New nurse on a Stroke Unit

MelEpiRN · May 17, 2012

Congrats! I'm sure you'll have plenty of mandated courses. You can go ahead and get certified in the NIHSS (stroke scale). It's free- go on stroke.org and click on Healthcare Professionals. It'll take a few hours to complete, so I'd start it as soon as you can.

Just be patient and ask tons of questions. Your hospital probably has a stroke coordinator- I'm sure whomever it is would be more than happy to help you learn!

Dray11 · Jun 9, 2012

I graduated last year and began working my first job on a neuro unit. There was a lot to learn but my coworkers are superb resources. I think it depends on the facility - I work in a facility that is the level 1 trauma center/big hospital with all the specialties in a state where many hospitals are regional hospitals or critical access hospitals. We get a lot of transfers from smaller facilities for rule out CVA, TIA or other disorders. My unit is neurology and neurosurgery and we share the floor our unit is located on with NSICU, we handle step down and general acuity patients. We take general med surg patients too depending on housewide census. Gen post surg patients are great - I had one last week readmitted with questionable infection in their incision - all I did for that patient was pass meds, control pain, do accuchecks and check in on them - they walked to the bathroom just fine, fed themselves etc. We are a tele unit and our units monitor tech watches the monitor for two other floors. A lot of neuro patients have cardiac issues too. Many of my patients are q2 neuro checks and q2 vitals.

Lots of CVA patients are out on one side or have major deficits so there is a lot we do for them. Then again though, I have had patients with a history of stroke and you can barely discern any lingering deficits. Lot of managing tube feeds/NGs/PEGs, lot of central line management, sleep apnea management (CPAP, BiPAP). Lots of our patients come on with increased confusion or CVA or TIA but they already have some form of impaired cognition or dementia. Some get combative. Because we get transfers for rule out brain mass we see a lot of inoperable brain tumors and palliative care patients. There are a lot of comorbidities to consider - patients with chronic kidney problems, on dialysis, patients with CHF, diabetes, COPD and actually a lot d patients with problems caused by polysubstance abuse.

We have some frequent fliers that provide entertainment for the unit staff. I had to have emergency surgery myself in April and had to take at least 4 weeks off work because of the amount of work we do with our patients. I just now (5 weeks after returning to work) feel like I'm not over exerting myself at work daily.

mh356, BSN, RN, EMT-B · Jun 14, 2012

If you have worked ER/Trauma and been an EMT then you should be fine on a neuro floor (just my 2 cents). I also worked as a tech in an ER as an EMT-loved that adrenalin rush, and I really enjoy the variety neuro provides me. The best advice I could give you is to just keep checking on your patients. Sometimes when they are quiet its not a good thing-I had a pt once that used her hemerrhoid cream as chapstick and another that loved to be naked (in front of her visiting son-in-law!) When I first started on my unit I bought a used Hickey book (Neurological and Neurosurgical Nursing) on Amazon and would look up diseases of my patients every night after work. That way I could apply what I was seeing to what I was reading and made such a difference.

JerseyNurse87 · Jun 16, 2012

Thanks everyone! Just started orientation.... taking in all the advice!

Madhu Latha Rouse · Jun 18, 2013

hello,

i am also a new nurse on stoke unit,just started from 1st of june 2013,and than q to jersey what ever answers you wil be getting ,that would be so helpful to me.thank u all.