New Grad

  1. Hey everyone! I just recently accepted a position in a stroke certified Neurosurgical ICU at a level 1 trauma center, and will be starting sometime in June or July after I graduate with my BSN in May. I have had some experience in critical care, but no experience at all when it comes to neuro, let alone a neuro ICU.

    What kind of things can I expect to see intervention wise (ventilators, hemodynamic monitoring, ICP monitoring, etc)?

    What kind of technical skills will I be utilizing?

    And lastly, what is the best advice you can give a new graduate working in a neuro ICU?
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  2. 10 Comments

  3. by   fresnovet
    I am about to embark on the same path, I start next month. What advice do you have for me? Considering that you have been working for some months now. Me: New Grad, BSN; Confident, fast learner, and passionate.
  4. by   daxdagr8t
    I'm starting on the 24th as a new grad as well. I have two years experience as a LPN Psych Nurse just hoping I can survive the residency.
  5. by   Okami_CCRN
    Oh boy, congratulations on landing a job in Neuro ICU. I occasionally work in a Neuro ICU, so here are some of the things you can expect to see

    -Tons of interventional radiology cases (coilings, embolectomies, intra-arterial cardene/TPA, clot retrievals)
    -2% Saline, 3% Saline, and when it's really bad 23.5% Saline
    -Temperature Management
    -Video EEG
    -Ventrics/subarachnoid bolts/screws
    -Nimodipine (such big pills)
    -Very high BP parameters (expect to maintain SBP of 150-200 at times)
    -vasopressors (mostly NeoSynephrine)
    -arterial lines, triple lumens, PICC's
    -Q1h neuro checks for everyone
    -Precedex (do they make it for inhalation yet?)

    Just remember these patients will look like hell, but it's always a treat when they come back to visit!
  6. by   fresnovet
    Thank you for the update! When you say occasionally... is it because you are doing orientation through step-downs? You just started right?
  7. by   Okami_CCRN
    Quote from fresnovet
    Thank you for the update! When you say occasionally... is it because you are doing orientation through step-downs? You just started right?
    I primarily work in a mixed medical/surgical ICU and float on occasion to the Neuro ICU.

    We do not float/orient to step-down, and I have been working there for quite a while.
  8. by   fresnovet
    Quote from Okami_CCRN
    I primarily work in a mixed medical/surgical ICU and float on occasion to the Neuro ICU.

    We do not float/orient to step-down, and I have been working there for quite a while.
    Oh no my apologies, I assumed you were the original poster miznurse17. That was why I asked you those questions too now that I think about it. The info you provided was very helpful. Thanks again.
  9. by   ICURN1028
    The biggest piece of advice I can give to you as a new grad (whether working in med/surg, neuro ICU, ER, etc) is to bring a small notebook and jot down notes regarding the diagnoses/procedures/medications/treatments/etc you encounter. Look these up on your days off (even just 30 minutes of reviewing) and soon these unfamiliar terms will be like a second language to you. You will greatly benefit by learning not only the 'how' but the 'why'. Good luck!
  10. by   fresnovet
    Thank you ICURN, I will be sure to keep a clinical log on those key points that you provided.
  11. by   miznurse17
    Fresnovet, although I was hired in February, I didn't graduate school until May, and didn't start until last week! Last week was all hospital wide orientation, so I will finally be on the unit this week ! I will post again in a few days after I get a few shifts under my belt. Good luck to you!
  12. by   Delia37
    Quote from miznurse17
    Hey everyone! I just recently accepted a position in a stroke certified Neurosurgical ICU at a level 1 trauma center, and will be starting sometime in June or July after I graduate with my BSN in May. I have had some experience in critical care, but no experience at all when it comes to neuro, let alone a neuro ICU.

    What kind of things can I expect to see intervention wise (ventilators, hemodynamic monitoring, ICP monitoring, etc)?

    What kind of technical skills will I be utilizing?

    And lastly, what is the best advice you can give a new graduate working in a neuro ICU?

    The American Association of Neuroscience Nurses (AANN) website is a great resource, with current guidelines and procedures common to neuro patients.

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