Podcasts about critical care nurses

On episode 514 of The Nurse Keith Show nursing and healthcare career podcast, Keith interviews Dr. Dina Hewett, Ph.D., RN, MSN, JM, a nurse, educator, leader, and the author of the 3rd edition of "Fast Facts for the Critical Care Nurse" which is scheduled to be published in May of 2025 by Springer Publishing.  In the course of their conversation, Keith and Dr. Hewett delve into the specialty of critical care nursing, the many challenges faced by new graduate nurses embarking on a career in critical care, how to bridge the gap between nursing school and novice practitioner, technological advances in critical care, and much more. Dr. Dina Hewett received her BSN from Brenau University, MSN from Georgia Southern University and Ph.D. in Higher Education from the University of Georgia. In 2021 she completed a master's degree in law from Liberty University. Her certifications include CCRN – Alumnus, Nurse Executive Advanced and is a certified Six Sigma Black Belt. With over thirty years of experience as a critical care nurse, Dr. Hewett's career has encompassed both hospital administration and academics. During her tenure in hospital administration, she served as the unit manager of the Cardiothoracic Intensive Care Unit and director of nursing of multiple units including critical care, inpatient rehabilitation, and respiratory therapy. Dr. Hewett is the immediate past President of the Georgia Nurses Association. She is an AACN-Wharton Executive Fellow. Previously, she served as a board member of the Georgia Association of Nursing Deans and Directors, and a member of the Education Committee of the Georgia Board of Nursing. Dr. Hewett has also served on the Government Affairs Committee of the American Association of Colleges of Nursing. Dr. Hewett is a Regional Vice President of Campus Operations, Chamberlain University. Her recent publications include "Fast Facts for the Critical Care Nurse (3rd edition)", and chapter contributions for the 13th edition of Ackley & Ladwig's Nursing Diagnosis Handbook. Dr. Hewett lives in Gainesville, Ga with her husband and three dogs. This episode of the Nurse Keith Show is brought to you in collaboration with Springer Publishing, who have been delivering award-winning healthcare education and exam prep materials focused on nursing, behavioral health, and the health sciences for more than 70 years. We thank Springer Publishing for their support. Connect with Dr. Hewett and Springer Publishing: ⁠Dr. Dina Hewett on LinkedIn Fast Facts for the Critical Care Nurse, 3rd edition Springer Publishing Contact Nurse Keith about holistic career coaching to elevate your nursing and healthcare career at ⁠NurseKeith.com⁠. Keith also offers services as a motivational and keynote speaker and freelance nurse writer. You can always find Keith on⁠ LinkedIn⁠. Are you looking for a novel way to empower your career and move forward in life? Keith's wife, Shada McKenzie, is a gifted astrologer and reader of the tarot who combines ancient and modern techniques to provide valuable insights into your motivations, aspirations, and life trajectory, and she offers listeners of The Nurse Keith Show a 10% discount on their first consultation. Contact Shada at ⁠TheCircelandtheDot.com ⁠or shada@thecircleandthedot.com.

Following more than a decade of military service as a Critical Care Nurse, Nadine Muller became a high-performance coach, mentor and international best-selling author. In her book ‘A Reason to Rise' she shares her journey of overcoming immense personal and family adversity. Nadine is today's guest on our radio show Brainwaves, where she will discuss her struggles and how she rose above them.

Show Notes for Episode 42 of “The 2 View” – Pink cocaine, holiday heart syndrome, pertussis, research updates on Zepbound and Semaglutide, and much more. Segment 1 – Pink cocaine What is Pink Cocaine? Dea.gov. DEA: United States Drug Enforcement Administration. https://www.dea.gov/pink-cocaine What is Pink Cocaine? Poison.org. POISON CONTROL: National Capital Poison Center. https://www.poison.org/articles/pink-cocaine Segment 2 – Holiday heart syndrome Blackburn R, Ajetunmobi O, Mc Grath-Lone L, et al. Hospital admissions for stress-related presentations among school-aged adolescents during term time versus holidays in England: weekly time series and retrospective cross-sectional analysis. BJPsych Open. Cambridge University Press. Cambridge Core. Published November 19, 2021. https://www.cambridge.org/core/journals/bjpsych-open/article/hospital-admissions-for-stressrelated-presentations-among-schoolaged-adolescents-during-term-time-versus-holidays-in-england-weekly-time-series-and-retrospective-crosssectional-analysis/924EE2CD1A8CFAC30E7090674FCEAF72 Carey M, Al-Zaiti S, Kozik T, Pelter M. Holiday Heart Syndrome. ECG Puzzler. Researchgate.net. AJCC: American Journal of Critical Care. American Association of Critical-Care Nurses. https://www.researchgate.net/profile/Mary-Carey/publication/260446497HolidayHeart_Syndrome/links/573dda6308ae298602e6d0b1/Holiday-Heart-Syndrome.pdf Ettinger P, Wu C, De La Cruz Jr C, Weisse A, Ahmed S, Regan T. Arrhythmias and the “Holiday Heart”: Alcohol associated cardiac rhythm disorders. Sciencedirect.com. ScienceDirect. American Heart Journal. https://www.sciencedirect.com/science/article/abs/pii/000287037890296X Greenspon AJ, Schaal SF. The “holiday heart”: electrophysiologic studies of alcohol effects in alcoholics. Ann Intern Med. PubMed. NIH: National Library of Medicine: National Center for Biotechnology Information. Published February 1983. https://pubmed.ncbi.nlm.nih.gov/6824246/ Jain A, Yelamanchili V, Brown K, Goel A. Holiday Heart Syndrome. Nih.gov. NIH: National Library of Medicine: National Center for Biotechnology Information. Updated January 16. 2024. https://www.ncbi.nlm.nih.gov/sites/books/NBK537185/ Joglar JA, Chung MK, Armbruster AL, et al. 2023 ACC/AHA/ACCP/HRS Guideline for the Diagnosis and Management of Atrial Fibrillation: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. Circulation. AHA | ASA Journals. Published November 30, 2023. https://www.ahajournals.org/doi/10.1161/CIR.0000000000001193 Segment 3 – Pertussis CDC. About Whooping Cough. Whooping Cough (Pertussis). Updated April 2, 2024. https://www.cdc.gov/pertussis/about/index.html Center for Drug Evaluation, Research. FDA Drug Safety Communication: Death resulting from overdose after accidental ingestion of Tessalon (benzonatate) by children under 10 years of age. FDA: U.S. Food and Drug Administration. Published June 28, 2019. https://www.fda.gov/drugs/drug-safety-and-availability/fda-drug-safety-communication-death-resulting-overdose-after-accidental-ingestion-tessalon Pertussis. Who.int. World Health Organization. https://www.who.int/health-topics/pertussis Simma L, Gesch M. Eyelid Ecchymoses and Subconjunctival Hemorrhage in Pertussis. N Engl J Med. Published December 11, 2024. https://www.nejm.org/doi/full/10.1056/NEJMicm2409052 Something sweet – Research updates: Zepbound and Semaglutide Ernst D. Zepbound Approved for Obstructive Sleep Apnea in Patients With Obesity. Monthly Prescribing Reference. MPR: Medical Professionals Reference. Published December 20, 2024. https://www.empr.com/news/zepbound-approved-for-obstructive-sleep-apnea-in-patients-with-obesity/?utmsource=eloqua&utmmedium=email&utmcampaign=NWLTRMPRTOPTDrug-DatabaseSS-LAS-LI1-LI2-9654122924_AL&hmemail=1f%2FJfEV7hN5vJr6vg%2FQRqK0NA6IXtyO3&sha256email=092493d8223fdfa40d9e995176d13e5fc5b5211674db9deb440c025fd462c80c&hmsubid=&nid=1639413404&elqtrack=True Semaglutide shows promise as a potential alcohol use disorder medication. Research Update. Nih.gov. NIH: National Institute on Alcohol Abuse and Alcoholism. Published March 13, 2024. https://www.niaaa.nih.gov/news-events/research-update/semaglutide-shows-promise-potential-alcohol-use-disorder-medication Recurring Sources Center for Medical Education. Ccme.org. http://ccme.org The Proceduralist. Theproceduralist.org. http://www.theproceduralist.org The Procedural Pause. Emergency Medicine News. Lww.com. https://journals.lww.com/em-news/blog/theproceduralpause/pages/default.aspx Trivia Question: Send answers to 2viewcast@gmail.com Be sure to keep tuning in for more great prizes and fun trivia questions! Once you hear the question, please email us your guesses at 2viewcast@gmail.com and tell us who you want to give a shout-out to. Be sure to listen in and see what we have to share! Looking forward to another year together!

In this episode, we explore the critical role nurses play in advancing health equity within the ICU. Jennifer Adamski, president of the American Association of Critical-Care Nurses, shares insights on how nurses can make a difference at the bedside and the challenges they face. We also discuss strategies for empowering nurses and fostering a culture of equity in critical care.This episode is sponsored by Medtronic.Areia C, King E, Ede J, Young L, Tarassenko L, Watkinson P, Vollam S. Experiences of current vital signs monitoring practices and views of wearable monitoring: A qualitative study in patients and nurses. Journal of advanced nursing. 2022 Mar;78(3):810-22Williams EC, Polito V. Meditation in the Workplace: Does Mindfulness Reduce Bias and Increase Organisational Citizenship Behaviours? Front Psychol. 2022 Apr 11;13:747983. doi: 10.3389/fpsyg.2022.747983. PMID: 35478759; PMCID: PMC9035788.Lewis CL, Yan A, Williams MY, Apen LV, Crawford CL, Morse L, Valdez AM, Alexander GR, Grant E, Valderama-Wallace C, Beatty D. Health equity: A concept analysis. Nurs Outlook. 2023 Sep-Oct;71(5):102032. doi: 10.1016/j.outlook.2023.102032. Epub 2023 Sep 6. PMID: 37683597.Bhavani SV, Wiley Z, Verhoef PA, Coopersmith CM, Ofotokun I. Racial Differences in Detection of Fever Using Temporal vs Oral Temperature Measurements in Hospitalized Patients. JAMA. 2022;328(9):885–886. doi:10.1001/jama.2022.12290P Malhotra, L Shaw, J Barnett, E Hayter, N Hill, P Stockton. St Helens and Knowsley. P179 Patient safety alert: a prospective study on 100 patients highlighting inaccuracy of pulse oximeter finger probes used on ear lobes. Teaching Hospitals NHS Trust, Prescot, UK. 10.1136/thorax-2018-212555.336Torp KD, Modi P, Pollard EJ, Simon LV. Pulse Oximetry. 2023 Jul 30. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan–. PMID: 29262014Nitzan M, Romem A, Koppel R. Pulse oximetry: fundamentals and technology update. Med Devices (Auckl). 2014 Jul 8;7:231-9. doi: 10.2147/MDER.S47319. PMID: 25031547; PMCID: PMC4099100Giuliano KK, Bilkovski RN, Beard J, Lamminmäki S. Comparative analysis of signal accuracy of three SpO2 monitors during motion and low perfusion conditions. J Clin Monit Comput. 2023 Dec;37(6):1451-1461. doi: 10.1007/s10877-023-01029-x. Epub 2023 Jun 2. PMID: 37266709; PMCID: PMC10651546Gudelunas MK, Lipnick M, Hendrickson C, et al. Low Perfusion and Missed Diagnosis of Hypoxemia by Pulse Oximetry in Darkly Pigmented Skin: A Prospective Study. Anesth Analg. 2024;138(3):552-561. doi:10.1213/ANE.0000000000006755

Natalie welcomes two guests to the show today; 1) Sarah Koren, former Critical Care Nurse Specialist from Philadelphia who made aliyah in 1988; and Ezra Fleishman, Teacher, who made aliyah from Brooklyn just before Sukkoth, about a week ago. Sarah is a Team Leader for the Republicans Overseas and is in charge of Pennsylvania. She discusses her aliyah which began in the WUJS program in Arad, and her subsequent careers as a Critical Care Nurse first in Yoseftal Hospital in Eilat, and later in Hadassah Ein Kerem and Sheba. Regarding her current work with the Republican Party, Sarah explains the challenges involved with Absentee voting and more. She emphatically declares that this U.S. Presidential Election is the most important one in our lifetime. Natalie next welcomes Ezra Fleishman to the program who moved with his wife to Ramat Beit Shemesh to be near his two daughters. He describes the ease of living in this Anglo "bubble" and how there are Rabbis who give sermons in English, classes are in English, and shopkeepers speak English. Returning Home 20OCT2024 - PODCAST

In this episode, Graham Willett and Geraldine Fela share stories about how the union movement has stood up against homophobia. Graham Willett is a recovering academic, a socialist and an historian. He has been involved in groups as diverse as the Gay Community News collective, ACTUP and the Australian Queer Archives. Geraldine Fela is a labour movement historian and author of Critical Care: Nurses on the frontline of Australia's AIDS crisis. She is also a member of Solidarity. Read more about the fight against homophobia. Find out more about Solidarity. This talk was recorded at a forum hosted by the Melbourne branch of Solidarity on 26 September.

