Just got a new grad job in neuro - what to expect?

Specialties Neurological

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I was offered and accepted a position on the neuroscience floor. It is at a teaching hospital and is a certified stroke center. I have never set foot through the door, so I don't know what to expect. It's not anything that I planned on or imagined myself doing, but I'm sure I will learn a lot, and I'm just thankful to have a position lined up. During the interview, it was mentioned that there were several nurses who had been there for a long time - so I look forward to drawing from their knowledge and experience. From the literature I was given, their patient population includes: traumatic brain injuries, epidural & subdural hematomas, seizure disorders, cervical & lumbar strains, laminectomies, multiple sclerosis, Parkinson's, strokes, aneurysms, and subarachnoid hemorrhages.

I plan on reviewing all the above, cranial nerves, communication issues, and of course neuro assessment. Is there anything else you all recommend? Any insight on what I can expect, or tips to handle it? How well will this prepare me for other units/floors if I decide this isn't for me, long-term? What do you love about it, what do you hate about it?

Thanks!

Specializes in Pediatrics.

That was the main influence! I had a desire to help people on a more personal, hands-on level and was trying to decide if I should quit my secure, stable government job (in the midst of the recession). It just came down to "I'll go where You send me." Also, since I was in newborn screening, we always had pics & logos of little feet on everything.

And no, you are not old! :)

Specializes in Pediatrics.

Just a little update - I'm on orientation, and things seem to be going well. The staff seems supportive and always willing to help & answer my questions. There seems to be quite a bit of psych cases, but I think I'll also have a decent exposure to med-surg type "stuff" to build my foundation. All in all I think it's going to be ok. I may not want to stay there forever, but I'm feeling much better about it. Thanks for the support & encouragement!

Specializes in Oncolgy, Neuro, Med/Surg.

Thats awesome to hear, I work on a Neuro unit and love it, My best days are when I come back after 3 or 4 days off and see that pain in the A** patient that was combative, pulling lines every 10 min, in a halo, and 4 point restraints walking down the hall with family and the say hello and know my name. Now that is a great day!

I agree with all of the above. Neuro is a wild ride. You will learn a lot!

Off the top of my head advice:

- Use good body mechanics, lift with your legs, use the mechanized bed raising capabilities as much as possible.

-Turn patients who need help moving every 2 hours.

- Be proactive with the techs. You will learn wich ones you have to keep on top of about turning, changing wet or dirty diapers, bed baths etc. Be as helpfull to them as you can with out taking over their jobs for them.

- Don't be afraid of trachs, just go over the protocol before trach care the first couple of times and periodically after that.

- Never allow a patient with a feeding tube to lie flat with in a hour of feeding ( I have seen some nasty tube feed aspirations from patients who are a little out of it, or family members who are ignorant lowering the head of bed on their own, so lock the head of the bed at at least a 30 degree angle when the patient is getting tube feeds.

- keep coming back here with questions!!!

- Take care of your self, make sure you bring enough food and snacks, take vitamines, practice some sort of stress management other than the consumption of pills or alchohol.

I love this thread! I am also a New Grad RN and will start on the Neuro Unit next week at a certified stroke center and teaching hospital! I am SOOO excited to learn more and really apply what I have learned. I am taking all the advice that was given to Hands & Feet and have a review session before next week comes.

Thanks again for all the helpful advice!!!:nurse:

Me too I am soooo excited. I never went to neuro in clinicals so I didn't know what to expect. So far I have one more week of classwork before i hit the floor!

I love this thread! I am also a New Grad RN and will start on the Neuro Unit next week at a certified stroke center and teaching hospital! I am SOOO excited to learn more and really apply what I have learned. I am taking all the advice that was given to Hands & Feet and have a review session before next week comes.

Thanks again for all the helpful advice!!!:nurse:

I was just hired on a neuroscience floor. I have clerical experience in outpatient psych/substance abuse which I'm hoping will help me acclimate a bit. I didn't have clinicals on a neuro unit (lots of cardio...). I start orientation in a couple weeks. I'm very excited!

Specializes in Neuro-Surgical, GU, GYN, Med Surgical.

