Neuro ICU Nurse – What You Need To Know

by | Dec 6, 2022 | Neuro Nursing, Neuro Featured | 1 comment

As you explore different nursing jobs and try to decide where you want to work, have you thought about becoming a neuro ICU nurse? This job requires a lot of patience, attention to detail, and the ability to care for clinically complex individuals while extending empathy and compassion. Let’s discuss what you need to know about being a neuro ICU nurse.

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neuro icu nurse what you need to know

What Is A Neuro ICU Nurse?

Other names for Neuro ICU nurses include neuro nurses, neurocritical care nurses, and neuroscience nurses. A neuroscience nurse works with patients who are suffering from neurological problems.

A neuro ICU nurse is a neuroscience nurse that works specifically in the Intensive Care Unit (ICU). You might have also heard it called neurocritical care nursing.

Neuro ICU Nurse Salary

How much a neuro ICU nurse earns will depend on where they live and the type of hospital in which they work. Unfortunately, in the nursing profession, those who work in complex units do not receive higher compensation. Pay rate tends to have ranges that are dictated by the local market. Nurses work in New Jersey make substantially more than those in rural Iowa.

The 2021 media pay for nurses nationwide was $77,600 (source).

Neuro ICU Nurses vs. Regular ICU Nurses

The responsibilities of a Neuro ICU nurse are very similar to a general ICU nurse. The only difference is a neuro nurse is focused more on neurological surveillance and intervention. To get a basic understanding of an ICU nurse’s responsibilities, you can read my post “What Do ICU Nurses Do?” It’s a really in-depth look at what a normal shift is like for ICU nurses.

To speak to responsibilities specific to neuro ICU nurses, let’s begin with the neuro-specific disease processes you’ll encounter.

Neuro ICU Nurse Responsibilities

One of the main things that set this job apart from other nursing jobs is the type of patients they care for. It is their responsibility to care for critically ill neurologically compromised patients.

Due to the critical nature of these problems, the neuro ICU nurse will experience a lot of death and dying as well. Neuro patients are unique in that typically neuro disease processes requiring intensive care monitoring typically happen very abruptly and suddenly, leaving patients and loved ones in a state of utter shock.

Thus, the neuro nurse must be clinically sound but also emotionally intelligent enough to support patients and family members actively experiencing trauma.

Familiarity With Neuro Disease Processes and Diagnostics

Neuro nursing is a pretty vast specialty, however Neuro ICU nurse narrows it down quite a bit. There are many neuro issues out there, but only a handful will land a patient in an intensive care unit. Below are some common patients of neuro ICU nurses:

  • Ischemic and hemorrhagic stroke
  • Subarachnoid hemorrhage
  • Intracerebral hemorrhage
  • Epidural hematoma
  • Subdural hematoma
  • Brain tumors – when the tumor is pushing on crucial structure, as well as post craniotomy for biopsy
  • Hydrocephalus
  • Spinal injuries
  • Central nervous system infections
  • Seizures and status epilepticus
  • … and more

To effectively monitor these patients, you’ll need to be familiar with common diagnostics as well. Those include:

  • CT, CTA, CT perfusion study – your neuro ICU patients will get head CTs without contrast ALL THE TIME
  • Cerebral angiogram
  • Transcranial doppler
  • EEG
  • Blood work – chemistry, CBC, coagulation labs, and more

We go over all of that in depth in my comprehensive neuro crash course. You can check that out here.

Neuro ICU Nurse Assessments

Neurologically compromised patients will require very frequent neuro assessments. This is because when something changes in the brain, it is evident in our bedside assessments, not vital sign changes.

This is a major difference between ICU and CVICU (cardiovascular intensive care) nurses. Nurses in these units focus more on vital sign changes and adapting appropriately. Neuro nurses will focus more on their bedside neuro checks to gauge if the patient is deteriorating. The signs are subtle! We dive deep into neuro assessments in our comprehensive neuro course here.


In addition to becoming a master at neuro checks, neuro ICU nurses are also responsible for communicating with neurologists, neurosurgeons, neuro-intensivists, and other healthcare team members about changes and constantly evolving needs. (Lesson #4 of my email course listed above discusses how to communicate to physicians about neuro changes.)

In fact, communication can be trying and difficult. A neuro ICU nurse must explain complex medical conditions to laypeople, many of whom have little experience or previous understanding of healthcare.

Additional Responsibilities of Neuro ICU Nurses

Other responsibilities that are specific to a neuro ICU nurse include:

  • Manage drains that go directly in the brain – including external ventricular drains (EVD)
  • Measuring intracerebral pressure (ICP) with a bolt or EVD
  • Completing thorough neurological assessments to both conscious and unconscious patients
  • Managing emotional distress with family members
  • Assisting in end of life care and terminal extubations
  • Administering tPA and monitoring patients afterwards
  • Overseeing organ donation and procurement
  • Facilitating brain death testing

As you can see, these are very serious situations that are a normal day of work for a neuro ICU nurse.

My Top Tips for New Neuro Nurses

In the below video, I go over some major tips for new neuro nurses. I discuss the importance of the sodium level, specific disease processes, and touch on neuro assessments as well.

Final Thoughts

Working as a neuro ICU is extremely rewarding, but also extraordinarily challenging. Your normal day of work will be someone else’s worst nightmare, and you are looked at to be the calm and confident nurse in control of the situation. I absolutely loved being a neuro ICU nurse and wish you the best of luck in your career!

Looking to prepare for your first acute care neuro nursing job?

Neuro Wise - A crash course for new neuro nurses

Neuro Wise - A Crash Course for New Neuro Nurses from FreshRN® is your one-stop ultimate resource and online course, crafted specifically for brand new neuro nurses. If you want to get ahead of the game so instead of merely surviving orientation, you’re thriving all the way through from day one to day done - this is the course for you.

Start Lesson #1 Now

More Resources on Becoming an Amazing Neuro ICU Nurse

Picture of Kati Kleber, founder of FRESHRN

Hi, I’m Kati.

Kati Kleber, MSN RN is a nurse educator, author, national speaker, host of the FreshRN® Podcast, and owner of FreshRN® – an online platform created to educate, encourage, and motivate newly licensed nurses in innovative ways.

Connect with her on YouTube, Pinterest, TikTok, Instagram, and Facebook, and sign-up for her free email newsletter for new nurses.

1 Comment

  1. BlueWA

    This is an informative and comprehensive guide to neuro critical care nursing, providing valuable insights into the field for those interested in pursuing this specialty.


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