Difference between neurological nursing and psych nursing

KelRN215, BSN, RN · Nov 3, 2012

They're very different but there is some overlap. Neuro nurses take care of patients with neurological diseases and psychiatric nurses take care of patients with mental illness. I worked in neurology for years and my unit was neurology, neurosurgery and neuro-oncology. Our primary diagnoses were seizures, brain tumors and hydrocephalus. We also saw some really, really rare congenital malformations and degenerative diseases. An adult neurology unit would probably see a lot of stroke, MS, Parkinson's, Alzheimer's (some cross over with psych there) and epilepsy with some other neurodegenerative diseases like Huntington's and ALS thrown in there.

Psych is very diverse and there are a lot of very specific areas you could work in. An eating disorders unit, for example, is quite different from a substance abuse unit. When I was in nursing school, our clinicals were on one of 3 units in psych: an acute care unit that was primarily patients who'd attempted suicide and people with bipolar disorder or schizophrenia who stopped taking their meds, a substance abuse unit and a woman's unit where the primary diagnoses were Borderline Personality Disorder and PTSD.

Most psych units operate completely differently than your average med/surg specialty unit. Every psych unit I've ever experienced operates as a milieu with multiple groups/day.

CharmC28 · Nov 13, 2012

Neuroscience unit get pt's with strokes, post-op Neuro sx, brain tumors, headaches, syncopes, or maybe even falls with head injuries. Psych units receive patients with mental illnesses. I work in a Neuro floor and we do get altered mental status a lot, but there's typically a significant history from the patient that requires a Neuro consult.

Hope this was somewhat helpful! :yes:

funvirgoRN · Nov 14, 2012

They are completely different. I have years of experience in neuro and a few years ago started working in psych because I felt it would be fascinating to work in an area that focuses on another aspect of the brain. Also I wanted something that was less demanding than bedside. Psych even though it's not physically demanding can be very mentally taxing. They both are rewarding and challenging but on different levels. On neuro the average is 4-5 pts per nurse. Sometimes less, lumbar drains, ICP monitors, more critical high acuity kids may make some nurses 2 or 3:1 while others go up to 5 or 6 pts. Often times we only have 1 tech on the floor, so a lot of the work we do ourselves. Majority of our pts are q2 vs/n, so you are in the rooms a lot. The psych facility I work at is different. The nurses are responsible for assisting in maintaining the milieu, giving meds, admissions and discharges, attending treatment planning, delegating tasks. We have psych techs that are responsible for running the groups. We do interact with the patients and address any concerns they have. Pysch is more talking and documentation. The unit I work on is a 50 bed max capacity and the nurses are responsible for the whole unit. It's not broken up into separate assignments. Usually one nurse will do charge, one will do meds and if there is another they will assist where needed. Documentation of patients is divided amongst all staff. Prior to doing psych, I thought I would love it so much I would want to stop working in neuro. That has yet to happen. If there is anything else I can answer for you feel free to ask.

TechnoDanceNurse · Sep 16, 2019

Neuro - you are doing heavy medical stuff, like IV, central lines, NG tubes other kinds of crazy tubes (like EVD drains)... you are doing lots of vitals and neuro checks - often on confused patients who will pull out their catheters and try to climb out of bed, play with their feces, etc. Lots of total cares - you will likely be doing feeding, bed baths, turning, brief changes, transfers, etc.

Psych - mostly oral meds, with an occasional feces-player-type. Mostly verbal/visual assessments. Mostly independent with ADLs.