ADVANCE: What are the duties of neuroscience nurses?

Gail Biba: The duties include vigilant monitoring of the neurological exam and close attention to precise details of that exam. Well-rounded knowledge of medical and surgical skills is important since that knowledge is applicable to care provided to medical neurology patients and neurosurgical patients.

How long have you been a neuroscience nurse?

I've been a neuroscience nurse for more than 20 years.

How has your practice improved with experience? Please provide an example.

My practice has improved due to the depth of knowledge gained in the field of the neurosciences. It has also provided me with optimal skills for managing patients and their families during times of stressful illness. For example, patients can arrive in the neuro ICU with a subarachnoid hemorrhage after rupture of cerebral aneurysm. Knowledge about immediate medical interventions and expectant neurological monitoring are essential to ensure proper diagnosis, treatment and interventions. Patients and their families are under a great deal of stress since subarachnoid hemorrhage often strikes suddenly and unexpectedly.

What got you interested in neuroscience nursing?

Great nursing educators taught me neuroscience nursing in terms that I could easily understand. Once I understood basic anatomy and pathophysiology, I was captivated by the manifestation and treatment of neurological diseases. I continue to learn new things every day.

What specific skills/education do you need to be successful in neuroscience nursing?

No specific skills or education are needed to enter the field but you definitely need compassion combined with a great amount of patience and resilience. Good self-care strategies are also important. Many neuro patients need the "tincture of time" to heal and to reach their fullest potential for recovery.

What support systems does your neuroscience unit provide for nurses? Is it possible, with support systems in place, for nurses to work in neuro for many years?

We have staff support groups in difficult times. We call on hospital social workers and pastoral care staff to assist staff through difficult cases. Staff supports one another through friendships outside of work, a listening ear and time off to relax.

It is possible for nurses to work in neuro for many years. The gratification of seeing patients get well over time is a powerful motivator to stay in the field.

Neuroscience is a complex specialty. To provide quality care to patients who present with a wide range of neurological and neurosurgical problems and deficits requires lifelong learning in disease management, psychosocial interventions and advanced technology. How do you maintain your competency?

I often attend conferences, workshops and lectures that are presented by nurses and physicians. I read articles published in the Journal of Neuroscience Nursing and in critical care journals. I lecture on various topics in my field. I maintain specialty certification as a certified neuroscience registered nurse (CNRN).

What do you like most about being a neuroscience nurse? What advice would you give to a new grad who is considering this specialty for her first job?

The diversity of the patient population is incredible. For example, neurotrauma, brain and spinal tumors, neuromuscular weakness disorders, stroke, meningitis, management of increased intracranial pressure and much more.

Advice to new grads: bring kindness, compassion and the desire to learn and we will teach you the neuro knowledge you need to be successful.

What do you like least about being a neuro nurse? What do you think is a solution for the problem?

Often others have the wrong perception that neuro nurses are caring for comatose patients all the time. This is inaccurate. The solution is to share information with other nurses about what neuro nursing is really all about.

What is your approach in meeting the cultural needs of the patient and his family?

The approach that works best for me is to learn as much as possible about various cultural norms and to respect those norms in my workplace. I often tap into other resources such as social workers, international office staff, interpreters and pastoral care staff for help as needed.

Since you began in neuroscience nursing what changes have you seen? What do you anticipate in the future?

Improvement in surgical technique, innovative interventional neuroradiological procedures, better methods to optimize cerebral oxygenation, tPA to treat ischemic stroke, and concentrated saline solutions to treat cerebral edema, are some examples of changes that have improved outcomes in neuro patients during my career. I anticipate better treatment of malignant brain tumors and improvement in the management of pain in neuro patients.