Neuro--tell me why you do/don't like it!!

Well, I've worked in NICU for 6 months now, and I'm loving it. The skills you need, the families you meet (funnily enough, I really enjoy that part), watching patients recover from seemingly impossible states, even road trips are still exciting at the moment! It is really sad, of course. But there is sadness in all areas of nursing. Perhaps it makes you appreciate the positives more.
I wasn't expecting to enjoy it so much, I had no idea really what the job would be like. I know I definitely need to learn much much more about the brain and neurology, but it's good to have motivation to keep learning. I'm also loving the teamwork - I've never worked with such a big team - it's a 13bedded unit (including HDU) and around 100 nurses!
To those thinking about it - go on, take the plunge. After all, if you're not enjoying it after 6 months to a year, move on - you'll have
gained some incredible skills and much transferable knowledge.

I work in SICU, but have floated to Neuro, and get a few neurosurgical boarders in our unit.
I avoid neuro patients when possible.
ICP drains scare me, and I have yet to really figure out all the zeroing, and turning stopcocks.
The tragedy factor is high- as high or higher than Burn center patients.
An agitated patient wears me out. The trauma docs are more liberal with letting us use sedation than the neuro docs.
The signs of a patient "going bad" are more subtle.
There is little room for error with the brain

I have worked in a Neuro/Pediatric ICU for a year now and I must say that I love it. My hospital has 4 ICUs : MICU, NPICU, SICU and CSCU. Although I don't mind being pulled to the other units, they just don't feel like home. I love the traumas! Nothing is more fun to me than a basal skull fracture patient who likes to get naked (and spending the day telling them to stop playing with that!!)..lol.. or intubating a frontal lobe contusion patient who is going buck wild.. Another post said it right, most people are suited to either hearts or heads.. You definitely have to have a good sense of humor (or a slightly twisted one..lol..) to survive neuro.. oh, and being really quick with restraints helps, too! It is challenging and can be difficult, but if you have a good team behind you, it can be an awesome experience!

I agree with you. I wonder where the heart of nursing has gone, let alone the heart. I see things like you talked about often and it hurts me because I have been the TBI/coma patient on a vent and now I am a nurse doing research on TBI. I worked in the unit for a few years but it was too hard for me to see the "professional" nurses worry about who is calling on their personnal phone more than that patient on the bell again! I precepted a few nurses while there and before I told them my story and showed a picture of the car I was in, I told them the old standard, "What if that were you or your mom or your son in that bed, what would you want for them?" Never think that could not be you, it could and for some, for me,it is.

Well, that all depends on the unit/facility. I started as a new grad and dove into neuro...per the suggestion of the senior cardiac RN's (" you can learn hearts anytime, but it's hard to go back and learn neuro after you get settled in any other ICU").
It was good for me because I had the opportunity to learn, and it was fast paced. If you're planning on going to one of those units where they keep a CVA for 6 weeks, run away! Neuro is just awesome, it's so complex and interesting...but you will be bored if you are not putting in ventrics, having fresh crani's, and throwing mannitol at head trauma's.
My fav neuro envionment is at a trauma 1 facility..and no residents! Ask the nurses! If the surgeons are cool about teaching you things, and you are able to see a variety of cases, go for it! If you can't handle AMS and repositioning every 5 minutes, then you might want to reconsider,lol. Good luck!

WOW! I am interviewing for a neuro unit in a couple of days and have been looking up info as I am a new grad. This post is awesome!! I had never thought about going into Neuro honestly, but the recruiter thought it would be a good fit for me. The more I have thought about it and looked up info the more excited and interested I become!!

I am not totally unfamiliar as my brother died of a neck injury and my father had a hangman's fracture and a frontal lobe injury. I remember being in the ICU with my father and how amazing the nurses were, all but 1 was willing to explain everything to me as they went and it really helped me cope.

Maybe this is my calling, maybe I can be that nurse that makes a difference in some small way.

Thank you all so much for this great information!!

Great thread. I started in 1974 so I guess I know a few dinasaurs by now. Did ER, Surg, Tele, Step down, CVICU, MSICU, MICU, and Neruo twice. Neuro seems to be home for the last 10 years. My thoughts.

At first it scared me more than a fresh heart crashing. A lot more. Then I realized it was because I didn't work at learning enough to know what was going on. Having taught neruo for the last 5 years that seems to be the route cause of everyone's fear.

First, find a good teacher and read read read. Ask every MD to explain. When you get conflicting answers just keep asking and reading. And realize that in neuro you can have more than one answer. Neuro is like doing cross word puzzles. At first you don't do well. Over time you begin to see the patterns. Then you begin to see the cleaver little twists to try and throw you off. I made it a game between myself and the docs to see who could figure it out.

Then I allowed myself to be wrong and not beat myself up but just go back more determined. Sometimes what you are seeing is an early stage so it is not clear what is happening. In those cases it is a matter of what is most likely and working from there. Learning to do a good neuro exam is KEY. Practice it until it is fluid.

