Thoughts on/advice for new grads in Neuro ICU please... - page 2

by AJ BSN 2008 12,069 Views | 19 Comments

Hello there, I just graduated last week with my BSN and was contacted yesterday by a very prestigious medical center near me for a job I applied for a Neuro ICU RN position. I am completely shocked and also very excited to be... Read More


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    Hello, I did actually start out as a new grad in a Neuro ICU unit. I have been there for a little over three months now. I am going to be honest with you, it's VERY difficult. You come out of school knowing the basics, enough to keep you safe. But trust me...........we know nothing essentially. I have never felt so totally ignorant as I did the day that I stepped out onto the unit for the first time. There is so much to learn, so many meds to manage, and then the patient acuity to consider as well. I love working my job, but it's very stressful at this point because I personally feel so out of my element or comfort zone. I have been told numerous times that I needed to be patient because it takes new nurses at least a year to a year and a half to feel comfortable in ICU. If you have already started , let me know how it's going. I'd love to hear from you.
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    jobs in the neuro ICU when you graduate?? Where the hell do you guys live?? I just graduated in May and I couldn't get a housekeeping job in an ICU around here right now...
    Consider yourselves extremely fortunate.
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    Any updates??? I will be graduating soon and I am also interested in Neuro ICU, but of course shaking in my boots because it seems so challenging.
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    Neuro is great....you'll love it....starting out in the ICU means you'll learn the "right" way.....just make sure that you become as competent as you can be with the interventions your hospital does....study up on procedures and ICP monitoring....don't assume, always ask.....if YOU think there is a change make sure you chart it...even if it is a simple one...it can mean A HUGE difference.....good luck....neuro is fun as well as complex...

    cheers
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    Ask questions! Lots and Lots of questions! I started as a new grad in a high acuity Neuro ICU. Patients coming form all over via copter to this facility and I was SCARED and thought the managers had lost their mind in hiring me! I was wrong--my orientation was about 12 weeks on days and then I did another 6 on nights (shift I was hired for) I was scheduled for 8 on nights but caught on quick so I chose to stop the orientation early and I worked same schedule as my preceptor for about 6 to 8 weeks so she would be there if I needed her. I spent alot of time studying at home-usually stuff I had seen that day that I needed to learn more about. You will do fine just have confidence in yourself but remember the seriousness of your tasks and that the body in that bed is a person-with family-and every small thing you do will impact survival. Good Luck!!
    fiveofpeep likes this.
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    Hi,

    I am a new graduate nurse who will have my interview next week at a major hospital for the Neuro-ICU position. I just have some questions:

    1. Will it be very difficult for me to work as a new grad in the Neuro-ICU?
    2. What are the usual cases i will encounter daily?
    3. What is the essential skill i need to have in order to be a successful Neuro-ICU nurse?
    4. What's the most frustrating thing and the best thing about being a Neuro-ICU RN?
    5. What interview questions do they usually ask???
    6. What's the most stressful thing you've experienced in this unit??


    I am so anxious about my coming interview. Hope someone could help me. I really want to get the job. For those experienced Neuro-ICU nurses who could tell me a little bit about their experience in the unit can send me an email at ed_the_great17@yahoo.com

    Thank you in advance and God Bless you all!!

    Alex
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    One thing I see in new nurses on our neuro ICU is they do not understand the emotional toll they will encounter everyday. The neuro ICU is a sad place to work. We do have those cases that really lift you and and make you proud, but they feel far between. We recently had a 48 hour period where 8 patients died. Our new nurses had a really hard time with that one. Make sure you are mentally and emotionally prepared, neuro ICU is not a happy place to work but it can be very rewarding.
  8. 1
    Wow, this is Déjà vu all over again! I had my senior practicum in an ICU as well (not neuro, cardiovascular recovery). I was hired into the neuro ICU as a new grad and almost had a heart attack when the final offer was made. Eight months down the line and I can't imagine working anywhere else. Here's my survival guide to working in the neuro ICU as a new grad:

    1.) First and foremost, but kind to yourself. The first year of nursing sucks balls. Situations will be overwhelming enough with you berating yourself on top of it. Work on positive self-talk and just honestly give yourself a break.

    2.) If you don't know, ask. Honestly no one has ever been annoyed by me asking questions at work. Even the neurosurgeons enjoy my questions. Just make sure you approach them correctly, some people have egos and they think you're challenging their decisions. Just be curious and genuine in your search for knowledge.

    3.) Get a second opinion. If you think someone's pupils are fixed or uneven, get another pair of eyes in there. If they confirm your suspicions, contact the MD. I'm probably more responsible for most of the superfluous STAT CT of the head on my unit, but it's better safe than sorry. Sometimes the doctors disagree and just watch, sometimes they agree and have me go down for the CT right away. It's not your job to decide, it's your job to notify them of neurological changes.

    4.) Understand that most of the patients are helplessly messed up. Do your best, but don't take it personally when they deteriorate. There are a few miracles here and there, but they are far and few between. But it's so cool when they happen!

    5.) Learn everything. Simple enough right? Always carry a little notebook and scribble anything you don't know about. Either as for clarification immediately or go to the computer and look things up. Get the Joanne Hickey book and read it well, take advantage of any neuro learning opportunities at your hospital like traumatic brain injuries seminars and whatnot.

    6.) If you are unfamiliar with any of the machinery, go to the manufacturer's website and read up on it. Things like EVDs, Caminos, lumbar drains, ICP monitors, VAMPs, Flotracks, etc. can all be googled and read up on. There's really no substitution for just touching it all yourself and doing it, but you can practice with them once they've been removed from the patients. Practice setting them up.

    7.) Be humble. I can't tell you how many times this has saved me. Most people are scared of new grads in the ICU because they think we are pompous and think we know everything. Show them that you're interested in learning and they'll love you.

    My last bit of advice is to enjoy it. You only get to be new once, so take advantage of your orientation. See as many procedures and brain surgeries as possible. Try to get the most complicated patients because your preceptor will always have your back. Go for the unstable patient with increased ICPs in a pentobarb coma with continuous EEG and 7-8 drips. You won't get to have that much fun again in a long time, so take advantage of it!

    Wow okay, that was long-winded. If you have any specific questions, private message me. Welcome to the neuro ICU, it's gonna be one hell of a ride!
    m2theRZA likes this.
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    Hi,

    I just got an offer to work at the Neuro-ICU Unit last Monday. I am a new grad nurse so I'm excited but anxious that I will go straight to the ICU. What topics, procedure, medications or things I should read in advance??? I want to prepared as much as I can.


    Thank You All and God Bless!

    Alex
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    Hi,

    Also, can someone here give me a good book that I can read????


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