A Day in the Life of a NeuroNurse!
- 0May 14, '13 by anxioustudentHey guys! (: I'm finishing up my pre-req's before I start my nursing courses. I am going to be a 5th generation nurse, so it's the only thing I have ever wanted to be! No confusion there... Just confused on what I want to specialize in. I have always wanted to work in the Emergency Room. (Both my parents were EMT's, that's where they met!) Years ago, I wanted to specialize in burn surgery. Then I got married at the young age of 17 and was shipped over seas as a military wife to the UK! Needless to say, my nursing career was put on hold. For the next two years I debated burn surgery or neonatal as my specialty I was stuck on becoming a neonatal nurse for some time. Well almost four years later.. After doing my pre-req's and taking all my psych classes, I am now stuck on neuroscience. I am very interested in it, and was super excited when I found it listed as a catergory on here!
So my questions to you wonderful nurses... What is like to be a neuronurse? How did you specialize? How long did it take? What was it like at first on the floor?
Any and all advice/information would be greatly appreciated.
Thank you all <3 (:
- 0Jul 18, '13 by afoxSo I'm on a general floor. We care for 5-6 patient's a night. I have a lot of stroke patient's who can be anywhere from a normal person with no residual effects (just watching them/waiting to d/c them) or someone who is absolutely dependent on care. We get a lot of patient's who have seizures. G-tubes are common of my floor because a lot of people have been dysphagic. We get central lines/foleys. We also have patients with spinal cord injuries, spine surgery, brain surgery, MS, Lou Gherigs, meningitis. I've seen a lot of motorcycle accidents where they remove a portion of the skull to allow for swelling. I see a lot of Lumbar puntures done. Confused patients are normal to have. We take general medical overflow patients, too. Basically- i get the more stabilized Neuro patients and the ICU/Intermediate floor gets more critical patients, but then they come to us.
Every night is different for me. We do Q4 hour neuro assessments. (Our intermediate floor does Q2 hour checks and have 2-3 patients and our Neuro ICU does Q1 hour assessments and has 1-2 patients.)
My friend works in the Neuro ICU and see's a alot of motor cycle accidents and blunt force trauma. Yesterday she had a young guy who shot himself in the head but failed to die right away. So they do a lot of organ donation and dealing with hysterical families.
if you can think of any specific questions, ask and i'll try to answer.
- 2Jul 18, '13 by Cinquefoil, BSN, RNWhat is it like as a neuro nurse? ALWAYS INTERESTING!
Your patients may have thinking processes that just don't line up with reality, but each patient has a different variation of that. I've had a walkie-talkie, A&O x3 or 4 patient that JUST COULDN'T UNDERSTAND why we freaked out when they removed all the dressings from their orthopedic injuries and started improvising their own TX (and then got mildly combative when we tried to be involved in re-wrapping the bandages). I've had patients that were barely able to move their limbs, trached, aphasic, unable to swallow, NG or PEG tube, to be turned every 2 hours, who I WOULD SWEAR understood 80% of what was going on and why, and who were cooperative and pleasant. Also hemiplegic patients screaming and cursing like sailors one moment, then singing along to pop songs the next.
On our units, neuro checks every 4 hours are standard, making copying forward (and then accurately editing!) documentation a very useful skill to have. Also useful: a good sense for subtle changes in patient's mentation, and a stealth (conversational) way of accurately assessing how oriented the patient is.
Expect Traumas, CIWAS, strokes, aneurysms, spinal precautions. EXPECT PAIN! Neuro patients tend to be left in more pain than some other patients, because too much pain medicine would make it harder to see neurological changes until they're BIG changes. It's useful to ask the doc what the patient can expect their pain to be out of 10 after any given procedure, and then to reinforce that with the patient when you're talking to them. Also try to find out how long the pain usually lasts.
Fall risk management and knowing how to cajole sitters out of management when there are none to be had are big skills. Also knowing when to ask for restraints, to keep those hard-won NG tubes, embattled PEG tubes, and much-touched IV's in place.
Mood swings and head trauma are best buddies. Neuro is a hard specialty if you want to know that your patients feel satisfied with the care you're giving them (you may be giving great care; they may or may not have the capacity to remember what you're doing or why, PLUS the pain issue), but great for honing assessment skills, knowledge gathering, being there for patient families, developing good nonverbal communication, and seeing dramatic turnarounds. Brains are truly amazing in how they can build new connections, and you can literally see patients' personalities, motor skills, and thinking improve shift by shift.