working in neuro

papawjohn · Oct 21, 2005

Hey Laura

I'm glad you have a story to tell with a happy ending.

I've been a Neuro ICU nurse in two level 1 trauma centers. I'll tell you my little story. I started in CCU when there were no CathLabs and when a Pt having an MI was a days-long adventure for the nurses caring for him. Then the CathLabs opened and CCU wasn't so much fun any more.

About that time the University Hospital opened a Trauma Center and I migrated over there. What appealed to me was Neuro because it is 'brainy' like CCU used to be. You are dealing with a Pt in constant and rapid evolution--just like an MI used to be. Once we watched the silly monitors and counted PVCs with our watches. With Neuro--you watch the ICP monitor for wave form changes, you watch the Pt--did his pupil move more or less sluggishly now than 1 or 2 hrs ago? You pulled the sheet over him--now his hand is over the sheet--did you do that? Or did he?

You watch the neuro signs like we used to watch monitors and calculations from MAP to urine output. You are constantly "responsible" for how your Pt is doing. And 'doing' means not his emotional or 'feeling' status. It means the actual documentable neuro status.

It's a constant, endless, important assessment 24hrs/7days. And if anything changes, what does it mean? It's a beautiful thing when done right. When you have to get the Neuro-Docs involved (almost always N-Surgeons) you are going right into the depths of what that person was and who that person can become. What is more important in life?

I love it.

Papaw John

Laura77598 · Oct 21, 2005

Hi Papaw,

Yes, I truly did have a GREAT outcome. When I was a kid (3-5) I had a bad fever, and had a febrile seizure which predisposed me for more seizures. I then developed epilepsy. The neurologists finally decided it was temporal lobe epilepsy around my 12 birthday or so. When I ws about 15 I started taking Depakote. That controlled them better for the most part, but I never did get gain complete control of the seizures. I also was dating age then too. When I was 14, I met my first boyfriend during my freshman year of highschool. He was the star trumpet player in our marching band. I played clarinet (not very well, medication induced tremmor interfered with my coordination) But Allen was a SUPERB rumpet player. He was also 2/1 years older than me, and the town nerd, I might add. However, I had epilepsy, and no one would let me forget it when I was growing up. I hated it. I felt like all I was was an incurable condition! Well Allen and I went to Homecoming together and then to prom. We dated for about 2 years during High School. Then in 1981, Allen graduated high school and enlisted in the U.S. Ar Force. I was upset, but I wished him well. Then I developed a hate toward him because he left me. I then moved on without him. Allen was also a genius. He had an I.Q. of 140. Well, he and I finally stopped writing and I graduated 2 years later.

Yeah, With Allen gone, I could move on with my life and go to college and leave Town myself. However, I couln't drive!!! Seizures! So I had to stay home for a couple of years while I attended our local community college. I figured that I would transfer to a larger college when I could earn enough credits. Then I would leave home and live on campus somewhere. That's what I did. I transferred to SWT and went home only on holidays. Yeah, I finally was more than just my condition. I lived in the honors dorm and worked out in the gym with most of the guys. I made a few close friends and lead a very normal life. Still had a couple of seizures a couple of times a month, but I was glad to be on my own, away from my parents. For the first time in my life, I felt independent. Proud, accomplished, capable!

One day our dorm was preparing for midterms, and the guys side of the dorm decided to throw a dorm party. They would have if for both guys and girls (a coed dorm) and we would all get a well-deserved break! Well, the girls next door and I went to the party. I had a few beers and felt great! I had a life now! We all started talking and just before the party ended people started asking about the people we dated in school before we got to this dorm. Most of us were about 18-22. I was 20. When my turn came, people asked me if there was anybody special that I went out with. I answered, Allen. I gave them some info and then they asked where he was now. I said that I didn't know... He is off in the Air Force somewhere. For a moment, I actually wondered what ever happened to ale Allen, off in the Air Force, hope he is havin a good life... Then the party ended and we all went back to our respective rooms.

About 2 weeks later, one of the resident assistants in our dorm (Joe, a real hottie) asked me if I was going to be at movie night. I told him I didn't know. I asked what he was showing. He told me: Top Gun! I had NEVER seen TOP GUN! It had been out for 3-5 years already, andI hadn't seen it yet. I told him, "No Thanks, I have a lot of studying to do." Truly, I just didn't want to see it and be reminded of Allen again. He was in the Air Force, and that was good. He will be happy in the fast lane of adventure and excitement. But now I have a life, and I don't want to think about it now. I told him no, and just went to my room to study for midterms some more.