I was lucky. I had a position that was like working with House MD. Only four of them. Each was recognized as being top for the state. I can't tell you how hard it was to see them take one look and diagnose from across the room and I was having to stand there and say " I don't know." My job was to triage all neuro cases coming into the hospital. Every single day I went home and read... determined to match them. Can't say I could match them in everything but I got damn good at strokes and stroke mimics. Knew I arrived when I could disagree with them and show them why they were wrong.

Now why do I like it after all that. After all the other fields it was a challenge. It made me think about brain function in different ways. I learned that the brain is magical and yet deals with the world on a yes/no basis. Something either works or it doesn't. And, there is that range in between were it is like a reostat for a light. On a lot or on a little. Off a lot or off a little. Still just an extention of the on/off but just to degrees.

I think I like being able to figure it out and know that my patients need someone who will stay there and figure it out. I feel that I can understand their thoughts even when they can't communicate. I try to put my mind in thier body and "see" what is wrong. I try to feel their energy and read their needs.

May sound a little strange but it is like taking care of your child. After a while you learn what they are feeling, you can hear them suddenly scream outside and know if it is play or something is wrong. That scream has a nuance that defines it. So does neuro. And neuro is energy. Little elec charges used for one cell to talk to it's neighbors and sometimes they chat in groups, wrap it all up and it is called function.

I teach students to focus on observation. Take time to watch every pt and after a while you will see that nuance before it becomes a crisis. I like turning the mystery into simple functions that either work correctly or don't.

Regardless of the dicipline you will see tragedy. In those cases it is what you do to ease the burden or transition. Love em like they are your kids and you will love neurology. Like your kids sometimes they aren't all that loveable but you still do.

Oh yes, neuro surgeons can be the biggest Ass. It ain't easy for them either, especially when they can't count on you telling them what is going on. You are their eyes and ears and they are dead tired and cranky. Got to love them too and then love yourself for doing it. You are special, it ain't easy reading minds but you can do it.

I am a new grad (May 2008) and kind of fell in to neuro at a large Level 1 trauma center/teaching hospital two months ago. It wasn't my first choice, but I think the Lord works in mysterious ways because it's a perfect fit for me! It is very challenging, and forces you to hone your assessment skills right quick because in neuro, assessment is everything! Then, depending on what part of the brain is involved, other systems become involved that you are now taking care of in addition to the brain injury. In my short time there, I have learned ALOT about a myriad of conditions! It is sad sometimes, because your patient may never fully recover (or recover at all), but so is the case with many areas of nursing. What is really rewarding is when someone you have been taking care of for awhile that is non-verbal says "Goodmorning!" to you for the first time. It's when the coma patient suddenly opens his eyes for the first time in months while you are doing your daily assessment. Its so many of the "little victories" that make such a huge difference in a patient's life. Think about what the difference would be for you between being fed or being able to feed yourself? Sometimes it's frustrating. Sometimes it's emotionally wrenching. Often times it's incredibly rewarding! I guess all I can say is give it a try, and be open to learning. If you don't like it, you can always transfer to another area. Just want to add this: it's interesting to note that our neuroscience unit has the highest nurse retention rate in the entire hospital!

I miss it to tell you the truth. I worked a 30 bed neuro unit in South Jersey and then moved out of state where they transported just about everything. When I first started, I was scared to death but I was fortunate enough to work with a gal who had tons of experience and she taught me so much. Also had 5 different neuro surgeons who were willing to teach. I love the diveristy and the challenge that neuro brings (see my handle). Currently working in Cardiac, love it not so much. Neuro more of a challenge. Getting ready to do ER again so we will see.

Why do I Love Neuro? Boy, that is kinda like asking why you love your kids. I think it has to do with knowing that so few can help your pt but you can. It is seeing recovery from disaster. It is reaching into the dark and shinning a light. It is realizing how much you saved vs what you lost. I have been showing a GREAT video at our hospital to help generate interest and explain what the fight is all about.

The video is about a Harvard neuro anatomist who happened to have a
stroke. (bleed) She relates how she thought "how cool is this, I can study my own brain while I am having a stroke." Her story is told from the perspective of the inside of the brain while areas are being shut down, and finding out what works and doesn't work. How she didn't know she couldn't speak or understand language until she tried to talk. "Oh, my God. They sound like a golden retriever. I sound like a golden retriever. woo woo woo woh"

She relates how she went from being a left brain to a right brain. How those two sides differed in how they saw the world. Her 'Stroke of Insight' tells us what is happening on the inside while it is happening.

It is insightfull and beautiful at the same time. The first minute is background info and then the ride begins.

Goto TED.COM
You can search via title, speaker, or gategory.

My Stroke of Insight

Jill Bolte Taylor

Science and technology

Oprah found this so intriging she did an entire series on re-training your brain.

It is only 17 minutes in length. Enjoy