Eating ice cream and getting nervous -- offered Neuro-ICU job, now a psych nurse

[pixierose, BSN, RN]

So, I've been a new nurse for 10 months ... in psych nursing.

I just received a job offer from a neuro- trauma ICU, same hospital.

I AM SCARED TO DEATH.

My job now? It's comfortable: good hours, good people, and I do enjoy psych. But even though I do some medical, I miss doing more of it (I really liked clinicals from school)

But that's the thing: I'm *comfortable.*

The new job? More hours, but very good reputation. Good orientation. I know several people there and they enjoy it. More $$$.

But it's an ICU, so very different from psych, and I'm just ... scared? Afraid I'll fail. I'm also very laid back. Very type B personality.

My questions are: how long did you stay at your first job? Did you regret moving to "greener pastures?" Is it normal to feel this nervous moving from such a different specialty? Am I crazy for thinking I should be even thinking I could go to the neuro ICU from psych? Hell, I used to be a SPED teacher back in the day ....

Ok, that's a lot of questions. I'm going to hit the chocolate chip cookie dough and try not to panic.

[missmollie, ADN, BSN, RN]

I can't say anything about moving to greener pastures, but I can answer questions related to neuro nursing, so pm me if you have questions. I work in neurosurgery, but we get overflow from neurology. Given the nature of the patients, I feel that psych nursing will be a benefit to working in neuro.

The questions you need to answer for yourself is what benefit is there for you? Do you need the increase in pay, do you want the experience, do you desire an ICU experience? Finally, have you ever worked in neuro before, and if not, can you pick up a day as an overtime and work in acute/progressive to see if you like it, or could you shadow someone in the ICU for a day?

Neuro is a different beast altogether, and when we have people pulled to our floor, they either love it or hate it. There is no in-between.

My best advice is to think about why you want to make this change, and make that decision based on good information and an understanding of what the job entails. Best of luck!

[nutella, MSN, RN]

To be honest - I think you are going to be fine.

I worked in neuro ICU many years ago but I doubt that too many things have changed in that area. The folks who had significant trauma in their head - no matter what -where often intubated and sedated for some while with daily wake ups etc.. Once they have to wake up for real , they would go through agitation/confusion etc..There were many hours I had to spend literally sitting next to the bed because the physician did not want to sedate them in any way and the patient was constantly needing redirecting and such. But it was not the same acuity and craziness that I experienced in CCU. You need a lot of patience in neuro ....

[Davey Do]

Wow, pixierose. Tough decision.

I started out in Psych as an LPN and worked the unit for 2 1/2 years before getting out and into OR. But I really wanted to taste the medical end of things.

The thing is, I never spent more than a couple years in a medical area. For one reason or another, I always ended back in Psych.

The other posters gave great info, advice and support.

The thing is- you have to make the decision based on what's best for you, so go do what you want to do. The very best to you, pixierose!

[MurseJJ]

I can't say anything about moving to greener pastures, but I can answer questions related to neuro nursing, so pm me if you have questions. I work in neurosurgery, but we get overflow from neurology. Given the nature of the patients, I feel that psych nursing will be a benefit to working in neuro.

The questions you need to answer for yourself is what benefit is there for you? Do you need the increase in pay, do you want the experience, do you desire an ICU experience? Finally, have you ever worked in neuro before, and if not, can you pick up a day as an overtime and work in acute/progressive to see if you like it, or could you shadow someone in the ICU for a day?

Neuro is a different beast altogether, and when we have people pulled to our floor, they either love it or hate it. There is no in-between.

My best advice is to think about why you want to make this change, and make that decision based on good information and an understanding of what the job entails. Best of luck!

Agreed. I also work on a neurosurg stepdown, and we get neurology patients as well. A psych background will definitely not go to waste in neuro, even in the neuro ICU (I actually have a coworker on my unit that was a psych RN for years then came to our unit, and she's great). She recently did an inservice on managing psychiatric presentations and therapeutic communication on the unit). I'm actually doing research on post-stroke depression, a major stroke complication, and have looked into the psychiatric implications of neuroscience diseases. There's a lot there.

And yes, with neuro, many either love it or hate it. Many times when I say I work in neuro, I get the s visceral, "why would you do that?" look/reaction, haha. If you're interested in the brain, neuro-trauma ICU can be fascinating. Presumably in addition to the usual ICU interventions, you'll also have brain-related monitors (brain tissue oxygenation, definitely ICP monitors, cerebral microdialysis, cerebral blood flow monitors, EEG, transcranial dopplers, etc).

Think about it, you're basically expanding your knowledge related to caring for patients with brain disorders and diseases.

Good luck!