A patient with a large TBSA burn injury is transferred to a regional burn center. You are faced with some difficult clinical decisions as the resuscitation proves to be challenging. Join Drs. Tam Pham, Rob Cartotto, Julie Rizzo, Alex Morzycki and Jamie Oh as they discuss the clinical challenges in titrating and troubleshooting during acute burn resuscitation.  Hosts: ·  Dr. Tam Pham: UW Medicine Regional Burn Center ·  Dr. Robert Cartotto: University of Toronto, Ross Tilley Burn Centre  ·  Dr. Julie Rizzo: Brooke Army Medical Center  ·  Dr. Alex Morzycki: UW Medicine Regional Burn Center ·  Dr. Jamie Oh: UW Medicine Regional Burn Center Learning Objectives: ·  Understand the role of colloids as complement/rescue to standard crystalloid fluid titration.  ·  Identify the fluid threshold associated with development of abdominal compartment syndrome ·  Understand the role of continuous renal replacement therapy for patients with acute kidney injury during the resuscitation phase. ·  List specific patient populations who may experience a more difficult resuscitation. References: 1.     Ivy ME, Atweh NA, Palmer J, et al. Intra-abdominal hypertension and abdominal compartment syndrome in burn patients. J Trauma 2000 https://pubmed.ncbi.nlm.nih.gov/11003313/ 2.     Cartotto R, Johnson LS, Savetamal A, et al. American Burn Association Clinical Practice Guidelines on Burn Shock Resuscitation. J Burn Care Res 2023 https://pubmed.ncbi.nlm.nih.gov/38051821/ 3.     Greenhalgh DG, Cartotto R, Taylor SL, et al. Burn Resuscitation practices in North America: results of the Acute Burn ResUscitation Prospective Trial (ABRUPT). Ann Surg 2023 https://pubmed.ncbi.nlm.nih.gov/34417368/ 4.     Cartotto R, Callum J. A review of the use of human albumin in burn patients. J Burn Care Res 2012 https://pubmed.ncbi.nlm.nih.gov/23143614/ 5.     Cruz MV, Carney BC, Luker JN, et al. Plasma ameliorates endothelial dysfunction in burn injury. J Surg Res 2019 https://pubmed.ncbi.nlm.nih.gov/30502286/ 6.     Falhstrom K, Boyle C, Makic MBF. Implementation of a nurse-driven burn resuscitation protocol: a quality improvement project. Critical Care Nurses 2013 https://pubmed.ncbi.nlm.nih.gov/23377155/ 7.     Salinas J, Chung KK, Mann EA, et al. Computerized decision support system improves fluid resuscitation following severe burns: an original study. Crit Care Med 2011 https://pubmed.ncbi.nlm.nih.gov/21532472/ 8.     Kenney CL, Singh P, Rizzo J, et al. Impact of alcohol and methamphetamine use on burn resuscitation. J Burn Care Res 2023 https://pubmed.ncbi.nlm.nih.gov/37227949/ Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more.   If you liked this episode, check out our recent episodes here: https://app.behindtheknife.org/listen

Labour movement historian Geraldine Fela talks about her new book, which discusses the vital political role nurses played in turning back the spread of AIDS, and of homophobia. Geraldine is a member of Solidarity. The book, Critical Care: Nurses on the frontline of Australia's AIDS crisis, is published by UNSW Press, $49.99. Read more about nurses organising. Find out more about Solidarity.

Susun Weed answers 90 minutes of herbal health questions followed by a 30 minute interview with Holistic teacher Sherry Pae.  Sherry Pae has been immersed in the fields of health care, holistic healing, personal transformational, group leadership, and spiritual evolution since 1972. She began in the field of healing as a Critical Care Nurse, where she dedicated 26 years to developing her capacity to be deeply present with another and was taken into the world of body-mind medicine through her experiences with her patients. She began teaching nurses how to be Critical Care Nurses inside of a holistic framework of healing, and her many gifts of haling emerged. She developed her ability to work with others as a teacher, a meditator, a CranioSacral Therapist, a psychotherapist, and an energy healer. She is currently a teacher within the Evolutionary Collective, engaging inthe Global Development of Mutual Awakening, which dedicated to the embodiment of love and unity-consciousness through our awakening together. Through it all she offers others the opportunity to experience the uniqueness of their life within the unfolding creation of shared unity. Patricia has a free, self-paced Introduction to Mutual Awakening e-Course available at www.evolutionarycollective.com/intro. The e-Course has 5 modules and includes free access to the first three chapters of Patricia Albere's bestselling book Evolutionary Relationships: Unleashing the Power of Mutual Awakening. Note: It would be wonderful if you can reference that during the interview as well as provide the link on the website. https://discovermutualawakening.com  

Architectural photographer John Gollings on his Heritage Address talk as part of this year's Open House Melbourne; Dr Jen explains the science of “inner voices” and how they impact our memories; the team discuss slides and playground equipment; Brad Collis, Operations Support Manager at Transurban describes what the inside of a traffic control room is like; historian Geraldine Fela talks about her book Critical Care: Nurses on the frontline of Australia's AIDS crisis; and Nat starts a debate on biscuits. With presenters Monique Sebire, Daniel Burt & Nat Harris.Website: https://www.rrr.org.au/explore/programs/breakfasters/Facebook: https://www.facebook.com/Breakfasters3RRRFM/Twitter: https://twitter.com/breakfasters.

    Join us on this captivating episode of War Docs as we welcome Abraham “Boxxy” Boxx, a critical care nurse and former Army National Guard flight paramedic, who shares his incredible journey from rural New South Wales, Australia, to becoming a combat medic in the Australian Defense Forces. Listen in as Boxxy recounts his early inspirations, such as the humanitarian efforts following the 2004 tsunami and his transition to the US Army National Guard. We explore the nuances of medical training in both countries, including Australia's extensive 18-month combat medic training, and how these experiences have shaped Boxxy's career.      Boxxy provides a vivid account of his global deployments, from jungle survival training in Southeast Asia to peacekeeping missions in the Solomon Islands and humanitarian aid in Pakistan. He reflects on the unique medical challenges faced in these diverse environments and the available support structures. This conversation highlights the importance of comprehensive training and robust support for medics working in austere conditions, drawing contrasts between his military and humanitarian aid experiences.     In addition, Boxxy discusses his career transition to becoming a Certified Registered Nurse Anesthetist (CRNA), shedding light on the rigorous preparation and strategic planning required for this demanding field. He shares insights into balancing military service with a civilian career in the trauma ICU, memorable cases, and coping mechanisms for high-stress medical work. This episode also touches on the importance of integrating basic nursing skills into military medic training and the value of mentorship and support in advancing one's career in military medicine.   Chapters: (00:04) Military Medical Training Comparison (10:19) Medical Deployments and Lessons Learned (23:20) Career Transition and Medical Specializations (27:41) Medical Response in Resource-Scarce Environments (34:50) Enhancing Military Medicine Skills   Chapter Summaries: (00:04) Military Medical Training Comparison Nature's impact on Boxxy's journey from rural Australia to becoming a combat medic in the US Army National Guard and his aspirations to become a CRNA.   (10:19) Medical Deployments and Lessons Learned Early experiences as a medic in the Australian military, including deployments to Southeast Asia, the Solomon Islands, and Pakistan.   (23:20) Career Transition and Medical Specializations A critical care flight paramedic and nurse shares their journey from military service to becoming a CRNA, discussing rigorous preparation and coping mechanisms.   (27:41) Medical Response in Resource-Scarce Environments Pediatric patient's death in resource-scarce environment highlights need for specialized training and understanding local medical capabilities.   (34:50) Enhancing Military Medicine Skills Military medics need to integrate basic nursing skills, teach others, and learn from civilian practices to enhance prolonged field care.   Take Home Messages: Inspirations and Career Pathways in Military Medicine:    The episode delves into the motivational factors that drive individuals to pursue careers in military medicine. Highlighted is the influence of humanitarian missions, such as those following natural disasters, in shaping the career aspirations of medics. This underscores the significant role that early experiences and global events can play in guiding one's professional journey.   Comparative Medical Training Across Countries:    A major focus of the episode is the comparison of medical training programs between the Australian Defense Forces and the US Army National Guard. The differences in training durations, content emphasis, and qualifications achieved are explored, revealing how varying approaches can produce medics with diverse skill sets suited to different operational needs.   Challenges and Learning from Deployments:    The episode provides an insightful look into the diverse and often challenging environments where medics are deployed, from Southeast Asia to Pakistan. It emphasizes the importance of robust support structures and the need for comprehensive training that includes primary healthcare, pediatrics, and obstetrics to effectively handle the unique medical challenges encountered in these regions.   Career Transitions and Advanced Specializations:    Transitioning from military roles to advanced medical specializations is a key theme. The rigorous preparation and strategic planning required to become a Certified Registered Nurse Anesthetist (CRNA) are discussed, highlighting the balance between military service and civilian medical careers. This reflects the broader theme of continuous education and career advancement in the field of military medicine.   Impact of Experiences in Resource-Scarce Environments:    The episode sheds light on the profound impact of working in resource-limited settings on the career trajectories and educational pursuits of medics. Experiences in such environments drive the pursuit of further education and specialized training, reinforcing the importance of adaptability and continuous learning to improve patient care in challenging conditions. Episode Keywords: Combat Medicine, Critical Care Nurse, Army National Guard, Medical Training, Humanitarian Missions, Australian Defense Forces, Medical Deployments, Medical Challenges, Resource-Scarce Environments, Military Medicine, Certified Registered Nurse Anesthetist, Career Transition, Medical Specializations, Flight Paramedic, Trauma ICU, Nurse Anesthesia, Prolonged Field Care, Mass Casualty Situations, Mentorship, Support Structures Hashtags: #wardocs #military #medicine #podcast #MilMed #MedEd #CombatMedic #MilitaryMedicine #AbrahamBoxx #TsunamiRelief #CriticalCareNurse #ArmyNationalGuard #GlobalDeployments #TraumaICU #NurseAnesthetist #MilitaryTraining     Honoring the Legacy and Preserving the History of Military Medicine The WarDocs Mission is to honor the legacy, preserve the oral history, and showcase career opportunities, unique expeditionary experiences, and achievements of Military Medicine. We foster patriotism and pride in Who we are, What we do, and, most importantly, How we serve Our Patients, the DoD, and Our Nation. Find out more and join Team WarDocs at https://www.wardocspodcast.com/ Check our list of previous guest episodes at https://www.wardocspodcast.com/our-guests Subscribe and Like our Videos on our YouTube Channel: https://www.youtube.com/@wardocspodcast Listen to the “What We Are For” Episode 47. https://bit.ly/3r87Afm WarDocs- The Military Medicine Podcast is a Non-Profit, Tax-exempt-501(c)(3) Veteran Run Organization run by volunteers. All donations are tax-deductible and go to honoring and preserving the history, experiences, successes, and lessons learned in Military Medicine. A tax receipt will be sent to you. WARDOCS documents the experiences, contributions, and innovations of all military medicine Services, ranks, and Corps who are affectionately called "Docs" as a sign of respect, trust, and confidence on and off the battlefield,demonstrating dedication to the medical care of fellow comrades in arms.     Follow Us on Social Media Twitter: @wardocspodcast Facebook: WarDocs Podcast Instagram: @wardocspodcast LinkedIn: WarDocs-The Military Medicine Podcast YouTube Channel: https://www.youtube.com/@wardocspodcast      

