RainClover157

- you can convince a patient that you don't know how to remove restraints.- your disinhibited patient grabs your chest and you move it away unphased- you've had patients poop on the floor- you walk into the room and find the patient on full spine precautions drinking from the suction cannister- you're more impressed than mad when a patient escapes from restraints- you convinced your patient to 'go camping' in a net bed- you think 'vitamin H' and ativan should be available as airsole or dart gun for administration!

I'm trying to see if I can upload our unit's report sheet but I'm having some issues... so stay tuned! There are a few sites that I found particularly helpful especially when first starting. It really helps you "get the big picture" when you know what area causes what symptoms.

Anyone have issues with lateral violence where you work? Like between RN's or 'nurses eating their young' It's a goal for our unit is working to decrease but I don't really think it's as bad on our unit as it is on others...

How much experience have you had in the nursing field? almost 3years Where do you work? Level 1 trauma teaching hospital in a neuro special care unit What is the hardest part of your job? Dealing with things that I have no control over and different personalities- pts, family, co-workers, support staff or management, attendings, residents and interns. What is the easiest part? I love it when I can make a difference What is the most important thing you learned in nursing school? I don't know everything but I do know somethings What advice would you give a new grad? Ask, ask, ask questions! Know your resources. Also this might seem wrong but always think 'worst case scenario'. For example, if your trach pt pulls out the trach- what are you going to do? Good luck on the paper!

I started as a new grad almost 3yrs ago and have been working in a Neuro special care unit since the very beginning... I'm new to allnurses.com though. Hope I can be somewhat helpful to all those newbies I see posting asking for support!

I work nights in a Neuro specialized care unit a step down from ICU and more critical than floor nursing in a large teaching hospital. Typical pts we care for- brain/spinal tumors, traumatic brain injuries and spinal cord injuries, aneurysms- clipping/coiling or ruptured, subarachnoid hemorrhage, subdural hematomas, seizures, stroke- ischemic/hemorrhagic, and neuromuscular disorders.. Also rare things like meningitis and encephalitis. A few things I can tell you... Patience is huge- like telling an impulsive pt a million times not to touch something or get up but they aren't aware of any deficits. Also when pts are confused and insisting the year is 1970 and they need to go somewhere. Communication challenges- like unable to speak, mixing up words or nonsensical speech, it can be frustrating for pts and for nurses. Neuro pts often have airway management and cardiac issues. We do oral suctioning, crushing meds and for more severe dysphasia- trachs/pegs or NG tubes also a variety of different types of O2. Cardiac gtts and monitoring. Neuro drains- subdural, extraventricular (sometimes placed at bedside), lumbar, externalized VP shunts. Some days its physically demanding- lifting totals, restraining aggitated/combative confused pts, ambulating stroke pts and mentally exhausting of course but what nursing isn't, right? Neuro changes can be very subtle and slow or decline quickly- hindsight is always 20/20. You have to notice the small decline like when something is 'just not right' and you have to appreciate the small improvements which can take so long see- like see someone spontaneously move a finger or squeeze your hand for the first time. Neuro pts also say/do the funniest things- actually thinking they are driving a car or making ham with beans while sitting in bed, asking the IV pole out on a date, attempting to chew out of restraints! It's hard work but I love it! It challenges me in more ways than I thought nursing could, I learn something everyday and wouldn't want to work anywhere else. Hope this helps a little!