Help, my preceptor is in neuro....

  1. 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
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  2. 12 Comments

  3. by   RoxanRN
    Quote from 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!
  4. by   CHATSDALE
    the first step is always the scariest...you probably know more than you give yourself credit for
  5. by   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!
  6. by   GrnHonu99
    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!
  7. by   focker-male nurse
    Thanks for the great tips, Elkmnin06, they will be most helpful.
    Sorry about the buckeyes devastating defeat last night.
  8. by   GrnHonu99
    Quote from 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.
  9. by   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
  10. by   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!!!!!!!!!
  11. by   RN BSN 2009
    Wait a minute I thought NICU was neonatal intensive care unit?
  12. by   focker-male nurse
    Just to update. I have had 2 days under my belt and must say that I love it! My preceptor is a great teacher and is well respected on the unit. I know that this will be an invaluable experience. last visit we had a patient come back from surgery with a crit of 20! they were in shock and we had to slam blood in and then ffp because his coags were off. His HR got up to 172 then he got back to normal 2 hours later when he got the fluids back. It was a scary moment but it was interesting to see an emergent situation like that.
    Thank you all for the tips.
  13. by   Curious1alwys
    Soooo.........how is it going? Good still???
  14. by   focker-male nurse
    still great...may work there after graduation.

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