New Grad RN- Nervous about Neuro ICU Preceptorship

by DaughteroftheKing DaughteroftheKing Member

Specializes in Neuro ICU.

The Neuro ICU forum seems like a ghost town, so I figured I'd post out here :)

I am one of the very very blessed and fortunate new grad RNs (with LPN & CNA experience, but new as an RN) who got a job, and not only that in the very hospital & floor I so badly wanted!!

I start a 12 week preceptorship in the neuro ICU in July, and I am SUPER nervous.

I bought a "Neurological & Neurosurgical Nursing" book, got the first few chapters down on that, but I feel no matter what I'm going to walk in there as a big idiot. I mean, I did graduate nursing school with my clinical and classroom instructors always impressed with me, but really, as a new grad, I know just about NOTHING about being a neuro nurse in the ICU!

Just wanted to get some "It'll all be OK's" & ANY advice, tips, what not to do's, etc. from you nurses who have gone through this! :)

Thank you so much!

313RN, BSN, RN

Specializes in Neuro ICU. 1 Article; 113 Posts

I went to Neuro ICU as a new grad without any experience at all outside of Nursing school. One of my classmates started with me and we still get new grads hired regularly.

A 12 week orientation is a nice, long time to learn the basics of the job provided you have a good preceptor.

I find Neuro ICU to be pretty easy to handle compared to CICU. We also take MICU and SICU overflow, which aren't too bad either usually. If I was starting again I'd choose neuro ICU all over.

Ventrics are simple: open or closed. Impelas and ballon pumps and cordisis and swans- no thanks. Those patients are sick. The downside of neuro is the slow and/or incomplete recoveries.

As for hints and tips, I don't have too many. Just go to work every day, pay attention, ask a lot of questions and do your best.

You'll be fine.

Good luck.



Specializes in Cardiac. 68 Posts

Congrats on your job! You will be great!!!!



Specializes in Home Care. 1 Article; 2,188 Posts

Congrats to you!

I have a lot of respect for neuro ICU nurses, its a job I couldn't do. My son suffered a TBI several years ago before I became a nurse. Thankfully he made a full recovery.



Has 36 years experience. 1,246 Posts

Many hundreds of years ago, fresh out of nursing school, I started in neonatal ICU! Looking back, I can't believe that I had that much confidence in myself! I didn't know what I didn't know!!

You will be fine - lots of orientation! Take care!


Specializes in Level II Trauma Center ICU. Has 7 years experience. 365 Posts

I started in a general ICU within a level II trauma center as a new grad. I only had one yr of an externship on the pediatric floor as healthcare experience. Not to brag, but I must say that I thrived in the environment and I'm still there. I really like critical care; it's full of new challenges on a daily basis.

My suggestion would be to look up every med, test and diagnosis you're not familiar with. Be willing to admit what you don't know and ask questions! Be willing to help the other RNs in your free time, they will be your informal teachers as well. Don't be afraid to ask the docs questions as well; some of them are excellent teachers. I would also suggest that you participate in all of the codes you can if you're allowed (even if it's just as the recorder or compressor). It's the only way you will become comfortable in a code/crisis environment. Never, ever say "I've done that already" to anyone offering a learning experience; it's the fastest way to alienate your team. You don't ever want anyone to think you're a miss know it all because they will be tempted to let you sink or swim and you don't want that.

It's good that you're nervous, it means you respect the job and all it entails. It has been seven yrs for me and I still get nervous at times. I've had residents and hospitalists express nervousness too! Embrace it because it will keep you on your toes! Good luck to you!!



Specializes in Progressive Care Unit. Has 4 years experience. 76 Posts

I started in Neuro ICU when I was a new grad. All I can say is, you will learn most of the things there. Make most of your orientation and preceptorships. :)

Bring your penlight. You will be using it everyday. Assess your patients' pupils :eek: regularly. Sometimes, they just suddenly deteriorate. Most patients have the same drugs --Mannitol, Citicholine, Keppra, etc. Be in good terms with the CT scan people, you will be visiting them often. Don't strain your back, you will be turning comatose patients every 2 hours. You'll figure out the rest soon.

And yes, it'll all be Ok. :D :cheers:



185 Posts

Good luck!! I agree that it's good that you're nervous and eager to learn, your coworkers will pick up on that and be more apt to help you. I just got my first job too and take NCLEX-RN next Tuesday-I feel your pain!! I'm nervous about everything too (because I have no clue how much I don't know!) but the good thing is that I can't wait to find it all out and be an awesome nurse! good luck to you!

HouTx, BSN, MSN, EdD

Specializes in Critical Care, Education. Has 35 years experience. 9,051 Posts

I began nursing in a Neuro-Trauma ICU & loved it!!! Neuro is still my favorite clinical area. I think you'll find that neuro is more 'orderly' .... S & S are much more predictable than other organ systems. Take time to really learn neuro pathophys & it will be so much easier for you.

I can vividly remember my first few shifts after I transferred to a CVICU. It took me quite a while to get used to dealing with walking, talking patients. I kept forgetting that they had meal trays... and they got so messy and rumpled. My neuro patients generally stayed where I put them - LOL.

Let us know how it goes - hopefully, you'll earn that prestigious CNRN in no time at all.



Specializes in Neuro ICU. 213 Posts

Thank you all so much, I really appreciate it!! I'll continue to accept any more words of wisdom ;) haha.. always...

Well gonna go take your advice & hit the books!! Thanks again, and I cant wait :)



1 Post

I am in the same boat buddy

I am starting in neuro icu in two days

Just graduated here but i do have experience as a nurse.

Still i am stressed because i moved in Quebec since three yrs now and have been working for the past 2 yrs or so as an orderly

But the setting is different gud luck to U N ME TOO.

Dont worry we will b gr8 it just take tome and dedication

TheCommuter, BSN, RN

Specializes in Case mgmt., rehab, (CRRN), LTC & psych. Has 16 years experience. 226 Articles; 27,608 Posts

The Neuro ICU forum seems like a ghost town, so I figured I'd post out here :)
Moved to the Neuro ICU forum.
Dont worry we will b gr8 it just take tome and dedication
This thread was written five years ago. The original poster is now an experienced critical care nurse. Good luck with your new neuro ICU position!