vital signs, levels of consciousness, and overall responsiveness. Because patients may experience confusion, pain, nausea, or difficulty breathing, and may not be able to clearly communicate their needs, PACU nurses must proactively observe and respond to subtle cues. This role demands quick decision-making in a high-pressure, fast-paced environment to ensure patients safely regain consciousness and stabilize after surgery.

• Educational Incentive:
  An educational incentive of 2.5% for completion of an associate's degree, 3.5% for completion of a bachelor's degree, or 5% for completion of a graduate's degree.
• Bilingual Incentive:
  Incumbents may also be eligible for bilingual incentive depending upon operational need and certification of skill. Proficiency levels by exam are $0.69 per hour (Level I), $1.00 per hour (Level II), or $1.32 per hour (Level III).
• Certification Pay: $0.813 per hour based on scheduled work week hours for each qualified certification up to a maximum of five (5) certifications. One of the five certifications may be paid at $2.00 per hour for a National Certification.
• Evening Shift Differential: 7.5%
• Night Shift Differential: 15%
• Weekend Shift Differential: $2.00 per hour
• Continuous County Service Incentive Pay: 1% for 7 years, 1.25% for 12 years and 1.5% for 17 years
• Preceptor Pay: $2.50 per hour
• House Supervisor Pay: $4.00 per hour
• Charge Nurse Premium Pay: $2.50 per hour
• Float Nurse Premium Pay: $2.50 per hour
• In House Registry Pay
  • Non-overtime is 1.75 straight time base hourly rate
  • Overtime is 2 times base pay straight time base hourly rate
• Standby Premium Pay: ¼ of regular hourly wage or Federal minimum wage (whichever is greater)
• Health Plans:
  Biweekly contribution towards medical, dental, and/or vision insurance from authorized plans.
• Flexible Spending Accounts:
  Pre-tax benefit towards eligible medical, dental, and vision care expenses.
• Pension Plan:
  Participation in the County's defined benefit plan.
• Additional Benefits:
  Tuition Reimbursement, Disability Plans, Employee Assistance Program, Wellness Program.

• Uses the full scope of the Nurse Practice Act to assess, plan, organize, and provide nursing care to assigned patients;
• Conducts preoperative and postoperative assessments of the patients’ medical history, physical exam, vital signs, airway status, consciousness ABCs, pain, fluid/electrolyte balance, and psychological well-being;
• Reorients patients’ post-anesthesia and assesses the patient’s airways, bleeding, pain, signs and symptoms of distress; implements safety measures to prevent falls or injuries; evaluates readiness for discharge or transfer using Aldrete Scoring systems;
• Provides emotional support and education to patients and families regarding surgical procedures, pre-op preparation, post-op recovery, and discharge care;
• Ensures surgical readiness by reviewing medications, arranging diagnostics, obtaining signed consents, and confirming compliance with pre-op protocols;
• Follows prescribed doctors' orders concerning treatments and medications;
• Documents patient treatment and dispensing; makes patient observations; records and reports on all pertinent information, including changes in patient condition and general progress;
• Provides follow-through on judgment within the scope of accepted nursing practice;
• Assists doctors in examination and treatment;
• Provides unit…