Published Jul 7, 2009
I'm a new grad and will be starting on a Neurosciences Intermediate Unit (4 to 1 ratio) in the fall. When people ask me where I'll be working I tell them Neuro and they groan. Have I made a mistake?? Can you all tell me your experiences in Neuro...the good and the bad. I just want to know what to expect. Right now I don't have a clue?
PostOpPrincess, BSN, RN
It will be an excellent experience. Learn all you can.
I am in the same boat. I haven't been offered the position yet, but I have interviewed and I really want to work there. I'm a new grad too and I am in desperate need for a job...
you are going to psyche baby. Start lifting weights and building personal boundaries.
It's challenging, rewarding and in most places pays better.
And for your first lesson in psyche:
when people "groan" at you- ask them why.
sonny is partly right. I work on a neuro unit and if your hospital doesn't have an "official" psych unit, neuro is where those people will end up 9 out of 10 times. However, you'll also get lots of experience with back and neck surgeries, seizures, strokes, etc. I was nervous/scared for my first few months working there but I have learned a TON and now I really enjoy it! I'm spoiled though, our unit is probably one of the best run units I've seen and I don't just say that because I work there :)
I don't know why people would groan. I'd take neuro over a medical floor or surgical floor any day! I worked at a rehab hospital on neuro and I really liked it. Good mix of critical thinking and hands on technical stuff. Plus, they always had really interesting stories to go along with their injury. :)
there's neuro and then there's neuro. as rhapsodyRN said, we had the back & neck surgeries --they are often chronic pain patients, so you will learn not just post op care, but, dealing with and managing chronic pain.. we also got the strokes and seizures. and my favorite: DT's from EtoH w/drawal. No wait--my favorite is closed head injures. I didn't like it, but the nurses I worked with couldn't imagine doing anything else. neuro is much more interesting in a big university hospital than in a smaller one. either way it is physically demanding.
Here are some questions you could ask: (it would show how smart you really are): who arranges the discharge planning on the unit and how is it carried out? Are there case managers who arrange for durable medical equipment, home health evals or nursing home placements or is it up to the nurse? Case management is a whole specialty to itself, but often it is the nurses job. just more to learn.
other question: just to get on the surgeons good side (which never hurts)--after you have worked there a while, ask if you could please watch a surgery. they will wet themselves with glee. this is not a simply brown-nose technique. once i saw what happened in a couple surgeries i observed, the post op instructions made more sense, i understood how and why the patient was experiencing the pain they had. it just gathers together more of the big picture, to make you a better nurse. and that surgeon knew my name after that. and was a bit more patient with me. just a suggestion!
i could be wrong, but when i think of neuro, i automatically think of tbi x 4 pts = a lot of continual assessment w/interventions.
of course i'm exaggerating but would think you'd get a fair share of tbi's.
plus, anything with neuro...the brain (:dzed:)...tends to either fascinate or overwhelm new nurses.
personally, i find anything/everything about our brains, totally fascinating.
this is definitely a job where you will learn soooo much.
don't dread it...go for it!!
i am confident this job will result in you being physically, mentally, intellectually and creatively, on top of your game.
let us know how it goes.
and show 'em what you're made of.:balloons:
add: neuro nurses- would love to hear from you...
and correct me with anything i misstated, please.
Elvish, BSN, DNP, RN, NP
I did my first clinical of nursing school on a neuro unit at a big teaching hospital, and my first job out of nursing school was general surgery/ortho/neuro. Surgery/ortho I didn't mind so much - but I am just not cut out for neuro. Our neuro unit got the stroke pts, the DTs, the TBIs, as well as being a catch-all for any patient with any sort of dementia or mental illness. It's not my cup of tea all day every day.
But - you will learn a lot, and you will learn/hone many skills. I'm not saying this to discourage you, because you may find that you love it. :) I work mother/baby, and med-surg folks tell me all the time - "those babies scare the hell out of me." So, it takes all kinds. If you find you're a neuro 'sort', then great! If not, then great, 'cause there are other things you can pursue as well.
Good luck to you, and welcome to nursing!!
86toronado, BSN, RN
I :redbeathe neuro!!
Honestly, it was the first hospital job that I ever had, but after being on a neuro unit for 2 years, I tried cardio, just to see what else was out there, and I was back on my neuro unit ~6 months later. I don't know what it is, but to me, the cardiac patients just didn't seem "sick" enough to need my attention after my experience in neuro. Be prepared for a lot of total care patients, most of whom will need extensive rehab both during and after their hospital stay. I don't think my unit would function without the capable case managers and rehab specialists who serve our patients, as the other poster pointed out. But as my hospital runs it, my unit is the most sought after place to work in the entire system! As the other poster pointed out, our unit tends to get (as I phrase it); "the patients who should be in psych, but are too sick". But we also get strokes, TBI's, all types of back surgeries, brain surgeries, seizures, ID patients such as meningitis, encephalitis... I could go on and on with what I've seen... way more interesting than cardio anyway, with your endless "chest pain", CHF, and cardiac caths anyway...
My husband works in the ER, and when he tells other nurses that I work in neuro, a lot of them make that face/groan as you said. I think it must be that our patients just require a lot of intervention. But anyways, it (to me) is a great learning experience. If you think about it, no other part of the body can function without the brain, so you will get excellent experience that will serve you well elsewhere. But if you decide (as I did) that neuro is your niche, you will see some amazing transformations, and witness some miraculous recoveries, as well as some heartbreaking losses. I think it requires a special kind of person, and if you are that nurse, it could be very rewarding.
Ask about their lift policy. Make sure that the tools are available for safe patient transport. Ideally the hospital has a zero physical lift by staff policy. (You don't want to end up with a back neck injury of your own to rehab.)
I do agree with the start physical training advice. Work on strengthening your core because you will have some repositioning etc to do that does require hands on. Always think about your biomechanics because you are at greater risk for a physical injury.
As a psych nurse I get a few TBI/stroke vets but SCI are diverted to another unit in our hospital. We also have a polytrauma unit so I am on the fringes of the other areas.
NurseKitten, MSN, RN
You either love it or you hate it.
Get "Clinical Neuroanatomy Made Ridiculously Easy".
Learn your brain/spinal anatomy well. You'll need to know the difference between a laminar and facet fracture.
Rhoades and Bell wrote a good medical physiology text with a great neuro section. I use mine regularly to teach new techs and grads.
I was hired into our neuro ICU 4 years ago with an eye toward us becoming the defacto trauma unit, as well. The hospital was pursuing a trauma center designation, and I had ER experience, plus a trauma cert. I love it, but it largely has to do with the people I work with. Couldn't do the floor, but a 4:1 ratio doesn't sound too bad.
Ask questions. Devour basic neuro textbooks - AANN (American Assoc of Neuroscience Nurses) has a fabulous core curriculum, and I suggest you find a way to read their journals cover to cover. If your hospital doesn't subscribe, it's worth it to join so you can get them. Free CE's, and if your hospital is a designated stroke, SCI, TBI and/or trauma center (mine is all 4) then it saves you a TON of money on CE's.
Your physical care skills will get very good. You will get very comfortable with trachs, vents, and coordination of care across the continuum. Make friends with your case manager - they are an invaluable resource.
Go to the websites for both Brooks Rehab in Jacksonville, FL and Shepard's Rehab in Atlanta - they are two of the premier neurorehab places in the SE (where I'm at) and we are in their debt for the wealth of education material they provide.
Start by educating yourself as a "patient" or "family member" It helps you to know how to answer the "tough" questions. From there, you can build into a deeper, professional understanding.
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