In this episode of The Root Cause Medicine Podcast, we discuss how sleep disorders, sleep apnea, snoring, and mouth taping can affect you. They dive into: 1. What Are Sleep Disorders and Sleep Apnea? 2. Sleep Apnea Symptoms 3. Sleep Disorders During Perimenopause Emily Lucente is a board-certified nurse practitioner and member of the American Academy of Sleep Medicine. As a sleep care clinician and expert, she regularly educates on all aspects of sleep as she feels it's a significant foundation of overall health and well-being.

May is Mental Health Awareness Month. Since 9/11, more than 30,000 service members or veterans have committed suicide, which is more than four times that of those who passed away in combat over the same period. According to the DOD Suicide Prevention Office, in 2023, there were 92 suspected or confirmed suicides in the National Guard, which brings the total to over 400 guardsmen since the start of COVID-19, not counting Q1 of 2024, which have yet to be released. In this episode, 2nd Lt. De-Juan Haley is joined by Brianna Baker-Meckley, the 130th Airlift Wing's new Director of Psychological Health, Capt. Brittany Hypes, a Critical Care Nurse with the 130th Airlift Wing CERFP who, for the past year, has worked as the Suicide Prevention Program coordinator for the unit, and 1st Lt. Sammi Brown, the director of Public Affairs for the WVANG, to have a conversation about the topic of mental health and suicide.

Whether it's a comforting cuddle from a therapy dog or the gentle presence of a therapy cat, pets have a unique way of brightening patients' lives, reducing stress, and promoting overall well-being. Join us as we uncover the profound impact of pet therapy in healthcare. Julie Miller, BSN, RN, CCRN from the American Association of Critical-Care Nurses shares insights into the science behind pet therapy and heartwarming stories of its effectiveness. Discover how therapy animals reduce stress and promote well-being, and gain practical tips for implementing pet therapy programs in clinical settings. Tune in to explore the transformative potential of pet therapy in healthcare.

Welcome to another profound episode of Grieving Voices, where we explore the emotional intricacies of dealing with loss and healing.Today's guest is Denise Schonwald, a registered nurse turned nationally licensed therapist. With her holistic approach to care that encompasses mental, physical, and spiritual well-being, she offers insights into nurturing both body and mind.In this episode:Discover how Denise transitioned from critical care nursing into mental health support.Understand why honoring commitments is crucial for personal trust and self-care.Learn about the high burnout rates in nursing - especially post-COVID - and how self-care can prevent it.Explore the importance of emotional intelligence in recognizing when you're inflicting suffering on yourself through poor self-care choices.Gain strategies for managing anger effectively without damaging relationships or your own well-being.Delve into people pleasing: why we do it, its impacts on our lives, and how to establish healthier boundaries.Hear about grief's "waiting room" – what keeps us there and how to move forward.Denise's journey from a nurse fascinated by the intricacies of human anatomy to a spiritual teacher and family mediator is nothing short of inspiring. She has woven her experiences into a tapestry that offers comfort and guidance to those navigating emotional turmoil.Through her narrative, Denise uncovers an essential truth: honoring personal commitments is pivotal. When we falter on these promises to ourselves, trust erodes, leaving us vulnerable to self-inflicted suffering. Self-care isn't just about indulgence; it's preventative maintenance for our souls—something Denise has embraced through meditation and mindful practices like Reiki. These practices have been instrumental in managing stress levels after witnessing patients' crises firsthand as a critical care nurse and mental health professional.Denise sheds light on how emotions like frustration are precursors to anger—an emotion many grapple with yet struggle to manage effectively. RESOURCES:Book | Insightful Self-Therapy - Increasing Your Awareness about Mental Health and How to Live a Happier LifeBook | The Four AgreementsSNL Skit | People Pleaser's Support GroupSupport the showThis episode is sponsored by Do Grief Differently™️, my twelve-week, one-on-one, in-person/online program for grievers who have suffered any type of loss to feel better. Click here to learn new tools, grief education, and the only evidence-based method for moving beyond the pain of grief. Would you like to join the mission of Grieving Voices in normalizing grief and supporting hurting hearts everywhere? Become a supporter of the show HERE.

Learn more about serial healthcare killers. Medically-assisted opioid-related overdoses have become major news items. Erin Laferriere got involved in such a case, the Mount Carmen/Dr. Husel litigation in 2020. Dr. Husel was charged with 14 counts of murder. The nurses involved were charged civilly with negligence and were reported to their respective nursing boards. Erin was involved with the civil cases. In the course of her investigation, she also learned about much more than the process of medically assisted death. What astonished her was the degree to which the nurses involved went along with the doctor. Some of that may have been due to the deference nurses often show physicians, but also a deeper issue was identified. Erin says: “Nurses are not going to report medical errors if they're going to be punished for it, whether it's their mistake or also somebody else's mistake. That fear of losing your license, your livelihood, your passion, your profession is a very real fear, and it's becoming more common in the post-pandemic era.” Pat supported this, that when she was in a clinical position, her director of nursing said that if a nurse reported three medication errors, she would lose her job. This podcast will not only give you useful information should you ever come across such a case, but it will make you think. When a hospital punishes nurses for doing the right thing, how can they expect an environment in which a patient's pharmaceutical needs are correctly administered? Join me in this episode of Serial Healthcare Killers - Erin Laferriere What are the correct protocols for a “Do not resuscitate” case? When should a nurse question a medication order? Why did these nurses not question the medication orders of Dr. Husel? What role did the punitive atmosphere in the hospital play in this tragedy? How did the pharmacists become involved in this? Listen to our podcasts or also watch them using our app, Expert.edu, available at legalnursebusiness.com/expertedu. Get the free transcripts and also learn about other ways to subscribe. Go to Legal Nurse Podcasts subscribe options by using this short link: http://LNC.tips/subscribepodcast. https://youtu.be/qdOGodIfwcU Join us for a 3-day virtual event designed for legal nurse consultants just like you LNC Success™ Pat Iyer and Barbara Levin put together THE first Legal Nurse Consulting Virtual Conference in July 2020. They are back with their 9th all-new conference based on what attendees said they'd find most valuable. The LNC Success Conference implementation and also networking event is designed for LNCs at any stage in their career. Build your expertise, also attract higher-paying attorney clients, and take your business to the next level. After the LNC Success™ Virtual Conference, you will leave with clarity, confidence, and also an effective step-by-step action plan that you can immediately implement in your business. Your Presenter of Serial Healthcare Killers - Erin Laferriere Erin is a registered nurse and critical care expert witness with more than thirteen years of critical care experience. She obtained a Bachelor of Science in Nursing from Salem State College in 2009 and a Master of Science in Nursing with a focus on leadership and management from Walden University in 2015. She is clinically active in the adult intensive care setting and also a board certified in critical care nursing by the American Association of Critical-Care Nurses. Erin has spent her profession as a charge nurse, preceptor, educator, and legal nurse consultant. Connect with Erin ELNurseConsulting.com

Have you ever started a new and promising job, only to discover that it wasn't the nurturing and supportive space you thought it was? In this episode, host Sarah Lorenzini, armed with nearly two decades of nursing experience in various departments and leadership roles, provides a guideline to spotting the red and green flags that can signal a healthy or hostile workplace.Sarah explores what makes a healthy work environment, beyond reputation and first impressions, as she does a deep dive into the American Association of Critical Care Nurses' (AACN) six pillars of a healthy work environment. From communication to authentic leadership, she equips both new and seasoned nurses with strategies to assess key characteristics of prospective employers and identify signs of a healthy culture.For those dedicated to their current organization but seeking a better work culture that allows them to grow in their role, Sarah also reveals how nurses can promote positive change in their current work environment.Tune in to hear the essential interview questions you should be asking to evaluate potential work environments and make an informed career decision!Topics discussed in this episode:The AACN's standards for a healthy work environmentExamples of an unhealthy work environmentHow leaders affect work cultureIdentifying red flags in potential work environmentsIdeas to improve your current work environmentCheck out the AACN's Healthy Work Environments website: https://www.aacn.org/nursing-excellence/healthy-work-environmentsMentioned in this episode:Coming Soon! Rapid Response Academy: The Heart and Science of Caring for the SickClick here to learn more about the community that Sarah is building: https://www.rapidresponseandrescue.com/coming-soon-rapid-response-academy Rapid Response and Rescue Intro CourseCONNECT

