Struggling new grad neuro nurse

MiladyMalarkey, ASN, BSN · Apr 9, 2020

All I can offer is encouragement. I'm 8 months in now, new grad like you on a neuro floor. Neuro was not necessarily my first choice or a subject I excelled at in nursing school, but then again I just wanted a job and was happy to get it.

In honesty, I didn't start feeling somewhat "okay" until I was forced out on my own. Basically, it is going to be trial and error and what works best for you. I felt more anxious on orientation than I did a month off of it. Not to say I don't still get nervous, I'm just less nervous now because I've learned how to get the help I need to answer the many, many things I don't know yet. I was nervous wreck like the first month out on my own, but remember YOU ARE NEVER ALONE, help is a coworker/charge nurse/phone call away.

And it is normal to struggle with who has what neuro dx, why the tx for this is this, normal. This is only something experience will bring...I've barely a head start on you so I'm still constantly learning still, there are neuro things I've not even heard about yet, that the nurse who have been there for 10 years haven't either, those rare neuro things pop up sometimes, so how can I possibly know the reasoning for tx ahead of time? It's a hard growing process.

It sucks to learn trial by fire, but that really is how we learn in this job. It will get better, you will feel better, give yourself time. Will this make your anxiety go away? Probably not. But overtime, you will notice that something that made you so anxious no longer does because you know what to do or know who to ask to find out what to do. Hang in there. Being a new nurse can be hard, give yourself some slack.

breezyRN315, ADN, RN · Sep 11, 2020

I'm a new grad, 6 months in on a neuro/med/surg/tele floor - however, I did work on the floor as a tech for 3.5 years prior to that so I think that has helped me tremendously. I usually have 4-5 patients but on a bad night can have 6. I struggle with ADD as well, unfortunately.

Here are some things I've found have helped me:

I show up 30 minutes prior to my shift to gather the "meat and bones" information on my patients before I get report. I read the ED note first (and the most recent MD note if I have time), check out the labs, and imaging results. After I get report, I sit back down and take a minute to write out all my patients med schedule/nursing orders so I can get an idea of how I'm going to prioritize my shift. I know some nurses don't do this and rely solely on EPIC/Pyxis but with my ADD, I like to write all my tasks down so that I can cross them off as I go and continually reassess what my shift is looking like.

I would take time to really practice and study neuro assessments, understanding the physiology behind certain deficits. There are so many extremely detailed NIHSS explanations online. I've printed out some at work and reference it regularly. I also use the sticky notes in EPIC for any abnormalities I find during my assessment! Definitely helps me keep my patients straight when I'm charting.

Some nights I'm able to read through all the notes and feel very versed in my patients situation and care plan. Other nights, not so much. I'm realizing thats just the way it is in nursing sometimes.

It sounds like you're doing everything right so just hang in there!