Hi all,

Thanks for all the post I am a new grad RN, I just started on a neurosurgical unit in Albert Einstein Hospital in the Bronx on Tuesday and I feel like Im lost..Is that normal? It is alot of work that I pray to master one day soon.....I felt very overwhelmed when the day was done...there is so much to do for each patient and to learn..I feel like Im in school again getting ready to take my unit exam....Please help with any advice, It would be greatly appreciated..I feel like Im all alone? Has anyone else felt this way when they started their first nursing job..Do you guys have any tips that can save my job..My probation is about 3 months and I would love to pass it...I love nursing so I want to do my best!!!..Thanks in advance!!!

Mocha Nurse

Specializes in Medsurg/ICU, Mental Health, Home Health.
Hi all,

Thanks for all the post I am a new grad RN, I just started on a neurosurgical unit in Albert Einstein Hospital in the Bronx on Tuesday and I feel like Im lost..Is that normal? It is alot of work that I pray to master one day soon.....I felt very overwhelmed when the day was done...there is so much to do for each patient and to learn..I feel like Im in school again getting ready to take my unit exam....Please help with any advice, It would be greatly appreciated..I feel like Im all alone? Has anyone else felt this way when they started their first nursing job..Do you guys have any tips that can save my job..My probation is about 3 months and I would love to pass it...I love nursing so I want to do my best!!!..Thanks in advance!!!

Mocha Nurse

Hi MochaNurse...

Every nurse feels like this at first. A Neurosurg unit is challenging for any level of nurse, from novice to expert. But you will learn SO much. I think you will be fine. Just learn as much as you can, ask preceptors and nurse educators available to you for help...remember, they want you to stay on your unit also. If they lose you they are out time and money training you. So ask for help - it is in their best interest that you succeed!

Specializes in Neuro-Surgical, GU, GYN, Med Surgical.
Hi MochaNurse...

Every nurse feels like this at first. A Neurosurg unit is challenging for any level of nurse, from novice to expert. But you will learn SO much. I think you will be fine. Just learn as much as you can, ask preceptors and nurse educators available to you for help...remember, they want you to stay on your unit also. If they lose you they are out time and money training you. So ask for help - it is in their best interest that you succeed!

Thank You so much for your response DeLanaHarvickWannabe I am very appreciative of your input. I have faith in GOD that I will be just fine. I will definitely take your advice and talk to my Preceptors and Nurse Educators. You are so right about the cost to train me as well as the time. Thanks so much Ill keep you posted as to how it goes from here on, I go back on the floor for 2 days starting tomorrow..I am so anxious and nervous but , I will say a prayer before i go.

Mocha Nurse..

First of all, congratulations!

The floor I work on is stroke overflow (stroke floor only has 19 beds) at a teaching hospital that is stroke certified, so we do receive quite a few neuro patients.

My first MedSurg clinical rotation, though, was on a floor that sounds like yours. (Same hospital - before it expanded and became really specialized - all neuro was lumped onto one floor). Oh my goodness, I learned SO MUCH! I personally think a neuro floor is a great choice for a new nurse, because you will perfect those skills you learned in school. The things you'll learn on that floor will help you in whatever field you enter in the future!

I'm not going to lie, it will be difficult. I think all new nursing jobs are, but neuro patients can be very stressful and the A & P involved is quite complex. But please do NOT give up...remember no matter what, that your AllNurses family is here for you!

As for what to study, I did a little research for you. (I am a huge dork who regularly spends $100 at a time on nursing books, even though I've been out of school for four years!)

These titles sound yummy! (Some are pricey, so shop around...all can be found on Amazon).

The Clinical Practice of Neurological and Neurosurgical Nursing (Clinical Practice of Neurological & Neurosurgical Nursing) - Joanne V. Hickey, 12/2008

Care of the Neurological Patient (Essential Clinical Skills for Nurses) - Helen Iggluden, 6/2006

Clinical Neuroanatomy Made Ridiculously Simple (3rd Edition) - Stephen Goldberg, 1/2007

Wish you the best!

Thank you for this post:up: I start as a new grad on the neurology/neurosurgery unit in Jan at Johns Hopkins Hospital:yeah: I would have never thought about Neuro until I did share time on the unit and learning all the different diagnosis that I could barely pronounce lol. I will do review with the literature you provided...

My only concern, as a new grad starting out in a specialty does that hinder you if you decide to go to another unit such as cardio?

Hickey's book is sort of the "Bible"...but there were errors re: pseudo seizures in the last edition I got (about 8 years ago). It gives good introductory info on a lot of neuro disorders, but for interest in specific diseases, you'll probably want to look for books on those disorders on their own.... it can get pricey, but there is SO much to learn.

But Hickey is a good intro book :)

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