“One of the things about futility is many people will say, ‘Oh this is futile care,' when what they really mean is, ‘Who in their right mind would want this?' or ‘I would never ever want this,' and that's different. That's not futile care. That's potentially inappropriate care. And sometimes that's the big step for folks,” Lucia D. Wocial, PhD, RN, FAAN, HEC-C, senior clinical ethicist in the John J. Lynch Center for Ethics at the MedStar Washington Hospital Center in Washington, DC, told Jaime Weimer, MSN, RN, AGCNS-BS, AOCNS®, manager of oncology nursing practice at ONS, during a discussion about futile care: how to recognize it, how to approach communication during difficult situations, and how to address a nurse's associated ethical distress.  You can earn free NCPD contact hours after listening to this episode and completing the evaluation linked below.   Music Credit: “Fireflies and Stardust” by Kevin MacLeod  Licensed under Creative Commons by Attribution 3.0  Earn 1.0 NCPD contact hours of nursing continuing professional development (NCPD), which may be applied to the treatment care continuum, psychosocial dimensions of care, or quality of life ILNA category, by listening to the full recording and completing an evaluation at myoutcomes.ons.org by September 15, 2025. The planners and faculty for this episode have no relevant financial relationships with ineligible companies to disclose. ONS is accredited as a provider of NCPD by the American Nurses Credentialing Center's Commission on Accreditation.  Learning outcome: The learner will report an increase in knowledge related to futility in care and how to speak up for patients and prevent ethical distress.   Episode Notes  Complete this evaluation for free NCPD.   Wocial's Moral Distress Thermometer for Nurses   Oncology Nursing Podcast:  Episode 222: Ethical and Moral Dilemmas of Futility in Cancer Care and Treatment  Episode 78: Ethical Distress Impacts Nursing Practice  ONS Voice articles:  Moral Injury and Trauma in Nursing  Four R's and Resilience Approach Help Oncology Nurses Respond to Morally Distressing Challenges  Sort Through Ethical Dilemmas in Medically Futile Care  When Do You Stop Fighting?  Clinical Journal of Oncology Nursing articles:  The Ethical Dilemma of Medical Futility: The Case of Mr. X  Understanding the Moral Distress of Nurses Witnessing Medically Futile Care  When Does Treatment in Cancer Care Become Futile?  American Association of Critical Care Nurses moral distress resources  American Nurses Association moral distress toolkit  End-of-Life Nursing Education Consortium (ELNEC)    To discuss the information in this episode with other oncology nurses, visit the ONS Communities.   To find resources for creating an ONS Podcast Club in your chapter or nursing community, visit the ONS Podcast Library.  To provide feedback or otherwise reach ONS about the podcast, email pubONSVoice@ons.org.  Highlights From Today's Episode  “It's a term that appeared in the literature back in the 1980s when it became clear that we had medical technology that could sustain people's lives but not actually return them to a healthy state. And so, there was this attempt to try and identify and define when it was that the care we were providing, the treatments we were providing, could no longer work. And so, some people tried ‘qualitative futilities,' some people tried ‘quantitative futility.' People have been working on it for a long time, but the shortest definition is a treatment intervention that will not have its intended effect.” TS 1:52  “And first of all, it says futility is a definition that should be used sparingly. There are lots of times when a treatment may be considered what we call ‘potentially inappropriate.' And when thinking about what's the difference between futility and potentially inappropriate? Futility is, it's clearly not going to work. Potentially inappropriate is, well, it might work, but there are lots of competing reasons why maybe we ought not to do it. And some of those reasons might be significant burden. Some of them may be the patient won't be able to achieve a neurologic state where they be able to actually perceive the benefit of ongoing biological existence. That statement, it has some very clear recommendations about: be very careful about how you use the words.” TS 7:15  “In my work as a clinical ethicist, far and away the more frequent reason we get called is families want to keep going. It's not the other way around. And in fact, when a family or a patient is ready to stop, those become incredibly difficult for the healthcare team, particularly when there's a physician who feels like, ‘But I know this will work. Don't not do this. You have a 50%, 60%, 70% chance of surviving. don't you want to try?' So to know that you have the ability to give them a chance is one thing.” TS 13:33  “And here's the tragedy in this, and I hear oncologists say this, ‘Well, it's not time yet.' That's my favorite response, it's, ‘Not yet. Not yet.' So, when you ask most people, ‘If you knew that you were going to die in the next three months, are there things that you would want to do before you die?' most people are like, ‘Well yeah'. To fail to invite this conversation robs them of this choice.” TS 16:04  “Step one: Don't keep it to yourself. A lot of it is making sure that you talk with other folks, and if you work in an inpatient setting and your hospital is Joint Commission certified, then there is some mechanism in place in your institution for dealing with an ethics challenge. But the idea is what we do is hard. And one of the biggest challenges for people who are experiencing ethics distress or moral distress is very rarely do ethical challenges happen when people are having a good time. There's a tragedy somewhere, and part of the big challenge is to separate the tragedy, like the cosmic unfairness, injustice, from ‘Are we as a healthcare team contributing to the injustice?'” TS 40:51 

As parents, our journey never truly ends. From the sleepless nights of infancy to the challenges of raising adolescents, and finally, the bittersweet transition to adulthood, the role of a parent is ever-evolving. In today's episode, Whitney invites you to explore raising adult children through the lens of a faithful Proverbs 31 woman, drawing inspiration from the experiences of a resilient mother, Heather Garfield.   Heather, a mother and critical care nurse who has been through it all, shares her insights into the challenges and joys of raising adult children. She exemplifies the qualities of a woman who remains steadfast in her role as a mother, even as her children reach adulthood.   Heather's journey as a faithful Proverbs 31 woman and her experiences in raising resilient adult children serve as an inspiration to all parents. As we learn from her story, we are reminded that parenting is a lifelong commitment, filled with celebrations and challenging moments, all of which contribute to shaping our children's lives and the beauty in the season that we're welcomed into once our children are grown.  The Well Mastermind registration is open. Are you ready to grow your business with a community that is rooting for you?    Get all the details and join The Well Mastermind here.   Connect with Whitney: Website Follow Whitney on Instagram @whitneykroneberger Interested in one-on-one coaching?  Contact Whitney: wkroneberger@gmail.com   Join Whitney's Free Facebook Group  

   Join us as we engage in an enlightening conversation with retired Army Colonel Kim Biever, a seasoned medical professional with vast experience in critical care nursing. Listen in as Kim discusses the emerging need for large-scale combat operations preparation in the current operational environment. She shares invaluable insights on the importance of readying medical personnel for the future and the urgency to tailor training to the right level of provider. We also touch on the necessity of reflecting on past events and experiences for lessons learned and innovative ways to simplify tasks for medical professionals on the battlefield. Later, Kim highlights the weight of kindness and flexibility when leading others and sheds light on the various roles in nursing, emphasizing that there's something for everyone in this noble field. Learn from her experiences of creating positive outcomes through the simple act of being kind to people and gain insights into the diverse opportunities available in the nursing field.   Chapters: (0:00:00) - Preparing for Large-Scale Medical Operations (0:11:31) - Leadership Lessons and Nursing Advice   Chapter Summaries: (0:00:00) - Preparing for Large-Scale Medical Operations (12 Minutes) We hear from retired Army Colonel Kim Biever, a Critical Care Nurse, Nurse Practitioner, and Clinical Nurse Specialist. We discuss the current operational environment and the need to prepare for large-scale combat operations. Kim shares her insights on the importance of preparing medical personnel for the future and the need to bring training to the right level of provider. We also explore the need to look back at past events and experiences to apply lessons learned and how to innovate and make things easier for medical professionals on the battlefield.   (0:11:31) - Leadership Lessons and Nursing Advice (6 Minutes) Kim found her passion in nursing. She realized that taking a moment to be kind to people can be highly beneficial in creating positive outcomes. Kim shares the importance of kindness and flexibility when leading others. She also explains the variety of nursing roles and how there is something for everyone in the nursing field. Episode Keywords: Medical Operations, Combat Operations, Training, Provider Proficiency, Past Experiences, Lessons Learned, Innovations, Kindness, Flexibility, Nursing Roles, Army Colonel, Critical Care Nurse, Nurse Practitioner, Clinical Nurse Specialist Hashtags: #wardocs #military #medicine #podcast #CombatMedicine #MilitaryNursing #BattlefieldInsights #PowerOfKindness #NursingLeadership #OperationalMedicine #RetiredMilitary #HealthcareHeroes #ArmyMedics   Honoring the Legacy and Preserving the History of Military Medicine The WarDocs Mission is to honor the legacy, preserve the oral history, and showcase career opportunities, unique expeditionary experiences, and achievements of Military Medicine. We foster patriotism and pride in Who we are, What we do, and, most importantly, How we serve Our Patients, the DoD, and Our Nation.   Find out more and join Team WarDocs at https://www.wardocspodcast.com/ Check our list of previous guest episodes at https://www.wardocspodcast.com/episodes  Listen to the “What We Are For” Episode 47. https://bit.ly/3r87Afm WarDocs- The Military Medicine Podcast is a Non-Profit, Tax-exempt-501(c)(3) Veteran Run Organization run by volunteers. All donations are tax-deductible and go to honoring and preserving the history, experiences, successes, and lessons learned in Military Medicine. A tax receipt will be sent to you. WARDOCS documents the experiences, contributions, and innovations of all military medicine Services, ranks, and Corps who are affectionately called "Docs" as a sign of respect, trust, and confidence on and off the battlefield, demonstrating dedication to the medical care of fellow comrades in arms.     Follow Us on Social Media Twitter: @wardocspodcast Facebook: WarDocs Podcast Instagram: @wardocspodcast LinkedIn: WarDocs-The Military Medicine Podcast

Hospital readmissions due to inadequate or incorrect treatment cost healthcare and the U.S. government billions of dollars. This is particularly notable in cardiac care. By continually reviewing and revising standards of care, professional medical organizations seek to ensure that the standard of care reflects the latest proven findings regarding treatment and care. Ruth Pierce, a nurse with 37 years of experience, who is also a legal nurse consultant, currently works as a field reviewer for a national accreditation company. She is a charter member of Pat Iyer's LNC Elite coaching program. She shares her wealth of knowledge about how standards are developed, how long it takes for them to be generally adopted, and why knowing the timeline in a legal case is crucial to applying the time-appropriate standard of care principles. She also explains the difference between accreditation, a baseline level of approval, and certification, which characterizes a hospital that goes beyond the basics. The information in this podcast will give you a big-picture view of how standards are developed, changed, and filter down to the clinical level. It will provide you with an essential background for understanding how deviations in standards of care occur. Join me in this episode of Unveiling Standards of Care and Cardiac Care Guidelines - Ruth Pierce What's a leading cause of hospital readmission? How is the medical community addressing this issue? Why are national standards of care essential? Why must an LNC be acutely aware of timelines when evaluating patient care? How did the current guidelines for cardiac care get developed? Listen to our podcasts or watch them using our app, Expert.edu, available at legalnursebusiness.com/expertedu. https://youtu.be/eV37wUJq4Os Announcing LNC Success™ Virtual Conference 8 October 26,27 & 28 LNC Success™ is a Virtual Conference 3-day event designed for legal nurse consultants just like you! Pat Iyer and Barbara Levin put together THE first Legal Nurse Consulting Virtual Conference in July 2020. They are back with their 8th all-new conference based on what attendees said they'd find most valuable. This new implementation and networking event is designed for LNCs at any stage in their career. Build your expertise, attract higher-paying attorney clients, and take your business to the next level. After the LNC Success™ Virtual Conference, you will leave with clarity, confidence, and an effective step-by-step action plan that you can immediately implement in your business. Your Presenter of Unveiling Standards of Care and Cardiac Care Guidelines - Ruth Pierce Ruth Pierce, MBA, MHA, RN, CCRN-K, CPHQ has been a nurse for over 37 years. Her experience includes Emergency Department, Flight Team, Paramedic, CCU, CVICU and Mechanical Circulatory Support Device/Solid Organ Transplants. Currently, she works as a cardiac/VAD field reviewer for a national accreditation company. Visiting and certifying hospitals across the country gives her a unique ability to understand the current cardiac standards and trends in patient care. Ruth is also the past president of her local American Association of Critical Care Nurses chapter and NC Association for Healthcare Quality. Connect with Ruth https://windwardcoveconsulting.com

The American Association of Critical Care Nurses hosts an annual conference called NTI. Sarah and her team were able to attend NTI 2023 and they're all recapping their experiences at the 4-day event in the episode!Sarah is joined by her team, Walker, Elisabeth, and Ashley, as well as special guest, ICU Nurse Sarah. They recorded each night to share the key takeaways from each day of the conference, from the wonderful people they met and inspirational speakers to the educational lessons in their sessions.You'll hear highlights from NTI 2023, including how artificial intelligence is being used in the medical field, life-changing products and technology, the importance of mentorship, and LOTS MORE.Tune in as Sarah and her fellow nurses discuss what's new in the world of nursing, and how NTI's upcoming virtual sessions can help you become a better nurse!Topics discussed in this episode:Everyone's experiences in the pre-conference cadaver labThe valuable role that mentorship plays in shifting the culture of NursingWhat everyone learned during the first day's super session and classesExciting events from day 2… including the “Critical Care Challenge”Walker's discoveries talking to sepsis researchersThe effect of COVID-19 on nursingRebuilding after COVID and our path forward as NursesGet more information on AACN's National Conference NTI and the upcoming virtual event on June 12-14th!https://www.aacn.org/conferences-and-events/nti?tab=NTI%20VirtualConnect with our guest, ICU Nurse Sarah's, Instagram:https://www.instagram.com/iseeu_nurse/Mentioned in this episode:AND If you are planning to sit for your CCRN and would like to take the Critical Care Academy CCRN prep course you can visit https://www.ccrnacademy.com and use coupon code RAPID10 to get 10% off the cost of the course! Rapid Response and Rescue Intro CourseIf you would like to check out Sarah's 1hr, 1 CE course, go to: http://www.rapidresponseandrescue.com To get the FREE Rapid Response RN Assessment Guide and the coupon code for $10 off the cost of the course, message Sarah on Instagram @TheRapidResponseRN and type the word PODCAST!

