It is very difficult to go straight from nursing school
to an ICU. Even more specialized is a Neuro ICU. The care is based fully on assessment skills. It is up to you as a nurse to recognize neuro changes before it is too late for something to be done. Going for a stat head CT becomes a regular occurance, as you have already discovered I'm sure.
1. My best piece of advice is rely on the input of your co-workers who have been there longer. Anytime you sense a change in your pt, bring the charge nurse into the room to observe with you. Call the Neurosurgeon right away, don't wait until its too late. Give him/her the chance to make the decision on what to do based on your assessment.
2.Never get slack on doing hourly neuro assessments. Check those pupils, LOC, and reflexes EVER SINGLE HOUR!
3. Do your reading on neuro specific conditions. Know why and when Mannitol, 3% Saline, steroids, paralytics, and Nimotop are used. Know the anatomy of the brain so you can understand where certain strokes occur and what physical symptoms may result.
4. When you are helping a neurosurgeon with a procedure at the bedside (bolt, monitor, drain...etc) let him/her know that you are new so they don't get frustrated with your speed. In general, they will be much more understanding if they know you are still learning.
These are just a few things that I learned in my first two years in the Neuro ICU (which is the GREATEST place to work in my opinion).
Have fun, learn lots!