Registered Nurse - Progressive Care

Neurosciences Unit Job

D5 is a 43 bed neurosciences unit with three levels of care. We take patients with ischemic and hemorrhagic strokes, brain tumors, aneurysms, seizures, traumatic brain injuries, neuromuscular diseases and other diagnosis involving the neurologic system. There are 22 neuro floor beds with patients requiring every 4-hour monitoring. There are also 21 neuro progressive care beds with patients requiring monitoring from every 15 minutes to every 2 hours. Additionally, there are 7 Epilepsy Monitoring Unit (EMU) beds embedded in the 22 neuro floor beds. These patients are seizure disorder patients admitted electively with their anti-convulsant medications on hold and hard wired to continuous EEG. This allows the physicians to identify the area of the brain where the seizures are occurring. Many of these patients become candidates for brain mapping with surgically placed grids to further pinpoint the area causing the seizures. This mapping allows the surgeon to determine if the patient would be a candidate for surgical removal of parts of the brain to stop seizure activity and still allow the patient to have functionality. Patients in the neuro progressive areas are those with fresh strokes, subarachnoid hemorrhages, TPA administration – either initiated or maintained on the unit, craniotomies, ventriculostomies, lumbar drains, SEPS drains, anti-hypertensive medication drips such as Cleviprex and other neuro patients requiring close monitoring. Neuro progressive patients usually advance to floor patients in a few days. The nurse-to-patient ratio for floor patients is typically 1:4 or 5 and in the progressive areas 1:2 or 3, depending on acuity.