A recent NPR article suggested that death by natural causes is preferable rather than resuscitation by CPR due to injuries the victim might sustain. Critical care flight nurse Teri Campbell joins Steve and Jane to warn that the article could scare off bystanders from performing life-saving CPR and discuss the truth behind some of the side effects experienced during CPR. Learn how you can save a life through CPR training at www.illinoisheartrescue.com See omnystudio.com/listener for privacy information.

An online transcript is available. The book from which these reflections are drawn is available to download or read online..On today's program, we are listening to nurses as they reflect on their experiences on the frontlines during the COVID-19 pandemic. These are stories of uncertainty and fear, of anger and resilience, dedication, recovery, and camaraderie. But most of all these are stories about caregiving. The readings that make up this episode are drawn from the book, Providence Nurses Inspire Hope through Healing: Reflections from the Frontlines of the COVID-19 Pandemic, edited by Hilary Alison, Katie Adams, Katie Grainger, and Hayley Pike. Our thanks to the editors and to all the nurse-contributors, including:  Syl Trepanier, SVP Chief Nursing Officer, Renton, Wash. •  Shandria Dyer, Critical Care Nurse, Santa Rosa, Calif. • Nanny Rawlings, Nurse Navigator, Complex Care Management, Bainbridge Island, Wash. • Starr Salvatore, Clinic/Triage Nurse, Lacey, Wash. • Amanda Meyer, ICU Nurse, Spokane, Wash. • Ana Rocha, Oncology Nurse Practitioner, Santa Monica, Calif. • Ashlee Dowling, Senior Clinical Informatics Specialist & ICU Nurse, Missoula, Mont. • Lady Lou S. Sayson, Certified Registered Nurse, Lubbock, Texas • Christine Marshall, Emergency Care Center Nurse, Orange, Calif. • Jennifer Gentry, Chief Nursing Officer Central Division, Portland, Ore. • Illeana Bassoco-Barajas, Med Surgery Oncology Nurse, Fullerton, Calif... 

Adult-Gerontology Acute Care Nurse Practitioner (AGACNP) provide care for the sickest of the sick in a variety of clinical care settings.  And in a world where the baby-boom generation is living longer and needing more health care, nurses with expertise in treating older adults in the acute care setting will be in high demand.  So, if you're looking for a career where you can make a real difference, you might consider becoming an Adult-Gerontology Acute Care Nurse Practitioner. It's time for another riveting episode of This Is Getting Old: Moving Towards An Age-Friendly World.  We're excited to welcome two advanced practice nursing faculty join us: Linda Briggs, D.N.P, ACNP-BC, FAANP and Helen Brown, M.S., ACNP-BC, FNP-BC, FAANP.  Key points covered in this episode: ✔️ A Trailblazer in Nurse Education: Dr Linda A. Briggs' Legacy in the Field Linda A. Briggs has been a cardiovascular specialist for decades – so long that she's earned dual certification as an Adult Acute Care Nurse Practitioner. She received a Fulbright Specialist, and she was awarded the GW Bender Teaching Award in 2017, proving her commitment to educating future nurse practitioners.  ✔️ From ED to Classroom: Experienced AGACNP Nurse—Helen Ferguson Brown Helen Ferguson Brown has over 20 years of experience in Emergency Departments and a passion for quality patient care. She is an acute care nurse practitioner and an adjunct clinical instructor at GW University, where she's been teaching AGACNP students for 5 years. Her dedication to education has earned her national recognition, including the esteemed Circle of Excellence Award from the American Association of Critical Care Nurses. ✔️ Mastering the Art and Science of AGACNP: What They Do and Why It Matters? Acute Care Nurse Practitioners (AGACNPs) are the superheroes who save lives in emergencies. These highly trained nurse practitioners take care of those who are the sickest of the sick, the physiologically unstable, technologically dependent and highly vulnerable patients, and they work their magic in all sorts of settings - not just hospitals.  They might be found saving lives in rehab centers, performing superhero feats in ambulatory surgical centers, or even flying high as flight nurses on helicopters. No matter where they're based, AGACNPs are ready to leap into action whenever their patients need them. ✔️ From Bedside to Boardroom: Where AGACNPs Make Their Mark The American Association of Critical Care Nurses wants to remind us that care isn't bound by location. AGACNPs, who traditionally work in hospitals, can also be found in other settings - outpatient clinics, urgent care facilities, and even rehab and long-term care facilities. Their adult general background allows them to work in many different places. The possibilities are endless for these versatile healthcare professionals. Although they work with a team, they are more like independent providers, taking charge and making the tough calls. ✔️ AGACNP Salaries: How Much Can You Really Make? Are you ready to give your nursing career a boost? As an AGACNP, you have your pick of exciting job opportunities, especially in hospitals. And we're not just talking pocket change - according to ZipRecruiter, the average salary in Jan 2023 is a sweet $108,054. But wait, there's more! In Washington, DC, you can rake in a cool $115,659, as reported by Salary.com. Keep in mind, the numbers may vary depending on location and workplace. ✔️ AGACNP Training Using Simulate Simulation labs at GW are top-notch, allowing students to diagnose and assess critically-ill patients. From scenarios based on real-life experiences in the emergency department and ICUs, they have to diagnose various conditions, from septic shock to arrhythmias. Essentially, they're given a chance to practice their AGSCNP skills  without any real-life consequences, of course. ✔️ Mapping Out Your Nursing Degree Are you a nurse passionate about helping the most complex and critically ill patients? If you're a BSN-prepared nurse or certified nurse practitioner seeking to become an advanced practice nurse, look no further than GW's AG-ACNP program!  Our part-time MSN program spans 48 credits and 600 clinical hours, while our BSN-DNP program covers 70 credits and 1000 clinical hours. For those already holding a Master's degree, our post-Master's certificate might be right up your alley with 20 credits and 600 clinical hours. Don't wait; apply now to take your nursing career to the next level! ✔️ AGACNP Education at GW Want to dive into the world of adult gerontology acute care nursing? You can find out all the juicy details on Nursing.gwu.edu! Apply now ~ and if you need any help or have questions, you can call Dr. Linda Briggs, D.N.P., ACNP-BC, FAANP, at 202-994-6259.  If you have questions or comments or need help, please feel free to drop a one-minute audio or video clip and email it to me at melissabphd@gmail.com, and I will get back to you by recording an answer to your question.  --------------- About Melissa Batchelor, PhD, RN, FNP, FGSA, FAAN: I earned my Bachelor of Science in Nursing ('96) and Master of Science in Nursing ('00) as a Family Nurse Practitioner (FNP) from the University of North Carolina Wilmington (UNCW) School of Nursing (SON). I genuinely enjoy working with the complex medical needs of older adults. I worked full-time for five years as FNP in geriatric primary care across many long-term care settings (skilled nursing homes, assisted living, home, and office visits), then transitioned into academic nursing in 2005, joining the faculty at UNCW SON as a lecturer. I obtained my PhD in Nursing and a post-master's Certificate in Nursing Education from the Medical University of South Carolina College of Nursing ('11). I then joined the faculty at Duke University School of Nursing as an Assistant Professor. My family moved to northern Virginia in 2015 which led to me joining the George Washington University (GW) School of Nursing faculty in 2018 as a (tenured) Associate Professor. I am also the Director of the GW Center for Aging, Health, and Humanities. Please find out more about her work at https://melissabphd.com/.

In this podcast episode, the host Deanna Radulescu talks with Mark Sias and his  experience in the wrestling industry and meeting famous wrestlers while training at Florida Championship Wrestling. They then shift gears to discuss the notary business and how it can be done remotely online. The host explains how they started their own notary business and how they help people get documents notarized both in person and online. They also share success stories from students who have taken their course and started their own successful notary businesses. The host also discusses their upcoming book on digital platforms for remote online notarization, which will provide insights on which platforms are worth investing time in and which ones to avoid. Overall, this episode provides valuable information for anyone interested in starting a notary business or learning more about remote online notarization.00:00:00 Introduction To Label Free Podcast Live With Guest Speaker, A Renaissance Man In A Linebacker's Body.00:01:55 Wwe's Proving Ground In Tampa: Meeting Brand Names And Taking Photos.00:11:46 Remote Notarization: The Fascinating Concept Of A Notary Being Able To Notarize From One State To Another.This episode is brought to you by,  @activationproducts ! Bringing you The top level ingredients, top level products and, ultimately, top level health. Turn back the hands of time! Head to link below and use discount code: LABELFREE15 for 15% off! https://shop.activationproducts.comAs always thank you for the support, to contact me directly follow the link below:https://www.labelfreepodcast.com​ Stay Healthy, Stay Ready- Deanna Marie Radulescu#podcastguest #labelfreepodcast  #activationproducts #prowrestler #notary

On this episode, I will share with you the secret sauce of a prolific nursing career. It touches education, evidence-based practice, staying up to date, networking, and "recharging your batteries". This episode is about nursing conferences,  like the American Association of Critical Care Nurses' premier conference, NTI, should be a pillar of every nurse's career.By the end of this episode, you will know how to make the most of nursing conferences in general, and specifically for NTI. You will also get a sneak peek into some of the fascinating sessions on tap for NTI 2023.Learn more about NTI 2023Guests: Sarah Wells, RN MSN CNL can be reached at sarah.wells@aacn.orgTravis DiCenzo-CrotalloConnect with the AACN!IG: @exceptionalnursesFB: @aacnfaceTwitter: @AACNme

From bedside nursing to breathwork facilitation, Rachele Scevola has breathed new life into her career and her health. Known as The Breath Nurse, Rachele has over a decade of experience as a critical care nurse, and after her own struggle with chronic health issues, trauma, anxiety, depression, and burnout, she discovered the transformative benefits of breathwork. She then decided to turn her passion into a business.