Well the movie came and went, and I just went on my merry way. about a month later, I went down to the lobby, my usual hangout area, to study. I NEVER went to my bedroom! I really only went there aftter about 1:30 or 2:00 in trh mornng after I knew I could not stay up any longer, and I had to go to sleep. I hated that room! I have had shoe boxes that were bigger! Anyway, after I had gotten all my books and materials for my classes I went to the lobby to study. About 2 hours later, I just simply couldn't concentrate on anything! I suddenly stopped and just stared for a few minutes. Then I got this nagging feeling in my GUT that I had to go to my room for a minute. I didn't want to go there, and I surely didn't think I was going to study there, but I felt like I needed to be there for some strange reason. I have never had that happen to me. I didn't need meds, money, food, or books, but I felt that I was supposed to go to my room and I would understand when I got there.

I went upstairs to my room, I had no roommate,but up I went anyway. I got to my door, put my hand on the knob, and heard the phone ring from the other side of the door. I went in, and answered the phone:

"Hello?"

"Hello, Laura? This Allen...."

I don't think I could move!!! I couldn't move, or breathe, or speak, or think!!! I was completely paralyzed from the head down! I just stood there unable to say anything. Like a Martian had just introduced himself to me. After a few more words, He was trying to see if I was still on the line... I finally found the power of speech and said , "yeah, I'm here....."

He continued on to tell me that he was "back in the states" for a while, and wanted to know if he could come by to say hi. He said, "Maybe we could grab a cup of coffee or somethin'." Foolishly , I said "Yea, sure." I still did not have my wits about me yet, so I just went along with it.

He told me that he would call me back when he was going to be in the area. (Almost like he would have his secretary contact me or something) I said o.k. and hung up. I still just stood there for about 20 more minutes, STILL AS A STONE!!! Not quite ablt to faint, but Nowhere near able to walk. I just went to my bed and fell on it!!! I didn't move for hours!

Finally I got up and went downstairs. A friend of my (the girl who lived down the hall from me) stopped me and asked me what was wrong. she said "You look like HELL!! What's Wrong?" I told her what had happened, and she was excited to meet him. "Oh no, I said, You are not going to meet him." She probed me for more, but I just left. about 2 weeks later, he clled my room, once again right after I walked through the door, and told e he would come by tomorrow at 4:00. I told him, O.K. I mean what else could I say? I didn't really want to see him again, but I decided to do it anyway. I told myself, 'What could happen? It's only a cup of coffee.

Well, he showed up, and I was in my dorm room. Our hall directory, Greg, called my room, and told me that I had a guest downstairs. i thought for a minute, and tried to imagine who he meant... then I thought, Oh yeah, you must mean Allen. I didn't really think of him as a guest. I went down stairs, awent through the doors, hoping the lobby was empty, but NO!!!!!!! EVERYONE THAT LIVED THERE AND MANY OTHERS WHO DID NOT LIVE THERE WERE ALL THERE IN THE LOBBY!!!!!!!!! I AM SURPRISED A CAMERA CREW WASN'T THERE SAYING FILM AT 11:00!!

I just tried to pretend that I was just there to meet an old friend of the family. I just casually looked around the lobby, trying to see if he was there, and looked, and looked, ano that's not him , no that's not him, no that's not him, no , oh who is ..... OH MY GOD IN HEAVEN THAT CAN'T BE... GOOD GOD ALMIGHTY !!!!! WOULD YOU JUST LOOK AT THOSE S H O U L D E R S?????!!!!!!! I just looked for a minute and then my head just kept going up, and finally stopped. MY GOD HE GREW !!

HE WAS 6 FOOT TALL, WITH THE DARKEST TAN I HAD EVER SEEN, AND SHOULDERS ABOUT FOUR FEET WIDE, AND THE MOST PLATINUM BLONDE HAIR I HAD EVER SEEN ON A HUMAN!!!!!!!!!!!!!!!!! He was wearing a leather jacket with patches on the shoulder, and a tight-fittin t-shirt with a bunch of military talk on it.

I just couldn't move, I started to feel my knees about to give out on me, so I sat down, but I just couldn't speak!!!! All I could think was:DAMN WHAT DID THEY DO TO YOU IN THE AIR FORCE??? What DID THEY FEED YOU AND WHAT DID THEY DO TO YOU AND CAN I GET SOME???????

He must have grown 10 inches while he was away. Anyway He took me out side, and we left to go to one of the local hangouts for coffee. We actually got something to eat, and I asked him what he had been up to. He told me, "Workin' in SAC."

I asked him what SAC was. "Strategic Air Command," he said.

"Really, doing what?"

"Fixin' Buffs."

"What's a Buff?"

"Bombers, B52's" he said.