[pixierose, BSN, RN]

I can't say anything about moving to greener pastures, but I can answer questions related to neuro nursing, so pm me if you have questions. I work in neurosurgery, but we get overflow from neurology. Given the nature of the patients, I feel that psych nursing will be a benefit to working in neuro.

The questions you need to answer for yourself is what benefit is there for you? Do you need the increase in pay, do you want the experience, do you desire an ICU experience? Finally, have you ever worked in neuro before, and if not, can you pick up a day as an overtime and work in acute/progressive to see if you like it, or could you shadow someone in the ICU for a day?

Neuro is a different beast altogether, and when we have people pulled to our floor, they either love it or hate it. There is no in-between.

My best advice is to think about why you want to make this change, and make that decision based on good information and an understanding of what the job entails. Best of luck!

Good questions to think about.

The job fell into my lap. I've been unhappy where I've been (management, not the job), so I threw my resume out there. Lo and behold, here we are. I never truly desired an ICU experience but I liked what I saw at the end of my interview when the NM took me around. I liked what I heard.

I think I'd like to request a shadow experience; I did ask at the interview, and they said they were good with it....

[pixierose, BSN, RN]

To be honest - I think you are going to be fine.

I worked in neuro ICU many years ago but I doubt that too many things have changed in that area. The folks who had significant trauma in their head - no matter what -where often intubated and sedated for some while with daily wake ups etc.. Once they have to wake up for real , they would go through agitation/confusion etc..There were many hours I had to spend literally sitting next to the bed because the physician did not want to sedate them in any way and the patient was constantly needing redirecting and such. But it was not the same acuity and craziness that I experienced in CCU. You need a lot of patience in neuro ....

Not the same acuity and craziness... I can definitely deal with that.

[pixierose, BSN, RN]

Wow, pixierose. Tough decision.

I started out in Psych as an LPN and worked the unit for 2 1/2 years before getting out and into OR. But I really wanted to taste the medical end of things.

The thing is, I never spent more than a couple years in a medical area. For one reason or another, I always ended back in Psych.

The other posters gave great info, advice and support.

The thing is- you have to make the decision based on what's best for you, so go do what you want to do. The very best to you, pixierose!

I'm wondering if this would be me too, Davey ... the entire time in nursing school, I wanted psych. Now I'm thinking about doing this. I think I'm nuts. I have a feeling I'll retire in psych...

[pixierose, BSN, RN]

Agreed. I also work on a neurosurg stepdown, and we get neurology patients as well. A psych background will definitely not go to waste in neuro, even in the neuro ICU (I actually have a coworker on my unit that was a psych RN for years then came to our unit, and she's great). She recently did an inservice on managing psychiatric presentations and therapeutic communication on the unit). I'm actually doing research on post-stroke depression, a major stroke complication, and have looked into the psychiatric implications of neuroscience diseases. There's a lot there.

And yes, with neuro, many either love it or hate it. Many times when I say I work in neuro, I get the s visceral, "why would you do that?" look/reaction, haha. If you're interested in the brain, neuro-trauma ICU can be fascinating. Presumably in addition to the usual ICU interventions, you'll also have brain-related monitors (brain tissue oxygenation, definitely ICP monitors, cerebral microdialysis, cerebral blood flow monitors, EEG, transcranial dopplers, etc).

Think about it, you're basically expanding your knowledge related to caring for patients with brain disorders and diseases.

Good luck!

Ok, this made me feel a lot better -- thanks!

[anewsns]

If you get a good orientation and are honest with what you need to know and ask a lot of questions you should be fine. I'm also the "very type B" kind in neuro step down. Just be mindful of small changes in status and air on the side of caution.

[Meriwhen, ASN, BSN, MSN, RN]

I'm wondering if this would be me too, Davey ... the entire time in nursing school, I wanted psych. Now I'm thinking about doing this. I think I'm nuts. I have a feeling I'll retire in psych...

Nah, you're not nuts: you're just looking at quite the specialty change. Well, they are related in a way...

I agree about requesting to shadow first before taking the job. It's one thing to see the unit during an interview...it's another to spend 12 straight hours in the trenches because that's going to really show you what working there will be like. After a shadow day or two, you may still like what you see, or you might decide it's not really that great after all. And either one is OK.

If you do accept the job, don't worry: psych patients are everywhere, even in neuro ICUs. So at least you'd know how to handle any mental health issues that arise :)

Best of luck whatever you decide!

[Lennonninja, MSN, APRN, NP]

If you're interested in the brain, neuro-trauma ICU can be fascinating. Presumably in addition to the usual ICU interventions, you'll also have brain-related monitors (brain tissue oxygenation, definitely ICP monitors, cerebral microdialysis, cerebral blood flow monitors, EEG, transcranial dopplers, etc).

Thanks to you I'm now googling cerebral microdialysis and it's both fascinating and horrifying!