Medically-assisted opioid-related overdoses have become major news items. Erin Laferriere got involved in such a case, the Mount Carmen/Dr. Husel litigation in 2020. Dr. Husel was charged with 14 counts of murder. The nurses involved were charged civilly with negligence and were reported to their respective nursing boards. Erin was involved with the civil cases. In the course of her investigation, she learned about much more than the process of medically assisted death. What astonished her was the degree to which the nurses involved went along with the doctor. Some of that may have been due to the deference nurses often show physicians, but a deeper issue was identified. Erin says: “Nurses are not going to report medical errors if they're going to be punished for it, whether it's their mistake or somebody else's mistake. That fear of losing your license, your livelihood, your passion, your profession is a very real fear, and it's becoming more common in the post-pandemic era.” Pat supported this, that when she was in a clinical position, her director of nursing said that if a nurse reported three medication errors, she would lose her job. This podcast will not only give you useful information should you ever come across such a case, but it will make you think. When a hospital punishes nurses for doing the right thing, how can they expect an environment in which a patient's pharmaceutical needs are correctly administered? Join me in this episode of Serial Healthcare Killers - Erin Laferriere What are the correct protocols for a “Do not resuscitate” case? When should a nurse question a medication order? Why did these nurses not question the medication orders of Dr. Husel? What role did the punitive atmosphere in the hospital play in this tragedy? How did the pharmacists become involved in this? Listen to our podcasts or watch them using our app, Expert.edu, available at legalnursebusiness.com/expertedu. https://youtu.be/qdOGodIfwcU You can still order the recordings for our 7th Virtual Conference! LNC Success is a Virtual Conference 3-day event designed for legal nurse consultants just like you! Pat Iyer and Barbara Levin put together THE first Legal Nurse Consulting Virtual Conference in July 2020. They are back with their 7th all-new conference based on what attendees said they'd find most valuable. This new implementation and networking event is designed for LNCs at any stage in their career. Build your expertise, attract higher-paying attorney clients, and take your business to the next level. After the LNC Success Virtual Conference, you will leave with clarity, confidence, and an effective step-by-step action plan that you can immediately implement in your business. Your Presenter of Serial Healthcare Killers - Erin Laferriere I am a registered nurse and critical care expert witness with more than thirteen years of critical care experience. I obtained a Bachelor of Science in Nursing from Salem State College in 2009 and a Master of Science in Nursing with a focus on leadership and management from Walden University in 2015. I am clinically active in the adult intensive care setting and board certified in critical care nursing by the American Association of Critical-Care Nurses. I have spent my profession as a charge nurse, preceptor, educator, and legal nurse consultant. Connect with Erin ELNurseConsulting.com

Letting Go of Critical Care to Find Nurse Coaching: Nicole Vienneau MSN, RN, NC-BC “I said, “Well, I'm a Holistic Nurse.” And I've never said that before. Because I've always been a Critical Care Nurse. But through this journey of Nurse Coaching, I have uncovered a deeper way of being a Nurse.” ~Nicole A. Vienneau MSN, RN, NC-BCAh-HasWhen Nurses come together, anything can happenMake the ask.  See the no, as a next opportunity.  You are never stuckIt's important to know that stories and their meanings can change over time based on new learnings and understandingsWhen you shift your thought process to what could become, your choices become limitlessNurses can ebb and flow into different specialties based on their needs, desires and interestsSymbolism and meaning are important to each person's story and a Nurse coach can learn more about their clients when they ask open-ended questions and offer silence and deep empathyWhat can happen when you let go of self-limiting beliefs and open to the possibilities?It's ok to ask for what you want and what you needArticles and Other ResourcesBattling Burnout with Nurse Coaching Vienneau and Ervin articleIntegrative Nurse Coaches in ACTION! Podcast with Shakira FranklynIntegrative Nurse Coaches in ACTION! Podcast with Barbara Dossey- Find Your Nursing Soul MateIntegrative Nurse Coaches in ACTION! Podcast with Barbara Dossey Energy of Your BreathDr Barbara Dossey websiteBlue Monarch Health, PLLCRestoration Room, PLLCTucson Nurses Week FoundationLetters to a Future Nurse Book collaboration Nicole is the author of chapter 14:  Nurse FriendsLet Go Nurse Coach blog****** Thank you for listening. We LOVE Nurses! Please leave us a 5 start rating and a positive comment about an episode you love! Follow Integrative Nurse Coach Academy on Facebook, Instagram, LinkedIn Learn more about our programs at the Integrative Nurse Coach Academy

For all the mom's, nurses, and those wondering if they have what it takes to be their own boss, Gillian is a prime example of someone taking destiny into their own hands. Gillian transitioned from nursing to online coaching, trying to figure it out on her own while listening to this very podcast. While the information we gave her helped, she admitted she couldn't do it on her own. Since then, she's hired 4 assistant coaches, 3x'ed her income, and balances time working and raising 5 kids!   Time Stamps:   (0:29) Our Client Gillian (2:22) Transitioning from Nursing to Coaching Online (4:33) Where Gillian Was Before IFCA (6:15) Gillian's A Ha Moment Signing Up for IFCA (9:11) Work Since IFCA (17:05) Hiring 4 Assistant Coaches (21:15) Feeling Taking the Leap (32:26) Advice to Mom's (34:28) Where to Find Gillian ---------- Learn More About Impact Fitness Coaching Academy,   To Learn More About I.F.C.A. - And How We've Helped More Than 1,700 Fitness Coaches, Experts, and Influencers Grow a 5-35k+ Month Online Fitness Business Without Paid Ads, Complicated Funnels, or Even Having a Large Social Media Following    Click Here→ to VISIT THE IFCA PAGE  ---------- GIVEAWAY!  Leave a rating + review on iTunes, and Have a Chance To Win a $200 Amazon Gift Card + Special Prizes! Winners Announced Monthly on The Episode. Simply leave a review, and send a screenshot to the Fit Biz Podcast Instagram Page!

Welcome to Episode Three! Get the details on our Giveaways at https://www.facebook.com/boldexplorationpodcast Today on the podcast we get to meet Tricia Doyle. She is a wife, mother, homeschool mom, nurse, and unschool travel fanatic! In this episode, we talk about how they began their journey into homeschooling and then the RV lifestyle where travel and exploration have taken center stage. Their Amazon Best Selling book contribution about their family was also a well deserved surprise! I know you will love Tricia just as much as I do! About our Guest: Tricia Doyle is the founder and primary author for Life's Next Leap. It is truly important to her to be able to share the story of her family through travel and how much it is continuing to evolve their journey—placing value on experiences over tangibles. She has co-authored a Best Selling book, Worldschoolers: Innovative Parents Turning Countries into Classrooms. Tricia is also starting a new blog called UNschool Travel Mom, sharing tips and advice for Homeschooling. She has been a Registered Nurse for fourteen years working as a Critical Care Nurse. Tricia was awarded many accolades such as Nurse of the Year and also being nominated for the Daisy award for her compassion and care. She has a Bachelor's degree in Nursing from Jacksonville University, has held many leadership roles in Nursing and enjoys teaching others. Tricia enjoys photography, nature, sewing, homeschooling, and most importantly spending time with her family. These are fully embodied in her role as the primary author and contributor for Life's Next Leap. You can see her passion for life through her stories and how she can utilize her enjoyment of teaching to an elevated level through homeschooling. Learn more about this author and her family's journey by visiting her site. Links below: Instagram: Instagram.com/LifesNextLeap Facebook: Facebook.com/LifesNextLeap TikTok: tiktok.com/@lifesnextleap?_t=8Z5DoZ9DZSF&_r= Linked In: Llinkedin.com/in/tricia-doyle-bsn-rn-pccn-883a62113 Blog: www.UNschoolTravelMom.com Instagram: Instagram.com/UNschoolTravelMom Facebook: Facebook.com/UNschoolTravelMom TikTok: tiktok.com/@unschooltravelmom?_t=8Z5Dun6Z4Ul&_r=11 Link Tree is: linktr.ee/triciadoyle Amazon – World Schoolers: https://a.co/d/9x0knC2

Join your host Sarah Lorenzini as she's interviewed by Keith Carlson, fellow nursing podcaster at The Nurse Keith Show.With the ability to stay grounded and alert during chaotic situations, Sarah is the epitome of being an anchor in a storm. In this episode, she shares how she found her niche in nursing, why rapid response nursing suits her work style, and how she coaches other nurses through the stress of emergent situations.Sarah gets fulfillment from helping others, and she does this in so many ways — education through storytelling on her podcast, teaching an online course that's approved by the American Association of Critical Care Nurses, and as a nursing educator.Tune in to get a sense of what it's like to be a rapid response nurse, and learn how you can develop the skills to become a better nurse!Topics discussed in this episode:What drew Sarah to rapid response nursingDiscovering what type of nursing works best with your work styleType of people that do well in rapid response nursingCommon reactions nurses have in a crisis situationHow to train yourself to respond differently to stressPursuing advanced certificationsWhy Sarah loves being a nursing educatorHelping nurses through her podcast and Rapid Response & Rescue courseWhat inspired Sarah to lead a rapid response team during the pandemicPeople that have inspired Sarah in her lifeCheck out this episode of The Nurse Keith Show podcast:https://nursekeith.com/the-excitement-challenges-and-satisfaction-of-rapid-response-nursing/Earn CEs by listening to Sarah and Keith's podcast through RNegade:https://myportal.pro/view_business_/rapid-response-rn-1668811051095x983153652413497300If you would like to check out the 1hr, 1 CE course, go to: www.rapidresponseandrescue.comTo get the FREE Rapid Response RN Assessment Guide and the coupon code for $10 off the cost of the course, message Sarah on Instagram @TheRapidResponseRN and type the word PODCAST!

