Good questions and I'm excited for you. May I ask what your current nursing background contains? You may be able to draw from past experiences and build on those skills when you move to the Neuro ICU.
If you haven't previously worked as an ICU nurse, I would assume that you would get at least 6 weeks of orientation, which more than anything will help you become familiar with your unit, patient population, and co-workers.
As far as drugs go, you've already mentioned two biggies - Dilantin and Decadron. IV Dilantin is incompatible with pretty much everything except MIVF's and you need to check levels to make sure they're therapeutic. Decadron raises blood glucose levels and may require BG monitoring in non-diabetic patients, or even worse, insulin gtts (AAACCCCKKKKK). Another commonly used drug is Nimodipine, which is a calcium channel blocker used to dilate cerebral vessels for patients at risk for or in vasospasm. In some patients it drops their BP, but others seem unaffected by it. Also Mannitol is an osmotic diuretic used to decrease cerebral edema. If your unit gets a lot of ischemic events, you should probably investigate TpA protocols at your hospital. The main thing to remember is TpA=huge risk for hemorrhage.
Other than that, propofol and ativan are your best friends
Know your Glascow Coma Scale backwards and forwards. It won't be long until you're referring to patient's by their score (i.e., Mr. Smith is a 9 today but he was a 5 yesterday). Also know nursing interventions to help reduce ICP, triple H therapy for vasospasm, and what physiologic symptoms preclude impending brain death.
Let's see....other practical tips:
1. Unless your patient is in a coma, paralyzed and sedated OR totally with it and ready to go to the floor, DO NOT TRUST HIM. Neuro patients are a crafty bunch, and unless you enjoy calling cranky doctors to put your drain back in, or like doing the required paperwork when your patient falls out of bed, I recommend utilizing restraints and watching your patient like a hawk.
2. Neuro patients are crazy and can't help it. You will likely be insulted, spit on, screamed at, threatened, cussed out, etc. If you're the sensitive type, don't let them get to you. I'm sure most of them would be embarrassed if they were actually cognizant of their behavior. A good sense of humor is key.
3. The patient's families are even crazier and can help it. Hopefully your unit will have strict visiting policies and it is your job to enforce them. I've found that very rarely are family members of any help at all to your patients while they're in the ICU. You'll see what I mean the first time a well-meaning family member awakens your newly sleeping patient after he hasn't slept for 2 or 3 days. The main problem is the families are usually so freaked out and exhausted that they have real difficultly focusing on anything but their own needs. I tell them to eat, sleep, and get some rest because they really need to be well for their loved one after they are discharged from the ICU.
4. Most neurosurgeons are big babies with huge egos and God complexes. Ignore them unless you need orders or something. Do not let them hurt your feelings and keep in mind that most of their tantrums have nothing to do with you.
Well, I think I've said enough. Good luck with your transition!