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The RN working in a neurointensive care unit may treat patients suffering from a stroke to traumatic brain injuries. The patient must be vigilantly monitored, watching for neurological decline in order to start intervention, if necessary, as soon as possible. Most facilities require the Neuro ICU RN to oversee only one or two patients at a time, so that they can offer undivided attention to these most critical patients.

The Neuro ICU Registered Nurse may be required to perform delicate procedures such as inserting central lines and pulmonary artery catheters. The RN may also assist the physician with bedside procedures such as inserting a drain into the patient’s skull to reduce pressure. Some Neuro Intensive Care Units specialize in trauma as well as neurological disease. The RN must know how to evaluate the patient with a brain injury that may impact the rest of the body as well as understanding how to treat and monitor neurological issues.

The RN in this unit will constantly assess the patient’s vital signs, speech capability, reflexes and responses. These patients require vigilant monitoring and observation and the RN in this unit will also use many types of monitoring equipment. In some Neuro ICU centers they depend on brain oxygen monitoring, EEG, monitoring of cerebral blood flow, neruoimaging, brain tissue chemistry and intracranial pressure. This technology allows the RN to be aware of what is happening in the patient’s brain even when the patient is unable to communicate.

The RN in the Neuro ICU must be able to work as part of a team. The Neuro ICU is normally staffed by many other health care professionals. The Neuro ICU may include neurosurgeons, anesthesiologists, neurologists, nurse practitioners, clinical pharmacologists, physical therapists, critical care nurses, occupational therapists, speech-language therapists, social worker and nutritionists. Communication between all these team members is essential to the patient’s recovery and daily meetings may be held to discuss progress and treatment plans for specific patients.


A neurological disorder or brain injuries may affect everything about the person, including their ability to speak, walk or care for themselves. In many cases communication is not even possible. There may be severe and devastating emotional and cognitive disabilities. The patient’s family is also having to deal with seeing their loved one in this state and not knowing if the patient will recover. The RN has to be very sensitive to these facts and help educate the family members about the long term implications of the patient’s condition.


Most employers would require the RN to have certifications in neurology and critical care in order to work in this type of unit.


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