In this episode we welcome critical care nurse practitioner, Kali Dayton, DNP, AGACNP. Kali is a member of the Society of Critical Care Medicine and host of the ‘Walking Home From The ICU' podcast. Kali works closely with international ICU teams to help transform patient outcomes. They focus on early mobility and management of delirium in the ICU. She joins us to chat about her early days and experience in the ICU, sedation in patients and the effects of mobility of patients in the ICU, medications, how she helps with patient healing and more. Kali tells us about what inspired her to start her podcast and shares a story about her experience with an ICU survivor.SPONSORBETTERHELPBetterHelp is the largest online counseling platform worldwide. They change the way people get help with facing life's challenges by providing convenient, discreet, and affordable access to a licensed therapist. BetterHelp makes professional counseling available anytime, anywhere, through a computer, tablet or smartphone.Sign up today: http://betterhelp.com/solvinghealthcare and use discount code “solvinghealthcare"TRANSCRIPTKK: We are on the brink of a mental health crisis. This is why I am so appreciative of the folks over at BetterHelp everybody the largest online counseling platform worldwide to change the way people get help with facing life's challenges by providing convenient, discreet, and affordable access to licensed therapists. BetterHelp makes professional counseling available anytime, anywhere through a computer, tablet, or smartphone. Sign up today go to better health.com And use a promo code solving healthcare and get 10% off signup fees.SP: COVID has affected us all and with all the negativity surrounding it, it's often hard to find the positive. One of the blessings that has given us is the opportunity to build an avenue for creating change. Starting right here in our community discussing topics that affect us most such as racism and health care, maintaining a positive mindset, creating change the importance of advocacy, and the many lessons we have all learned from COVID. If you or your organization are interested in speaking engagements, send a message to kwadcast99@gmail.com or reach out on Facebook @kwadcast or online at drkwadwo.caKK: Welcome to ‘Solving Healthcare', I'm Kwadwo Kyeremanteng. I'm an ICU and palliative care physician here in Ottawa and the founder of resource optimization that one, we are on a mission to transform healthcare in Canada. We're going to talk with physicians, nurses, administrators, patients and their families because inefficiencies, overwork and overcrowding affects us all. I believe it's time for a better health care system that's more cost effective, dignified, and just for everyone involved. KK: Kwadcast nation super exciting episode I got flowing with you. We got Kali Dayton. She is a nurse practitioner that has taken ICU delirium, ICU mobility so seriously, she's got her own consulting firm. She also has her own podcast ‘Walking from the ICU'. Such a great phenomenon. So, we got her you'll hear this episode. It's a live cast that we did a couple of weeks ago. I'm just proud of her. Someone that's taken getting people healthier and out of the ICU and functional seriously, and we need more of that going on right now. We're only gonna see higher demands. So, without further ado, I'm gonna bring Kali on but first, check out our latest newsletter, kwadcast.substack.com It has everything Kwadcast, our episodes, or newsletter, guest blog appearances, guest vlog appearances, you're gonna love it. Kwadcast.substack.com Check it out. Without further ado, I want to introduce you to Kali Dayton. Welcome to the podcast.KD: Thank you so much for having me on. I've been following your podcast; I appreciate your mission. I see a lot of our objectives are in line.KK: Oh 100% 100%. So, Kali, can you walk us through your story? You're a nurse practitioner. That is, like I said, changing the outlook for critically ill patients. How did you get here?KD: Absolutely. I'm sure a lot of my listeners know my story very well. I started out as a brand-new nurse, many years ago, over a decade ago, in awake and walking ICU. That's just what I call it now. That's the term that I've coined to describe what they do there. In the interview in my naivete, I was just excited to be there. I had no idea what they were talking about when they asked, ‘Would you be willing to walk patients that are on ventilators?' and I was willing to do anything, right. I was just brand new graduate. I said yeah, of course absolutely teach me everything. I didn't understand the magnitude of that question until probably three to eight years later. Because when I started working there, no one made a big deal out of it, for decades and that ICU it's a medical surgical ICU, its high acuity, they've had a COVID ICU throughout the pandemic. They've maintained it this practice of allowing almost every patient to wake up, usually right after intubation, unless there's an actual indication for sedation. What's been intubated on mechanical ventilation is not an indication for sedation. So, unless they have an inability oxygen with movement, seizures and cranial hypertension, something like that, otherwise they are awake. They're reoriented and they're allowed to communicate, tell us what they need. We manage their pain according to what they tell us. They're usually mobilizing shortly after within hours after intubation, and throughout the day, and throughout their time on the ventilator. So that was completely normal. No one told me ‘Hey, Kali, this is the gold standard of care. This is the model for all early mobility protocols in the world' Everyone knows about this ICU. No one told me that. So, I spent a few years there thinking that that was normal critical care, medicine, knowing none the wiser. Then I became a travel nurse, and I went to other ICUs in the in the United States. My very first contract when I walked into the ICU, it just felt different. But I knew I expected things to feel different, right? It's a new environment. But everyone was in bed. Everyone looked like they were asleep. There were very few signs of life, and I got my patient assignment, and the patient was sedated and on the ventilator. I didn't know why they were sedated. I wanted to continue my routine, do a neuro exam, hopefully get the patient in the chair ready for physical therapy, because that was my routine, in the wake & walk ICU. A lot of times physical therapy comes out of that patient is in the chair waiting for the physical therapist, take them on a walk even on the ventilator. So, I asked my orientee nurse, ‘Hey, can I get this patient up and take him for a walk?' and she looked at me in horror and said, ‘No, they're on the ventilator. They're intubated' What didn't make sense to me, because I've cared for at least hundreds, maybe even 1000s of patients that were on the ventilator and were awake and walking. I had no idea what she was talking about. I said, ‘I know that they're intubated. But why are they sedated?' ‘Because they're intubated?' and I say, ‘Okay, but why are they sedated?' and we went in circles. That was the first time it ever crossed my mind that a patient would be automatically sedated, just because they were intubated. I quickly realized that that was the common perspective throughout the ICU, that I was the odd man out there. Here's the thing. Despite my years of experience, treating patients like that, I knew how to do it. I didn't know why we did it. No one had taught me what sedation actually does. No one taught me what it's actually like for patients, and how much it changes outcomes. So, in that environment, I didn't have the tools to support my approach and my practices and to advocate for my patients. I was still kind of a new nurse, and I was, you know, you just had to fit in in the ICU. There's so much peer pressure, there's the culture is such a huge part of it. I ended up just taking the ‘When in Rome' approach and I just went with what I was surrounded with, and I ended up following along sedating my patients. I didn't really obviously know the difference. I mean, I saw a difference in outcomes. I saw patients stay on the ventilator for far longer. I missed the human connection, I noticed that there were a lot of tracheostomies and nursing home and LTech discharges that I did not see the way can walk in ICU 93% of survivors from that high acuity medical surgical ICU that I came from, went straight home after the after the ICU.KK: That is nuts. That is nuts.KD: That's what I thought was normal. So, I was noticing things, but I couldn't really put my finger on it. I couldn't advocate and I just went with it. Right. I even laughed at some of the nursing jokes about yeah, I hope my patient sedated, and totally snowed today. Thinking that that was funny, and it wasn't till years later that I was in grad school. Of course, even in my acute care doctorate program, nothing was mentioned about sedation or mobility practices. It was just assumed even in our case studies, it was assumed that if a patient came in with pneumonia, they were going to be sedated if they were on a ventilator. I was on a plane ride, and I sat next to a survivor. When he heard that I was a nurse and ICU nurse, the color dropped from his face. He started telling me about his experience over four years before that moment when he was a patient. He told me what it was like to be on a ventilator. He just barely mentioned the ventilator. All he could fixate on was what it was like to be in the middle of a forest with his limbs nailed to the ground and trees were falling down on him and he couldn't run away. Demons were coming to the sky and lots of things that he still couldn't talk about, because he was so deeply traumatized. I was stranger on this plane and he's sobbing to me, telling me about what he experienced. Of course, I wanted to diagnose him and I said ‘it sounds like you had ICU delirium' but that meant nothing to him. I came to realize as I listened with real empathetic ears, that that wasn't just a nightmare. Those weren't hallucinations. Those were vivid and real. He was psychologically scarred as if he physically lived through those scenarios. I was really shaken. I really hoped that he was one in a million, because he was telling me that for year after discharge, it was really difficult to relearn how to sit, stand, walk, swallow, that was really hard. The hardest part was that for year after discharge, every time he closed his eyes, he would be lost back in that forest back in that scenario, and he could not sleep. So, the depression, anxiety, physical disability, I didn't ask about the cognitive function because I didn't enough know enough to know that he wouldn't be at high risk of having post ICU dementia. He said that he still had not returned to his career. His life was over. He said ‘I know I feel bad even telling you this, I should be grateful to the ICU to him for saving my life, but my life is over. The life I knew before the ICU is gone. I lost my life in the ICU. If I were ever to become sick, I would never cross a toe back into the ICU. He was a DNR/DNI in his 40s, with no other real comorbidities because he never wanted to live through that again. I think what he meant by that was ICU delirium. I had worked in the ICU about six years. We have never I never heard anyone talk about anything like that. So, I thought this must be a fluke, he must be one in a million. So, I went survivor groups. I thought I would have to post and ask survivors questions. No, the second I got into survivor group, I just scroll through and almost all their posts were about the trauma suffered under sedation and these medically induced comas, what it was like to not be able to balance their check book, read a book, read a clock, like they were barely able to text. These are people thinking ‘How long is this going to last? my brain is not the same'. So that is what got me into looking into the research. I was shocked to find decades of research, exposing the harm of our normal practices. Yet we continue to do those things and I was back in that awake and walk ICU. Seeing a completely different way and I've seen this contrast from what I experienced for years as a travel nurse. Then where I was currently at as a doctorate student, nurse, and then I started working as a nurse practitioner, in that same ICU. That's when I started this podcast ‘Walking home from the ICU' to show what they were doing in the ICU and now it's turned into ‘how do we revolutionize our normal practices in the ICU?'KK: I got so much here, first. I never even would have comprehended or would have thought that your initial experience, I didn't realize that your initial experience was people were able to ambulate and get out of bed and reduce the amount of sedation. KD: People are gonna say ‘Oh, well, that must have been, you know, long term mentors or not that high acuity' They were the first ICU to publish the study back in 2007, showing that it was safe and feasible to walk patients on ventilators and in that study, they had PF ratios less than 100.KK: What that means in nonmedical folk is that your lungs were extremely damaged and require a lot of supplemental oxygen to make sure your saturations are high enough that your oxygen levels are high enough. So, this is the sickest of the sick. From a breathing perspective, getting up and hustling and movement answered. So that is amazing. From a personal side, it must have been an absolute mind F that you couldn't, that you went from one extreme to the other. I'm doing tell you from my I've worked in several ICUs in my country, and the latter is the norm, people aren't getting up on a ventilator, you know, they're not getting, they're barely getting up into a chair on a ventilator. KD: They aren't even getting sedation vacations, they're snowed. KK: One of my main jobs in the ICU when I walk in is minimize the sedation and even often I've seen in practice, they're getting Dilaudid or opioid infusions for no real reason to be honest with you. They're not post op. They have no pain syndrome and we're given pain medication in infusion, which accumulates and what you're describing to amongst patients, my other job is in palliative care when they get toxic or delirium. Delirium from medication. Yeah, that can be traumatic, these memories, these images. That must have been an absolute frustrating experience to go from one version to the other.KD: I was just really confused. I mean, I was still I feel like I'm still new in my career and impressionable. No one taught me the why that's the unfortunate thing about a lot of our medical education is we're taught how we're taught task lists, but we're not taught the why that allow us to critically think and see a bigger picture. I feel like looking back I was really victim to that. I but I would still ask every ICU ‘So, shouldn't this patient get up? Can I get them up?' because it I knew that was beneficial. I wanted that and a lot of it for me was, I wanted to see my patients get better. When you're walking a patient moments later, you know that they're progressing, you get to connect with them, you get to know who your patients are, I had no idea who my patients were, they were just bodies in the bed. That's not why I got into medicine. So even just selfishly, I wanted them to be off sedation, had I known that by taking off sedation, we could decrease their seven-day mortality by 68%. Oh, I would have been all over that, but I didn't know. I did work in one ICU, where they had some level of ABCDEF bundle, which is a protocol to help guide teams to minimize sedation and get patients up. There's such a spectrum of compliance and different approaches