Historical Information

From Fifty Years of Progress in Postanesthesia Nursing, 1940-1990

In 1980 the American Society of Post Anesthesia Nurses (ASPAN) was born of the need for education specific to perianesthesia care. ASPAN has continued to prosper with membership over 5,600 in 1989. Through ASPAN other avenues of growth have occurred which include a bimonthly journal devoted to perianesthesia nursing, a bimonthly newsletter, annual conferences, and an opportunity to become certified in this specialty of nursing.

FOUNDING DIRECTORS:
Margaret Bailey, RN
Maine

Mary Lou Barnett, RN
Minnesota

Elaine Brown, RN
Arizona

Charlene Cusick, RN
Michigan

Marie A. Darcy, RN
Florida

Alma Derway, RN
Connecticut

Jane H. Dillon, RN
New York

Betty Elliot, RN
Alabama

Hallie J. Ennis, RN
Oklahoma

Judy Ferrey, RN
Georgia
 		 Jovita Keane Gilligan, RN
Ohio

Anita Kay Kubin, RN
Texas

Jeanne R. Maher, RN
Illinois

Coleen C. Meyer, RN
Kansas

Ina F. Pipkin, BSN, RN
Washington

Mary Ruszovan, RN
California

Marilyn Schneider Glaser, BSN, MS, RN
Maryland/D.C.

Mary Ann Seinar, RN
Pennsylvania

Marge Wareham, RN
New Jersey

PACU Progress in the ...
1940s     1970s            
  1950s     1980s          
    1960s     1990s        

PACU Progress in the 1940s
The birth of Post Anesthesia Care Units (PACU, formerly known as Recovery Rooms) in the 1940s was the result of the necessity to centralize patients, equipment and personnel for the immediate and efficient postoperative treatment required. More extensive and complicated surgeries were being performed and the need for adequate and more detailed postoperative care increased. Surgery patients were cared for postoperatively in all nursing areas of the hospitals. During these years the medical and nursing staffs were at a minimum and most hospitals were not blessed with an abundance of equipment. To combat these problems, it was deemed necessary to introduce an area with specially prepared nurses to care for the newly operated patient.

PACU Progress in the 1950s
The 1950s ushered in an era of great progress in PACUs. Many hospitals realized the necessity for larger and more efficient facilities. This resulted in remodeling of the older units and special planning for the units in the construction of new hospital buildings. New "respirators" and blood pressure manometers were perfected and purchased by the more aggressive administrations.

At the close of the decade the need for increased staff was being addressed by administrators, and nurses were searching for more sources of education specific to their specialty.

PACU Progress in the 1960s
The 1960s were a time of growth and change within the postanesthesia arena throughout the country. Conceptually, postanesthesia rooms had been incorporated in most hospitals by 1960. It was apparent that these areas should be in close proximity to the operating suites.

PACU Progress in the 1970s
The decade of the 1970s was one of modernization and mechanization of both hospitals and their PACUs. More monitoring devices were introduced and computers were coming into use in some phases of hospital procedures, especially in the business office. Bed capacity increased markedly.

With the increase in PACU beds came increases in nursing staff and in many instances an increase in the number of hours the PACUs were open for patient care. The 1970s were years of rapid invention and manufacture of monitoring equipment of all varieties. Plastic and disposable items proliferated, making some aspects of PACU nursing easier.

PACU Progress in the 1980s
By the early 1980s exciting things were appearing in PACUs. New equipment and technology to improve patient care were being introduced. Computers were being installed and utilized in 23 of the 39 hospital PACUs questioned in one survey. Monitoring equipment was becoming an important adjunct to meeting standards of care. Forty percent of all PACU patients were being monitored with ECG monitors. Monitors with the ECG were most often used, followed closely by invasive monitoring systems.

Quality Assurance (QA) and the ASPAN Standards of Perianesthesia Nursing Practice were important as hospitals were becoming aware of the importance of risk management. Thirty-seven hospital PACUs utilized QA Programs and 32 utilized the ASPAN Standards of Perianesthesia Nursing Practice. Although care plans were available, many PACUs had not initiated these.

Ambulatory Surgery services were being established more frequently in the early 1980s as an alternative to the expense of inpatient surgery. Thirty-seven [hospitals] stated that the usual stay for the outpatient was one hour. The Ambulatory Surgery service was a separate department in 32 of the hospitals responding to the survey.

Into the 1990s
Since 1980, postanesthesia care of patients has vastly improved. Equipment has been updated to give the most accurate findings by using noninvasive and invasive monitoring. Nurses have been a part of the decision making team for purchase of equipment for their units. Input of the perianesthesia nurse is sought and equipment made to perianesthesia specifications. 

Increasing numbers of hospitals use the ASPAN Standards of Perianesthesia Nursing Practice. As more practicing perianesthesia nurses learn about the American Society of PeriAnesthesia Nurses, more nurses will use the Standards.

Benefitting health care, computers have been incorporated into the hospital and ambulatory surgery setting. In the future, nursing paperwork will be converted to computer data systems, allowing nurses more time with patients and their families.

As the 1980s ended, more outpatient surgical procedures were performed, increasing PACU and ASU patient cases per day. Ambulatory surgical centers are an integral part of the health care system. Nurses who work specifically with outpatients are supported by ASPAN. These ambulatory surgical nurses share many of the concerns of nurses working with inpatient perianesthesia patients.