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New grad starting on Neuro-tele unit... nervous!

Nurses   (8,461 Views 11 Comments)
by brina8615 brina8615 (New Member) New Member

1,943 Visitors; 24 Posts

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I graduated with my BSN in May and was just offered a position on a 41 bed Neuro-tele unit. I was hoping someone on here had some advice for me. I'm really nervous and unsure of what to expect. I tend to lack confidence in myself and make myself more anxious by thinking that I'm not ready to handle this kind of responsibility. But, I am smart and eager to learn. I don't know anything about neuro (or tele actually). Besides stroke patients, what will I see? And since it's not ICU, what kind of things will I be doing with/for the stroke patients?

I'm just looking for any advice/tips on being a good neuro-tele nurse and on what to expect. Is there anything I should be reading up on before starting in 3 weeks? It is part of the Versant new grad residency program, so I am going to have 18 weeks of training which includes an EKG course and critical care training.

I've always wanted to do pediatrics, but in this economy, I've been told over and over that it's best to just take whatever job you can for now, so that's what I'm doing. Unfortunately, I have to sign a 3-year contract. However, I feel like the training I am going to get and the skills I will acquire here will prepare me well for the rest of my nursing career... and the pay is good!

The other thing is this is a night position. Any tips on making the transition to nights easier? I think it will be better to start out on nights because it will be a less chaotic atmosphere (and I don't have a choice)... but I will have 8 patients, so I'm sure it will still be BUSY. Does 8:1 seem realistic/safe to you? It seems like a lot of patients to me!

Basically I just want someone to tell me that everything is going to be okay! :hug:

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1,438 Visitors; 19 Posts

First off Congrats on the job - I graduated 2 yrs ago and started on a tele unit which gets a bit of everything including stroke pts. You will do fine. It's scary starting out, ask questions and don't be too vocal as you start out. Watch, listen and learn. Find supportive coworkers and accept that you won't know everything starting out - no one expects you to, but you will learn and become a great nurse!

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474 Visitors; 3 Posts

Wow, again, Congratulations!!! I can't offer you any advice yet b/c I'm still looking for a job but I just had to comment b/c you sound exactly like me, excited, nervous, and scared. Just fortunately for you, you have a job already, I'm still waiting...I graduated in May and got my license in the end of June and I'm still waiting. But neuro.-tele, WOW that sounds fun, exciting, nervewrecking...lol, well you already know :) I'm very happy for you, I don't know where you're from but here in miami positions for new grads is practically dead, there is nothing at all and I'm just about to lose my mind. I'm assuming you'll see stroke pts., all different kinds of brain injuries, should be VERY interesting. I wish you the best of luck, and maybe after your first day you'll be able to come back here and talk about how amazing it was!!! ;)

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1,718 Visitors; 41 Posts

Wow, congratulations!! It's tough getting a job in this economy!!!

Well, to be honest, 8 pts in a hospital seems like a lot to me, especially on a Neuro unit... and a 3-year contract, is that with the hospital, or the unit itself. But I guess hospitals have the upper hand these days and can request pretty much everything! I'm sure you'll love it and I'm sure that orientation will be sufficient enough to train you how to care for 8 pts.

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1,943 Visitors; 24 Posts

It's a 2 year commitment to the hiring unit and then 3 years with the hospital. I don't know for sure, but I believe it's 3 years instead of 2 because I'm getting a sign-on bonus (at least I hope so! I'll find out at the pre-hire meeting on Friday), either way I'm really scared of the contract... it makes me feel like I'm trapped! If I want to leave, I have to give them $10,000. I'm trying to be positive though and hope that I like it there!

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17,210 Visitors; 1,338 Posts

Congrats on the new gig!

I will say start by reviewing your cardiac and neuro systems. Review your assessment skills for each system. Know what to look for neuro (pupils, LOC, follows commands, equal strength in all extremities, response to touch). Know what to look for cardiac (BP, HR, apical HR, heart sounds, radial and pedal pulses, cap refill, skin tugor, edema, temp) Review your electrolytes and know the lab values of each (which will probably be different for your hospital). Go over cardiac and neuro drugs. Know the difference between an ACE-I and a calicum channel blocker. Know what to look for when a patient is having a seizure, know your anti-seizure meds. Know what to look for when patients are going through ETOH withdrawal because I'm quite sure you will get alot of them on your floor.

I'm quite sure you will learn about EKG rythms, strips, and blocks in your EKG class.

Good luck to you! You will be fine.

Edited by shoegalRN
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PAERRN20 has 3 years experience and specializes in ER.

7,002 Visitors; 660 Posts

Not to be a downer, but a 3 year commitment would be a deal breaker for me. Think long and hard about this!

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8,428 Visitors; 506 Posts

Out of curiosity, what state is this in? I think I know what hospital it is. :) If so, congrats!

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lkwashington has 4 years experience and specializes in Tele, ICU, ED, Nurse Instructor,.

5,238 Visitors; 557 Posts

The ten thousand dollars you would have to pay back if you leave; I can understand this because it cost so much to train a new nurse. So the company has to get some of their money back because they are taking a chance also. This is the reason why most facilities are not hiring new grads due some may be leaving after six months to a year. A nurse only needs a year of experience to pretty much work any specialty they want. The hospitals are not taking chances believe it or not they are going to get their money.

There are certain courses you can take at the facility I work. You have to work a year before leaving. If you leave before a year after taking the course you would have to pay back. Life is a chance. You can wait and see what else can come by or try and see if would work out for you. Some nurses are working as CNA's this is lower pay.

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Zaphod has 4 years experience as a BSN, RN and specializes in ICU-CCRN, CVICU, SRNA.

5,816 Visitors; 181 Posts

que? work as a CNA?Not after spending all that time and money for the RN. I say go for the job-it will be tough and will get even worse. But after a year or two you will be very marketable and it might be a different environment for nursing all together.Dont worry so much about the contract-I am yet to see anyone pay those back and have consequences. Seriously, does anyone think that hospitals are overall on the loosing end when they hire a new grad. The pay is ridicilous and much lower than for per diem or agency, so they get a super cheep CNA salary nurse working for a year or so and then you have to pay back for the training for the job you did. I mean you have to get training for any job in this world and yet we as nurses take this crap from hospitals and agree-yes, we have to pay for our training(zombie like voice:)Anyways, sorry for the rant (not a fan of hospitals), but congratulations on your job-as soon as you are on your feet and know what you are doing start thinking about what YOU like and want.

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ittibittinurse has 18 years experience and specializes in med/surg and adult critical care.

1,865 Visitors; 37 Posts

Just remember that no question is a stupid question. Neuro patients sometimes have very subtle changes...and those subtle changes can be a big deal....so don't be afraid to let your charge nurse and the docs know these things....grown some thick skin.....be on time....and study all your drugs, assessments, cardiac and neuro conditions....you should be fine.

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