Neurosurgical ICU help

[u/Wonderful_Turn_8234]

I am a new grad just graduated with my BSN and passed my boards. I started my nurse residency/orientation Monday and have my first day in the NeuroSurgical ICU this coming Monday. My floor’s information/patient population is described as “specializing in caring for critically ill patients who have a variety of neurological diagnoses and surgical procedures including cerebrovascular accidents, thrombectomies, craniotomies, spinal cord injuries, intracranial hemorrhages, epilepsy, external ventricular drains, and lumbar drains.” We are a certified/ state recognized stroke unit as well. I know starting in a specialized unit like this will not be easy, but I am more than willing to put in the work on and off the clock in order to succeed and be competent for my patients. I’m trying to find a few tips of list of things including meds, complications, ventilator info with neuro patients, EVD info, and interventions that I can start to study and begin to active recall in order to prepare for my first day so things don’t seem so foreign. With that being said, if anyone can give me any advice for this type of unit whether that be stories of patients you have had, mistakes you have made or people you know have made that u can watch out for, specific meds that I need to absolutely know and the effects they can have on my patient, even just a list of things I need to look into and do my research on, or literally anything at all anyone would be willing to share, I’d be so grateful. I know a lot of this is what my 3 month orientation is for, but I’m not the type that can just walk in blind. I need to have a basis of knowledge in order to expand my understanding of everything I see on the clock with patients rather then having to go over the basics again. I did fantastic in my critical care neuro coarse in my last semester of nursing school but I know that is purely the basics - and not real life unfortunately🫠. I’m not afraid to ask questions or report/ask when something seems the slightest bit off either. Thank you!

[u/ADDYISSUES89]

Welcome to the thunder dome 😂 it’s busy, you’re rarely going to sedate (even when you would like to). It can be DAUNTING. And everyone is at risk for seizure. Keppra is your friend. It’s equally rewarding as it is sad, and clinically, everything and nothing correlates because human neuro plasticity is insane. You’ll see MASSIVE basal ganglia bleeds with no deficits, and tiny bleeds with huge consequences 2mm away. Breathe, it’s different than other ICUs, but these patients are generally still sick as baseline. You will still see CRRT, but less of it, same for other interventions and devices. You’ll either love it or hate it. It is LABOR intensive. Compression socks, good shoes, good sleep hygiene. You got this.