Must-Know Tips For Neuro Nurse Checks

by | Jan 19, 2021 | Neuro Nursing | 0 comments

These are the most essential tips you need to know when you do your neuro nurse checks. Don’t just do the checks, but know why you are doing them and use these tips to make your assessments even more accurate.

I already shared a detailed overview of what to do when you give a neuro nurse assessment of a patient. In this guide, I will be sharing specific tips that you need to do as you walk into the patient’s room.

Must-Know Tips For Neuro Nurse Checks

Top Tips For Neuro Nurse Checks

These tips will guide you through the “why” of your neuro nurse checks and guide your decision making process from the moment you greet the patient and their family.

One of the deficiencies of literature and resources on these neuro nurse tips is that they are so detailed. It’s just not realistic to take all of that detail and do it every four hours for five different patients.

My tips will help you set realistic expectations for yourself so you don’t’ become so overwhelmed that you just check out mentally.

#1 Don’t Wait For Vital Signs Or Pupillary Changes To Intervene

The very first thing I want you to know is that you shouldn’t just wait for something obvious to change before you intervene.

Brain damage happens slowly and can be irreversible. It’s very important that you pay attention to small details. We can’t grow brain tissue back. Even patients that seem alert and are talking could be experiencing a slow neuro decline, and it is up to you as the neuro nurse to detect it.

#2 Get A Solid Baseline At The Beginning Of Your Shift

This is very important and will help you be able to tell when something is deviating from this baseline.

Let’s say you have 5 neuro patients – and that is a lot for a neuro floor – you need to prioritize the first assessment at the beginning of your shift as the most important thing of all. Do not skimp on it. Make sure you go through the entire thing and don’t make any assumptions.

This way, if something goes crazy during the day and you miss a recheck, or you don’t have time to be as detailed later on, you still at least have this earlier one.

When things go downhill, if you have a really solid baseline you can compare the patient’s current state with the assessment you took at the beginning of your shift. You’ll be able to tell exactly what has changed and by how much.

The physician or neurologist is relying on you to detect and quantify the changes to them.

#3 Make Sure You Get Your Reps In

This is a very complicated process that is dynamic. That means it does have to change a little bit for each patient with whatever they can and cannot do. It is a lot to memorize.

In the beginning, you should have a checklist. Good news for you, I have a free checklist you can download and print! Walkthrough this checklist and make sure you are doing everything from head to toe.

Get reps in. Do it over and over again. Much like learning how to shoot a basketball, the more you practice, the easier it will be to recall each step of the process.

Keep repeating this process over and over until it is fluid and you know it so well that you don’t have to think about which step comes next, you just innately go to the next step.

Don’t underestimate the power of doing it repeatedly and building your mental and muscle memory. That’s how learning this skill works!

#4 Trust No One

Do you own checks. Do not trust the patient and do not trust the previous nurse.

Let’s look at an example. The previous nurse might say, “These are the patient’s deficits. They are disoriented to time, their right grip is a little weak, they have a left visual field cut.” Don’t take their word for it and then fail to do your own checks.

Instead, do a brief neuro check with that nurse at the bedside. Not a complete one from head to toe, but a brief one. Then, as the nurse tells you the deficits, confirm it with the patient.

This was you will avoid a very awkward issue where you get a report from a nurse, you know the patient’s deficits, but when you go in and assess the patient, what you see is very different from what the nurse told you. Then you don’t know whether a neuro change happened between their last assessment and your current one or it just wasn’t an accurate reporting of what they saw.

You also shouldn’t trust the patient, either. Verify what they are telling you. For example, even if they act like they are totally oriented, don’t take their word for it, do your neuro checks and verify it. In fact, I have had patients that seemed completely lucid swear to me that it is 1947.

#5 Neuro Checks Should Be Like A Golf Swing

One of the most important tips for neuro nurse checks is that they should be like a golf swing – you need to do them the same exact way every single time.

There are a lot of steps that you have to learn and memorize. If you do them out of order, you are more likely to forget pieces.

It is so important for you to do your neuro checks in the same exact order every time. It will help your brain memorize the process faster and it will also prevent you from missing a step.

Neuro Nurse Checks Video:

Final Thoughts

There you have it! These are my most valuable tips for new nurses that have to do neuro checks. I know it’s a lot to learn, but please take these tips to heart.

Don’t just wait around for a pupillary change, trust no one, get a really solid baseline, practice over and over and always do them in the same order every time.

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More Resources for Neuro Nurse Checks:

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.


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