Going to a Neuro ICU

Okami_CCRN, BSN, RN · Jan 24, 2017

It really depends on what kind of Neuro ICU you will be working, for example. I worked in a mixed medical/surgical ICU that took the stroke patients from the ER because our Neuro ICU was mainly neuro-surgical in nature.

I occasionally floated to Neuro ICU and I recommend you brush up on SAH, SDH, Status Epilepticus, brain tumors (GBM, etc), you get the idea. In terms of drugs review your drips particularly nicardipine, phenylephrine, esmolol, precedex, propofol, etc.

Other than that, the majority of your education will be done through a critical care course be it ECCO (essentials of critical care orientation) or a hospital provided course. Neuro ICU can be challenging and yes it is focused heavily on a good neuro exam, but in time with good support you will become competent. Best of luck.

sukinsin · Jan 25, 2017

Congrats. Hope you enjoy your new position.

OllieW, DNP, PhD, NP · Jan 25, 2017

Oh Neuro ICU where you spend half your day trying to keep your patients in bed and keep the EVDs in place. The fling and pull things and wiggle wiggle wiggle. Best of luck.

FDE123 · Jan 25, 2017

I expected that. But right now I come from a floor with 4:1-5:1 all bed jumpers and drug addicts and needy patient who won't stay still and pull off their tele and Ivs. I feel like the Neuro ICU will certainly have its challenging moments but at least I will only have a max of 3 patients within my general area being wiggle worms instead of 4-5 of them all at the end of different halls jumping out of bed and being self destructive or calling 1000 times in ten minutes because they want their pain meds or food trays or coffee. I really don't think anywhere could be as bad as the unit I'm currently on.

Workitinurfava, BSN, RN · Jan 30, 2017

Is not IMCU a form of ICU experience?

FDE123 · Jan 30, 2017

It is. However the hospital im at gives us critical patient with a medsurg staff ratio so it's extremely overwhelming

Cupquake12 · Jan 31, 2017

Congratulations! This is completely off topic but- may I ask how you landed the position?

I've been working in med surg/tele for about 13 months(10 months in one hospital, 3 months in another due to moving states). I'm really hoping to move to an ICU position, but every time I apply, I get rejected due to "lack of critical care experience". I have not joined AACN, and do not have my ACLS, yet.

I would love if you can give me some tips and share your story? What did you do during your 7 months that made you stand out? How did you apply to the ICU position? :)

8-ball, BSN · Jan 31, 2017

I work neuro ICU, you can start by getting your NIHSS or just watch the youtube video on how to do this assessment which will teach you the basics of how we assess, your hospital should pay for the class. Also you might be familiar with GCS if not youtube that as well. We do GCS Q1hr. Pupils assessment with PERRLA. Different lines we see from other ICUs are brain bolts, EVD, and lumbar drains. We do go to alot of CT scans and MRI, Neuro and trauma probably go to more scans than any other ICU, if you ever expect a change in neuro status anticipate a scan in your future.

FDE123 · Jan 31, 2017

The floor that I came from is considered a critical care step down unit. We got a lot of tach vents and drips that couldn't be on a med surg floor but didn't meet CCU criteria. I also came from a level 2 hospital and was a tech on the floor a little over a year before I became a nurse.

During the interview i told them what experience I had with the drips, vents, bipaps, strokes, etc and that I was really eager to learn and advance my knowledge. I also am not ACLS certified but most places allow 6 month grace periods for certification.

in your case, I would recommend becoming ACLS certified. It will show that you are ready to move onto the next level of nursing. And in your interviews mention what kind of patients you have. Post op heart cath, CABAG, etc. Also,mention you work on a telemetry fooor and are familiar with the 5-12 lead EKGs. Those are all things that boss's like to hear. If your interested in cardiac, maybe a Coronary Care Unit or a CVICU would be a good start for you.

I hope this helps :)