New Grad

fresnovet · Jul 9, 2017

I am about to embark on the same path, I start next month. What advice do you have for me? Considering that you have been working for some months now. Me: New Grad, BSN; Confident, fast learner, and passionate.

daxdagr8t · Jul 12, 2017

I'm starting on the 24th as a new grad as well. I have two years experience as a LPN Psych Nurse just hoping I can survive the residency.

Okami_CCRN, BSN, RN · Jul 15, 2017

Oh boy, congratulations on landing a job in Neuro ICU. I occasionally work in a Neuro ICU, so here are some of the things you can expect to see

-Tons of interventional radiology cases (coilings, embolectomies, intra-arterial cardene/TPA, clot retrievals)

-2% Saline, 3% Saline, and when it's really bad 23.5% Saline

-Temperature Management

-Video EEG

-Ventrics/subarachnoid bolts/screws

-Nimodipine (such big pills)

-Very high BP parameters (expect to maintain SBP of 150-200 at times)

-vasopressors (mostly NeoSynephrine)

-arterial lines, triple lumens, PICC's

-Q1h neuro checks for everyone

-Precedex (do they make it for inhalation yet?)

Just remember these patients will look like hell, but it's always a treat when they come back to visit!

fresnovet · Jul 17, 2017

Thank you for the update! When you say occasionally... is it because you are doing orientation through step-downs? You just started right?

Okami_CCRN, BSN, RN · Jul 18, 2017

Thank you for the update! When you say occasionally... is it because you are doing orientation through step-downs? You just started right?

I primarily work in a mixed medical/surgical ICU and float on occasion to the Neuro ICU.

We do not float/orient to step-down, and I have been working there for quite a while.

fresnovet · Jul 18, 2017

I primarily work in a mixed medical/surgical ICU and float on occasion to the Neuro ICU.
We do not float/orient to step-down, and I have been working there for quite a while.

Oh no my apologies, I assumed you were the original poster miznurse17. That was why I asked you those questions too now that I think about it. The info you provided was very helpful. Thanks again.

ICURN1028 · Jul 29, 2017

The biggest piece of advice I can give to you as a new grad (whether working in med/surg, neuro ICU, ER, etc) is to bring a small notebook and jot down notes regarding the diagnoses/procedures/medications/treatments/etc you encounter. Look these up on your days off (even just 30 minutes of reviewing) and soon these unfamiliar terms will be like a second language to you. You will greatly benefit by learning not only the 'how' but the 'why'. Good luck!

fresnovet · Jul 29, 2017

Thank you ICURN, I will be sure to keep a clinical log on those key points that you provided.

miznurse17 · Jul 30, 2017

Fresnovet, although I was hired in February, I didn't graduate school until May, and didn't start until last week! Last week was all hospital wide orientation, so I will finally be on the unit this week :)! I will post again in a few days after I get a few shifts under my belt. Good luck to you!

Delia37, MSN · Aug 1, 2017

Hey everyone! I just recently accepted a position in a stroke certified Neurosurgical ICU at a level 1 trauma center, and will be starting sometime in June or July after I graduate with my BSN in May. I have had some experience in critical care, but no experience at all when it comes to neuro, let alone a neuro ICU.
What kind of things can I expect to see intervention wise (ventilators, hemodynamic monitoring, ICP monitoring, etc)?
What kind of technical skills will I be utilizing?
And lastly, what is the best advice you can give a new graduate working in a neuro ICU?

The American Association of Neuroscience Nurses (AANN) website is a great resource, with current guidelines and procedures common to neuro patients.