How to Become a PACU Nurse

Gayle Morris, MSN
Updated March 8, 2023
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PACU nurses are vital to the care of patients after surgery. Take these steps for the quickest way to become a PACU nurse.
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How Long to Become

2-4 years

Job Outlook

9% growth from 2020-2030
For all RNs

Degree Required


The path of how to become a post-anesthesia care unit (PACU) nurse is specialized. Nurses who pursue this field enjoy a balance between critical care and patient education.

Advancements in surgical procedures have opened the door to better care options and increasing demand for surgical staff.

Many units are open only during the day and have staff on call for evenings and weekends, offering PACU nurses a strong work/life balance.

This guide covers the necessary steps to become a PACU nurse. This includes the recommended certifications, salary potential, and job outlook.

What Is a PACU Nurse?

Nurses who staff the PACU ensure patients awaken safely from anesthesia. Patients need the expertise and attention of an experienced PACU nurse, as they may experience pain, nausea, vomiting, fear, trouble breathing, or agitation, or have trouble regaining consciousness.

These highly trained critical care nurses are often the first person a patient sees when they wake up from anesthesia.

The PACU nurse monitors vital signs, administers medications, and must be skilled in resuscitation. They answer patient questions and may educate families on post-surgical care.

PACU nurses work in hospital settings, surgical centers, or outpatient surgical settings. Each day in the life of a PACU nurse is different; patients often do not spend more than several hours in the PACU.

The nurses care for a variety of patients, from babies to the elderly. In this fast-paced environment, the PACU nurse must be an expert communicator and have strong collaboration skills.

Steps to Becoming a PACU Nurse

There are several steps a candidate must take to become a PACU nurse. The path begins with nursing education and passing the certification examination needed to practice in your state.

Candidates may consider PACU certification to validate their knowledge and experience. Some employers might even require basic life support (BLS) or advanced cardiac life support (ACLS) certification.

Learn more about how to become a PACU nurse, and keep in mind the specific certifications or experience needed may vary per state or institution.

  1. 1

    Earn an Associate Degree in Nursing (ADN) or Bachelor of Science in Nursing (BSN) Degree From an Accredited Program

    Candidates can choose to attend an ADN or BSN degree program. ADN programs take an average of two years to complete, while students often complete a BSN program in four years.

    Employers prefer BSN-prepared nurses. New York has even moved to require nurses to have a BSN within 10 years of being licensed.

    ADN-prepared nurses can enroll in an RN-to-BSN program and complete their education in nine to 24 months while working. Candidates who hold a bachelor’s degree in a non-nursing field can complete an accelerated BSN program.

  2. 2

    Pass the NCLEX to Receive RN Licensure

    The National Council of State Boards of Nursing (NCSBN) developed the National Council Licensure Examination (NCLEX). The exam validates a candidate’s qualifications to practice as a registered nurse, and is mandatory in all states. Nursing students can register for the exam, find help studying, and get their results on the NCLEX website.

  3. 3

    Gain Experience in PACU Nursing

    After passing the NCLEX and obtaining a state license, nurses need several years of experience in medical surgical nursing and critical care to prepare to work in PACU. Most PACUs require two years of critical care experience.

  4. 4

    Consider Becoming a Certified PACU Nurse

    Nurses validate their knowledge and experience through certification. Nurses may be Certified Post-Anesthesia Nurse (CPAN) or Certified Ambulatory Perianesthesia Nurse (CAPA). Both certifications are for nurses working with sedated patients in a hospital or ambulatory care setting.

    CPAN certification is relevant for nurses caring for patients in Phase I post-anesthesia. CAPA is relevant for nurses working with pre-anesthesia, day-of surgery, and post-anesthesia Phase II. The American Board of Perianesthesia Nursing Certification, Inc. offers certification.

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PACU Nurse Education

The minimum educational requirement to be a PACU nurse is an ADN. However, most employers prefer a BSN-prepared nurse.

Both need at least two years of critical care experience. Candidates who choose an ADN program may complete their RN-to-BSN program while obtaining their critical care experience.

PACU Nurse Licensure and Certification

Nursing licensure and certification are necessary components of how to become a PACU nurse. An ADN- or BSN-prepared nurse must graduate from an accredited program, pass the NCLEX examination, and meet the state licensure requirements.

A PACU nurse must also maintain their nursing license. The State Board of Nursing sets the requirements for renewing a license. This nursing regulatory body oversees the administration of nursing licenses in the state.

Nursing students must check with their State Board of Nursing to determine the license and renewal requirements.

Nurses aiming to advance their careers as PACU nurses may need certification. Nurses must be eligible to take the Certified Post-Anesthesia Nurse (CPAN) examination.

Eligibility includes having 1,200 hours of direct clinical experience in the two years before the exam date. This experience prepares nurses to care for patients in a postanesthesia Phase I unit and have an active RN license.

Nurses can choose to hold dual certification in CPAN and CAPA. In this case, they must meet the requirements for both examinations. Eligibility requirements for CAPA include an RN license and 1,200 hours of direct clinical experience to care for pre-anesthesia Phase I, day-of surgery/procedure, postanesthesia Phase II, and/or extended care.

Working as a PACU Nurse

Responsibilities for PACU nurses depend on the work setting. For example, PACU nurses who work in an ambulatory care surgical center will likely take call shifts only on the weekends and may have added responsibilities for patient education and discharge.

In a large hospital setting, a PACU nurse may have scheduled shifts from 7 a.m. to 11 p.m., and on the weekends. They may also take call shifts on the night shift. In a hospital, a PACU nurse may be limited to caring for patients immediately after admission to the recovery room.

Other nurses may care for patients if they are being discharged following day surgery. This includes patient and family instruction on post-surgical care of dressing changes, medications, and drainage tubes.

Candidates with critical care experience and certification are sought after. According to August 2022 Payscale data, the average annual base salary for a PACU nurse is $103,000. The salary potential varies depending on geographical location, education, experience, and certification.

Frequently Asked Questions About Becoming a PACU Nurse

question-mark-circleHow many years does it take to become a PACU nurse?

It can take between 4-6 years to become a PACU nurse. Candidates who attend an ADN program may finish school in two years and work on two years of critical care unit experience. Employers often prefer BSN-prepared nurses, but earning a BSN takes an additional two years.

question-mark-circleWhat is the quickest way to become a PACU nurse?

The quickest way to become a PACU nurse is to complete a two-year accredited ADN program, pass the NCLEX exam, and work for two years in a critical care setting.

question-mark-circleHow hard is it to become a PACU nurse?

PACU nurses are highly skilled critical care nurses. Only the candidate can determine how difficult the process is. However, most units prefer nurses who are BSN-prepared, CPAN certified, and have basic life support (BLS) or advanced cardiovascular life support (ACLS) certification.

question-mark-circleDo PACU nurses get paid well?

The average annual salary for a PACU nurse is $103,000. This exceeds the average annual wage for all occupations, which is $58,260 according to the U.S. Bureau of Labor Statistics.

Page Last Reviewed: August 16, 2022

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