High acuity Neuro ICU

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Recently accepted my first travel contract in a high acuity Neuro ICU at a Level 1 Trauma Center. I wasn't nervous, but the manager said she was hesitant because I worked in a neuro ICU at a Level 2 Trauma Center, not a Level 1. Should I be nervous...? I can take EVDs, post-op cranis, do ICP monitoring and treat DI, and have pretty extensive knowledge of all the drips (just got into CRNA school). Anyone have any tips? I don't know everything, but I am 100% willing to give it my best shot and I always recognize when I need help and where to identify resources. 

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& just to offer even more background about my experience: SAH, SDH, ICH, ischemic stroke tpa, DI have used hypertonic saline, clevidipine, nimodipine, EVDs for ICP monitoring, and know how to recognize signs of increased ICP, decompensation with neuro patients, vent settings, and critical drips like pressors, vasoactive meds and such. Her comment just scared me a little 

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anesthegia said:

& just to offer even more background about my experience: SAH, SDH, ICH, ischemic stroke tpa, DI have used hypertonic saline, clevidipine, nimodipine, EVDs for ICP monitoring, and know how to recognize signs of increased ICP, decompensation with neuro patients, vent settings, and critical drips like pressors, vasoactive meds and such. Her comment just scared me a little 

Her comment should scare you a little. You have a manager that has no idea what the actual, practical day to day bedside practice differences are in a neuro ICU for level I and II trauma centers...essentially zero.

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offlabel said:

Her comment should scare you a little. You have a manager that has no idea what the actual, practical day to day bedside practice differences are in a neuro ICU for level I and II trauma centers...essentially zero.

Meaning...? 

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anesthegia said:

Meaning...? 

If that isn't clear enough...can't help you...

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Specializes in ACNP-BC, Adult Critical Care, Cardiology.

I think...he meant that the difference between level I and level II trauma facilities is the research component and the ability to provide 24/7 mutli-specialty coverage for all types of complex traumas required for level I designation. In many cases, patients are essentially similar. You should ask the manager what is different in their unit vs yours.

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