Abstract
The care of neurologic, neurosurgical, and spinal patients differs markedly from the care of other critically ill hospital patients. While the layperson and generally trained health professional are likely well aware of the need to monitor respiratory and cardiac functions, the monitoring of neurologic function remains less well appreciated or understood. While the intensive care unit (ICU) setting is clearly indicated for particular patients, the close monitoring unit also serves a critical role in the tertiary care hospital. While somewhat variable, the typical neurologic examination takes place every 4 hours. More frequent checks may be needed, but generally checks every 2 hours would militate for ICU level of care. That being said, the monitoring unit often places patients in an "open space" so that nearly constant observation is possible from a limited nursing staff. Increasingly, advanced practice personnel are being asked to perform in an intermediary role in these settings.