Neurological observations are carried out to assess a patient's level of consciousness and neurological function. It is appropriate to carry out these observations in any clinical scenario where the level of consciousness has changed or normal neurological function is in question.

It is impossible to be prescriptive with regard to the frequency of neurological observations as these will depend on the patient's presenting condition, medical diagnosis and underlying pathology, and the possible consequences (Braine and Cook [26]). Clinical knowledge and judgement will dictate the necessary timing interval for the assessment (Adam et al. [2]) and local guidelines should be followed. If the patient's condition is deteriorating, observations may need to be carried out as frequently as every 10–15 minutes for the first few hours and then every 1–2 hours for a further 48 hours (Adam et al. [2]).

The nurse must be competent to take appropriate action if changes in the patient's neurological status occur, and they must report any subtle signs that may indicate deterioration (Braine and Cook [26]). For example, patients will often become increasingly restless, or a previously restless patient may become atypically quiet (Adam et al. [2]). It should never be assumed that difficulty to rouse a patient is due to night‐time sleep as even a deeply asleep patient with no focal deficit should respond to pain (Baumann [16]). If the patient requires an increased amount of stimulus to achieve the same response as before, this may be an indication of subtle deterioration (Fuller [66]).