By then I couldn't believe half of what he was telling me. He had just returned from Guam and he fixed and maintained a fleet of B-52 BOMBERS!!!!!!!

We finished our food, and went back to my dorm in his 280 zx. I got out of th ecar, and he walked me up to the door, and said he' d call me sometime. He did. We dated alot after that. Then he went back into the AirForce for his last tour. He went to Arkansas for one more year. He sent me pictures of himself too. He even sent me one of him leaning out of a B52. When I went to Arkansas to visit him that summer, I went to his room on the base. I had never been on a military base before. He let me walk down the hall and around the flightline in my clingy little dress and with the cat calls and whistles I got you would have thought I was a naked playboy centerfold! I scolded him for letting me alone like that, and he promised not to do it again, and then we went out to the flightline, and it only got worse. I am on of the few civilians that can actually say that I have been in the cockpit of a B52 Bomber!!! That was an ecxperience!!! After that vacation, I went back to finish up my senior year of school.

I also had to take statistics. I really scked at math, but not Allen, Yes he taught me Statistics over the TELEPHONE!! I got out with a C in Statistics. and a minor in Spanish and a BA in psychology! oh yeah. Then after I graduated, we got married. During the second year of our marriage, he was in school at UT Austin. I was working part-time and he had just gotten a full time apprencticship or internship. with AMD in Austin. Well that was Wonderful!! we now had money to spend. And I needed a medical appt to update my prescriptions for Depakote. Now with medical insurance, we could afford doctors visitss, and , more importantly, medicine!!!!!

Well one day, Allen was on the internet (this was in 1991) when the internet was still young. Then he told me that there was this new surgery that I should look at. They say it can fix your seizures.

Now I had had epilepsy for at least 22 years at this time. I ridiculed him. Allen, I have had this for 22 years of my LIFE!!!!!!!!!!!!!!!!!!!!!!!! Don't you think that if there were a way to fix this they would have FOUND it by now??????????

He just gestured to the computer screen with his hand. I told him he was full of it, but everything Allen touched seemd to turn to gold for him and he had not been wrong yet...

I told him that I had an appointment with a new neurologist next week to fill my prescription. I told him that I would ask him about it then. I went to the neurologist, and asked him about the new surgery that Allen had told me about. He knew exactly what I was taking about. He gave me a referral to a Doctor Grossman in Houstan Texas. I went to them and they did test after test after test at Methodist Hospital. Then they determned that I was an ideal surgical candidate. In December of 1992, I had a temporal lobectomy and they took the right hippocampus and stapled my head shut. Iwill never forget that!!!!! i entered the surgery with a comment like: I have always wanted to really give you know it all doctors A REALLY GOOD PIECE OF MY MIND!!!!!!!!!!! NOW I'M ACTUALLY GOING TO DO IT!!!!!!!! I was in SHOCK!!!!!

I went to sleep, and eight hours later, I woke up and the first thing I noticed was that my auras were GONE!!!!! I had never felt so WONDERFUL!!

I think the most shocking thought I had was: Who knew that all you had to do was just SIMPLY TAKE IT OUT!!!

After that, Allen taught me how to drive a car....... He'll regret that one one day, boy howdy!! Now I drive with the big boys in HOUSTON TEXAS YE HAW!

We also have 2 beautiful daughters

Sandra and Lisa (8 and 5)

That is my story.

That is why I have n interest in neuro.

Laura

AKav8trix · Oct 22, 2005

Very cool story. :) I'm so glad the surgery worked for you and Allen sounds like a pretty awesome guy to spend the rest of your life with.

Your senior practicum (preceptorship, internship, whatever your school calls it during the last term of nursing school) is the best way to get your foot in the door in a high acuity neuro ICU. Many new grads have been hired that way direct into a specialty unit. Otherwise it might take a year or two on a stepdown neuro floor or general ortho/neuro floor to get the experience base to jump into a neuro ICU position when it becomes available.

Gennaver, MSN · Nov 6, 2005

Hey Laura
I'm glad you have a story to tell with a happy ending.
...
It's a constant, endless, important assessment 24hrs/7days. And if anything changes, what does it mean? It's a beautiful thing when done right. When you have to get the Neuro-Docs involved (almost always N-Surgeons) you are going right into the depths of what that person was and who that person can become. What is more important in life?
I love it.
Papaw John

Hi,

I am so glad to read this!

Another student nurse over here, who is totally surprised to be considered for Neuro. When I first started working towards my degree, (and all the while since then) in earnest in 1998 I would check out anything neuro from the library as my fun, "distract-me-from-my-studies" reading. Now I am pinching myself to think I met get to be in Neuro ICU, (posted in another thread).

Gen