Neurology

locolorenzo22, BSN, RN · Apr 22, 2009

I work on a ortho/neuro floor, and when it comes to neurology, it depends on what each case presents with. back surgeries have post op orders, neuro checks, monitoring for numbness/tingling, etc. strokes have dysphagia screens, neuro checks, etc. It just depends on what you need to do.

VORB · Apr 22, 2009

Generally neuro checks every 1-4 hours (sometimes 8) depending on your dept and the doc's order (in ICU it may be q1, while on the floor it may be q4), plus full NIH stroke scale assessment every shift on stroke patients. And the off-going nurse cannot leave before the oncoming does their NIH stroke assessment and their assessments agree. Any change in neuro status gets a call to the doc, but of course that goes for any patient.

Pay is the same as any medical/surgical department, as is patient load (5-7 in my facility).

MB37 · Apr 22, 2009

Pay is based on experience and facility - it's no more or less than cardiac or peds. I work in a neuroscience ICU, where we take care of strokes, aneurysms, traumas, s/p craniotomies/tumor resections, and other categories as needed. We also sometimes get the psych patients that happen to need ICU care. We do q1h neuro checks, keep most of our sick patients vented and sedated (except sedation holidays for assessment, of course), keep rooms dark and halls quiet, and do a lot of coordination between neurology, neurosurgery, trauma, critical care, and other medical teams as needed. We titrate vasoactive drips - typically to keep the pts hypertensive, within a specified range - as well as sedation, insulin, and other meds. You can't fake a neuro check by looking at the monitor, so you actually have to go in and use your assessment skills many times throughout your shift. Most nurses seem to either love or hate neuro ICU.