A few questions for those experience in the Neuro ICU

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    Hi! I am a student graduating soon. I am very interested in working in an ICU when i graduate, especially the Neuro ICU. A hospital near me has a great Critical Care Internships for new graduates. I am HOPING i am accepted into this program. I want to work in the NICU because it seems very rewarding and I am interested in learning about all of the different equipment, etc that is used. But i am afraid that since i have NO nursing experience, it will be too overwhelming. What is everyones impression of how New Grads fare in the NICU??

    A few extra questions...
    For those patients that are unresponsive, physically, what kind of care do you provide and how do you do it if they are unable to move, are heavy etc. (along the lines of toileting and bathing)

    How long is the average patient there? (I know there is no exact number because everyone is different, im looking for a very general ball park average, such as, is it common for patients to spend months here? or a few days to a week?)

    Lastly, any good advice for me?? Thank you!!
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  3. 7 Comments so far...

  4. 2
    You know, I'm not a new ICU nurse, but I'm new to Neuro ICU. I really found it helpful to start in med-surg. Reason being is because you need to start off with basic nursing. It's hard learning basic nursing and then ICU knowledge. I did a year of med-surg, 1year of ICU step down and then almost 3 years of ICU. It's a big learning curve for real. I'm going to be real. You will be stressed for a while. ICU alone is stressful. I wanted to work ICU right out of school, but I'm glad I didn't. When it was time for me to do my ICU thing, it still took me a long time to get adjusted. These people are sicker than the average patient.

    In med surg you learn to juggle 5 -6 patients at a time and you learn time management and prioritizing in an more stable environment. You can learn that in ICU, but for you it will be a crash course since you don't have experience. ICU is fast paced, fast learning, fast critical thinking. I'm still stressed just thinking about it. You will think that there is no hope for you during in the beginning because there will be so much stuff happening. But hang in there, it does get better.

    Don't get me wrong, you can learn to be a good nurse starting off in ICU. You will really appreciate it more if you had the basics down packed before hand.

    Now to answer yourextra questions.

    You learn have to take care of patients in school right and they give you all that good info. All that stuff is good. The best learning is doing. The more you do, the better it will be and you will feel more comfortable. You know every hospital has some type of protocol for Code blues and Rapid responses. You just have to find out where you fit in with that during your orientation and learn the different positions in a code situation. You will always have help around to help you move those heavy patients around. Those that can't talk back and it looks like they are always looking into the eyes of God, keeping talking and treating them as if they were able to hold a conversation and move around.

    Yeah it's hard to say how long a patient will be in the ICU. Some come in for observation over night. A lot of them come from post op surgery complications, which can keep them in there for like 2 or more weeks. A lot more of them come from outside world of hate and crime and just everyday living. Depending on the type of injury and complications will depend on the length of stay. You know we have large amounts of nursing home patients that comes to the ICU now. Specifically Neuro because they fell and hit there head, now they got a bad bleed and even seizures. Those patient already how a minimal of 2 weeks in the ICU. Most Neuro surgery requires almost 2 weeks in the ICU.

    So I hope I was helpful. I'm still trying to find my way in this nursing thing myself. I've worked a year in every ICU specialty
    (Trauma, Medical and surgical, Cardiovascular, now Neuro) and still get bored. I don't know what I'm looking for at the moment. I just like the variety and being a jack of all trades.
    JeanettePNP and hiddencatRN like this.
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    I'm a new grad on SICU but we're a stroke center so we're more like a neuro ICU honestly so I know from the last two months that it's insane and hellish but I'm enjoying it. haha. It's a ridiculous bout of masochism i think. Anyways, we don't have CNAs or LVNs. We have two patients so we do everything. We have a lift team that comes every two hours for skin care turns and we can use them for baths. You just gotta be quick and efficient about it. Can't answer that last one yet. I haven't been there long enough. ^_^
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    My hospital has a Critical Care Fellowship for new nurses and this is the only way we will hire new nurses to the NICU. I think the fellowship is a great way to experience every aspect of critical care and then decide which you want to focus on. Of course you can do NICU, it is no different than the other ICUs when you are a new nurse. Just make sure you take time and make sure you really want to work with neuro patients. They can be rewarding and frustrating at the same time.
  7. 0
    I was a new grad in the Neuro ICU over 5 years ago. I can tell you that it is not a place for a new grad who only has nursing school experience. Luckily, I was a nurse tech and ICU nurse extern prior to starting my job. Those experiences assisted me in becoming a successful Neuro ICU RN.

    My advice is to beg/plead/kill (j/k) for that critical care internship. It will help lay a successful foundation to build your nursing skills upon. As you continue in your nursing career remember these things---- Never assume you know everything. Always ask questions. Never stop studying. Look at your patient, not the monitor.

    Good luck.
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    You have to have "nads" per se too, you can't be timidin the icu, you have to be ready for anything at all times. I have founf the Neuro docs can be VERY intimidating or at they was for me, if u have to call them at 3 am you better have a good reason, be able to tell them what you have done for that pts problem, e.g. the pts icp has went up, what have u done to try to bring it down. Its a great place to work especially if the hospital has an intern/extern program
  9. 2
    I was a new grad in Neuro just about a year ago, so I'll try to answer some of your questions...
    In our ICU, we get a lot of strokes, TBI's, seizures, and brain tumors. Some are surgical, some are medical. The surgical patients tend to be more involved, since they tend to come back from the OR still vented, sedated, on pressors, etc. The medical patients are usually the seizures and ischemic strokes. Unless a seizure patient is in status epilepticus and needs to be vented, we rarely have a neuro-medical patient on a vent.
    As far as being a new graduate with no experience other than nursing school, I'll be honest with you... I don't remember the last time my unit hired a new graduate without at least some tech or CNA experience. Not that I can remember in the last four years. But we are a smallish hospital, we don't have a critical care residency the way some of the bigger hospitals do.
    Physically, it is demanding. Most of our patients literally can't do anything for themselves. We don't have techs in our ICU, but we do have 12 step-down beds on our unit and can sometimes borrow their tech for turns, etc. But it's usually pretty much total care for a 2 or 3 patient assignment. We (the RN's) try to help each other out.
    Average patient stay totally depends on diagnosis and outcomes, but I can tell you our average stay is probably 3 times that of CCU if not more; we're talking weeks, not days. It's a very interesting place to work, because you get to see patient who are completely helpless start to get better, but unfortunately on the other end of the spectrum, you will see heartbreaking cases such as a younger patient with a brain tumor, and you have to watch them get worse and worse.
    Wow, my post is getting long... I'll stop here. Feel free to ask more questions, I love answering them!
    JeanettePNP and hiddencatRN like this.
  10. 0
    I started working in the Neuro ICU as a new graduate and have been there for over 3 years now, currently the night charge nurse. Patients range from seizures, strokes, brain injuries, hydrocephalus (w/ and w/out shunts), drug overdoses, suicides, encephalopathy, basically anything that includes an altered mental status. We also get pre-eclamptic and eclamptic patients. Our unit also gets overflow from other ICU's so we usually have a few septic patients, CHF, COPD, DKA, chest pain, PE, DIC, so it depends on where you work but you might get the whole ICU experience with vents, a-lines, vasoactive drips, chest tubes, trachs, CVLs, PICCs, the whole deal.
    Typically our patients have a longer stay since most of them will be comatose due to a brain injury but their other vital organs are tip top keeping them alive, therefore families have a hard time pulling them off the vent as well as other reasons. Best of luck.


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