[focker-male nurse]

This is my last semester of nursing school and on top of clinicals we pick area to preceptor. I requested CICU but all that was available was neuro. I will be doing 150 hours this semester with a preceptor.
At first I was scared to death but now, after reading this message board, I am terrified!

I would appreciate any encouragement and tips for a student who will be light years out of his league.
What skills sets should I brush up on the most before going to the neuro ICU?
The hospital I will be at is UAB. It is a large teaching hospital with a level one trauma ER. I know I will see everything imaginable. It will be a great experience.
How can I prepare myself for the experience?

thanks,
matt

[RoxanRN2003]

Originally Posted by focker-male nurse

How can I prepare myself for the experience?

How were you planning on preparing for an experience in CICU?? Prep the same way. If nothing else, brush up on a basic neuro assessment. You'll do just fine!

[CHATSDALE]

the first step is always the scariest...you probably know more than you give yourself credit for

[auzzieneuronurse]

Matt - Neurotrauma is awesome. Being a bit scared is healthy helps keep you on your toes. But just enjoy it - be keen and interested, learn the art of neuro obs and assessment (takes time to perfect and pick up subtle changes) and get a hold of a the neurosurg bible Joanna Hickeys textbook great place to start. There are loads of tips on this forum ie common drugs to brush up on, good resources/websites and general questions. Good luck!

[ELKMNin06]

Congrats on working in neuro! Neuro is so exciting!!!!! There is never a day that goes by that I regret going into neuro!!

Things that I would suggest: basic neuro exam:

1.GCS
2.PERRL
3.Tongue midline?
4.Facial droop-have them smile
5.shoulder shrug
5.5 drift, do they have one?
6.strength in extremities
7.response to pain (if not following commands)
central and peripheral (if no response to central)

be familiar with following terms:
nystagmus
subarachnoid hemm (i see a lot of these in the ICU)
contusion
hematoma
CSF
Ventricles
EVD-know allll about these
intercranial pressure-how to decrease...normal limits..etc...
hydrocephalus
Halo vests

know about the spinal cord
know what controls what C3-C4=diaphram, etc.
spinal assessment..biceps, triceps, intrinsics, hip flex, hamstrings, dorsi flex, plantar flex, etc..
Fracture pts must lay flat


ICU and anatomy:
know about swan ganz catheters
Arterial lines
Central lines
Picc lines
Know about vents
hemodynamics

There are some things just off the top of my head. Good luck and enjoy, neuro is so exciting!

[focker-male nurse]

Thanks for the great tips, Elkmnin06, they will be most helpful.
Sorry about the buckeyes devastating defeat last night.

[ELKMNin06]

Originally Posted by focker-male nurse

Thanks for the great tips, Elkmnin06, they will be most helpful.
Sorry about the buckeyes devastating defeat last night.

Thanks, devastating is definitely the word for it.

[Bunny Bear]

I think it is absolutely wonderful that you have the opportunity to work in Neuro-ICU. In my opinion, NICU is not only the most fun and exciting place a nurse can work, but one of the most rewarding. This clinical will provide you with a wealth of knowledge and experience that will prove beneficial.

The other responses have wonderful suggestions on preparing for NICU. I agree that it is perfectly normal to be nervous. In fact, I still get nervous from time to time. Just remember, you are still a student. You will never be alone in taking care of these patients. Take advantage of that and ASK QUESTIONS! Ask to participate in as many procedures as possible. Other nurses won’t mind if you help if something interesting is going on with their patients. Be hands on. The more you do, the less nervous you will become and the more you will learn.

Be sure to learn about drips and titration. Ask what is going on physiologically, i.e.: Why are the blood pressures being kept so high? Why is it important to keep temps low? Most of all… Have Fun!!!!

I have a feeling you’ll want to work there once you graduate! J

[curious one]

I can understand your terror being in NICU. I've been in critical care nursing for a few years and still learn something new all the time. My advice is to stay open,receptive,seek out opportunies to observe procedures,help others when you can,ask questions and look stuff up in Hickey's (neuro bible),oh yeah, stay humble. Good Luck in your new career!!!!!!!!!

[iceyspots]

Wait a minute I thought NICU was neonatal intensive care unit?