to it. So, I was taught to do an awakening trial, which means you turned on sedation. The purpose really should be to get them off sedation, it should be sedation cessation, but I was taught. So, you know, at five o'clock in the morning, we must turn down sedation, it's super annoying, I know but just turn it down. Wait to see them thrash - that's how you know, when you see all their limbs move that they haven't had a stroke. When you can tell they can't tolerate the ventilator, then you turn the sedation back on and call it a failed trial, just chart it. I was confused. I didn't know what the objective was, I didn't know what we were doing. I didn't know why they were agitated. For her to say it's because I can't tolerate the ventilator. That was confusing to me because I'd seen so many patients tolerate the ventilator. I didn't understand delirium, and I hated awake new trials. They were laborious, they were stressful, they felt unsafe. It's hard to see patients between delirium, it's hard to see them be so uncomfortable, and you can see the terror in their eyes. But again, when in Rome, I just did what I was told, unfortunately. So, this is my journey now is almost my penance for the harm that I caused my patients during those years. KK: Well, Let's be honest, Kali, you can't be looking at it that way, man. We all remember sedation is the norm. What we're doing now is trying to advocate for change. I can't emphasize enough the change can be dramatic for people like it really comes down to function. If you in the ICU and you're paralyzed into intubated on sedation and analgesia, you're not moving, like you're not using your muscle. Then when you're trying to go back to what you want it to where you want it to be. I think a lot about our COVID patients. They were in the 40s/50s/60s, that are trying to get back to working, trying to get back to doing the activities that they love to do. When you think about this not only are you impacting their ability, like they're not getting to their functional level, but what's it doing for their family. Now you got a loved one that's got to take care of them, that might have to take off time off work too. It just is an absolute amplifier when people can't be functional.KD: For those that maybe don't work in the medical field, or even especially those that do, here's what we're not talking about the bedside, here's what we're not telling patients and families. When we go into surgery, they give us informed consent, they tell us here are the remote risk that things that could happen, right. What we don't do before intubation for patients and our families is tell them the actual risks of sedation. We don't understand ourselves that sedation is not sleep, it disrupts the brain activity so severely that they don't get real REM cycle. So, my perspective is that it's a form of torture, really, I mean, that's what we do, and war in the military, we deprive people of sleep, and that's what we're doing to our patients when we give medications that make it so they cannot get restorative sleep. Many of our study, sedatives are myotoxic, meaning that they're toxic to the muscles, so it causes more muscle breakdown. Then on top of that, if there's absolute disuse when you're stopped sleeping deeply sedated, you're not even contracting a muscle usually. So that disuse makes it so that our muscles break down more. That disruption of sleep often caught is one of the mechanisms that causes delirium, which is acute brain failure. It's an organ dysfunction. That can turn into long term post ICU, dementia, cognitive impairments. So, they cannot return to their normal lives can't take care of their families can't go back to their jobs because they can't. Cognitively their brains can't function the same way anymore. They have this post ICU PTSD because of those vivid scenarios that they live. I'm not going to call them hallucinations, because that's, that's not accurate. Those were real to them. We just don't see that big picture of sedation, and we just don't even question and I do that a lot in my life too. They're things that I'm just taught that I don't question, but we don't question whether or not sedation is necessary. Sometimes it is. When we understand how risky it is, then we can do a true risk versus benefit analysis for each patient to say, ‘they're intubated for this reason, does that necessitate sedation?' If not, let's get it off and see what they need. Let them communicate. Let's prevent delirium. Your platform is all about preventative medicine. In the ICU you come in with one acute critical illness and we sign them up for chronic conditions?KK: Absolutely, as you said, like it really is about what can we do to prevent this from becoming a chronic condition. Honestly, it's a culture change, from what I could see. What's sad about medicine, is that we have data to support how bad things are or how good things are. The amount of time we invest in create that change is limited. If you look at the data for sedation vacation, so that same principle of, turn off someone's sedation, periodically, that we know that has positive outcomes, like we know that, but you could go through an ICU, throughout any country in North America and the odds are that they're not getting it routinely. Why doesn't that happen? That's why I'm proud of Kali. Number one, being a champion of this, ICU care sucks, but a lot of us that will end up in there. So, we want to be able to optimize care, but also like just doing some about it. It's one thing to want to bring attention to it but also, being an activist. I think it helps. So, you've got the podcast, Kali, you've done some other work, how else have you been able to increase awareness? You could even get into like, what the podcast also has done for you or in the people around you?KD: So with a podcast, I started that right before COVID hit. I don't know if your god person but I, God told me to start a podcast in December 2019. I barely even listened to podcast didn't know how to start one, but I couldn't. I couldn't rest. I knew exactly that I had to start, I had to put out 32 somewhat episodes by the beginning of March of 2020. I didn't know why it had to be so fast and so furious, and survivors came out of nowhere. I interviewed my colleagues, researchers, it was just this miraculous setup that just came together, put out all these episodes, and then COVID hit. I thought ‘well now it's all gonna be all about COVID, and no one's gonna care about this'. God back handed me and said, ‘This is for COVID They're gonna be millions of people on ventilators, how is this not relevant to COVID'. So, I continue to throw out COVID Even though I recognize that the ICU community was not really in a place to revolutionize. The hard thing is that this could have been so beneficial to COVID we created more work for ourselves with the sedation practices, you talked about awakening and breathing trials. Once I just looked at only wake & breathing trial started sedation, turn it off once a day and then turn it back on. Decrease ventilator days, by 2.4 days, days in the ICU decreased by three days in that hospital decreased by 6.3 days, when we're in a staffing crisis, we need to have a process of care that's efficient actually gets patients out of the ICU. Instead, we created this bottleneck where patients are now stuck on the ventilator because they're too weak to breathe on their own. Even if their lungs are better. Now they need tracheostomies. They're stuck in a ventilator. We can't at least in the States, we couldn't get them to LTACH because LTACH's were too full of all the other COVID long term patients. So, then the ICU wasn't rehabilitating these patients, and so then they develop more hospital complications, and then they ended up needing more care. It's just we created so much more work for ourselves. It just was a hard time to really take on a new endeavor and totally change your practices. But during COVID, everyone ran back to the 90s. Not everyone but a lot of people ran back to the 90s. As far as using benzodiazepines, higher doses of sedation, deeper sedation longer times, there was so much fear. We did a lot of fear-based medicine. So, I just kept chugging along with my podcast, knowing that the community was going to need healing after all of this. We were going to need a lot of rehabilitation within our own clinicians, but also within our practices. So now, teams are coming to me saying what we're doing now. We're still doing COVID care even these are not COVID patients, we're still we're back to deeply sedated patients. Where are we lost so many seasoned clinicians, new clinicians came in during COVID. They've been trained to deep deep, deeply sedate, they don't know how to move patients they're scared to. But one team said I look on my ICU It's not an ICU, these aren't ICU patients. These are LTACH patients. These are rehab patients that we're not rehabilitating. We're bottlenecked. We can't get these patient outpatients out, we can't get new patients, we're stuck. We're creating that kind of scenario. So now, I work as a consultant and I do training with the teams, I teach them the why the reality of delirium, giving them a picture of an awake & walking ICU using real case studies, pictures, videos, so that we have a vision of what could be I feel like the ABCDEF bundle when it was rolled out in the mid 2000's good change happened, a lot of things moved forward. I do feel like we didn't explain fully the why behind it. Until every ICU clinician hears the voice of survivors, they won't be afraid of sedation, they'll still be inclined. We started, we continued this start sedation automatically, then at some subjective point down the road, start to take it off, when they come out, agitated, turn it back on, we just didn't, we didn't give them this perspective of ‘Hey, most patients should be awakened walking. Here's how to treat delirium and here's how the team works together' we put a lot of it on nurses, which is not fair, feasible or sustainable. So, as I work with teams, I tried to really give them a foundation of why, and then how, how to treat patients without automatically sedating them. When the sedation necessary. How do we navigate appropriate and safe sedation practices? When do we use it? How do we mobilize patients, I go on site with teams and I do simulation training, we do real case studies and practice and the whole team practices together. Because it's a skill set, we think about pronation, when we started printing patients, everyone was terrified. And it took so many people and it took so long, you know watching every little line and now teams flip them like pancakes, right? It becomes a skill set. So, I tried to get them opportunity to practice that on a pretend patient. So, they can think through critically think through the scenario, think through delirium, thanks for ICU acquired weakness, then practice mobilizing patients with different levels of mobility.KK: My brain is going like, the whole time, it's like you need to come see our group.KD: Let's do it. I'll hope on a plane tomorrow – I can't actually. I'm going to Kentucky tomorrow, but let me know I'll be there!KK: We would absolutely love to have you. Just knowing where a lot of clinicians lack is hearing the voice of the people that have gone through it. Clearly, that's been a motivator for you in terms of why we need to pivot and provide less sedation to our patients and mobilize our patients and avoid them from having all these secondary complications as a result of being immobile. The means are there. KD: The data is strong; the data is really powerful. I mean, decreased mortality by 68%. Who doesn't want to do that, right? So, but almost even more powerful are the voices survivors, when you hear their voices in your head when you're sitting in a patient. It's haunting COVID, there were times when patients could not oxygenate the movement. I had to sedate them. I hated it. I just felt sick because I, I just didn't know what they were experiencing. I didn't know if they were in pain. I didn't know what was going on underneath that they were going to live with us the rest of our lives, it's because of the survivors that have interviewed on my podcast, they are the educators.KK: Yeah, I have so many ideas going through my head. I would love after when we jump off, links to the some of the episodes from the survivors that we can pass along to our group, to our show in general, but our group to give a sense of what it really is like to go through this. Yeah, our patients don't come I mean, every once in a while we get a patient come back and say how they're doing but they don't give us the they don't give us the negative side, they really focus on showing some gratitude. KD: Which is good, but if they came back, it's probably because they weren't too traumatized to come back. The ones that don't come back. I mean, why would you go back to the place that you are sexually assaulted?KK: Yeah, no, yeahKD: It's like to trigger and some people can't even go the same street as that hospital. On my website under the resources tab, the clinician podcast, at the bottom, the page is organized by topics. One of those topics is survivors of sedation and mobility, as well as survivors of an awake & walk ICU. So, you can hear their different perspectives and testimonies, it's organized by different topics. KK: You're an organized cat, I'm looking at it right now. I can tell you, you're very structured and organized just by the way your website is set up. It's on point.KD: It's curriculum. This is education, this is not just a hobby. I mean, this is we've got to make sure we get the right information to the right people.KK: You're so boss. You're gonna be running an organization one day, and ICU, I don't know. I see big things for you.KD: We'll see. I mean, I have a lot of optimism for the future of critical care, going to conferences, meeting with people at the bedside podcast listeners reaching out. It's not just me that cares about this. That's why I continue is that there are so many people that I call revolutionists, sometimes as the lone voice in their ICUs. But they're bringing big changes, they're making waves there so my motivation with podcasts is to provide the ammo, the quiver the arrows in their quiver, so that they can share that with their colleagues get more buy in, so that they don't have to reinvent the wheel. It's a lot to change a perspective and change a culture. It's hard.KK: Yeah, and maybe just seeking some advice, we had Dr. Wes Ely on the show and how to create some culture change around this issue. I want to hear your perspective. Kali, how do you think you do create that culture change? Because you bring this up to many staff, and they'll be like, ‘Oh, they're gonna extubate themselves? Oh, we're short staffed. This is not gonna be able to work.' What are your thoughts?KD: Yeah, this has been a lot of my journey is figuring out what are the barriers? and how do we address them? I think we're over the checklists. I think it is important to systemize and protocolized our practices. When we implement these kinds of changes, we this can't just be “Hey, Nurse, take off the sedation' that is not going to work. They have some valid fears at all I had ever seen. With a patient coming off sedation. After days, two weeks of sedation, I would have a lot of inhibitions. When I'm busy. I don't have time to wrangle that patient. I don't have time to make sure they don't self extubate. I have a Thank you for reading Solving Healthcare Media with Dr. Kwadwo Kyeremanteng. This post is public so feel free to share it.whole episode on unplanned extubations, but delirium increases the chances of unplanned extubations by 11 times. So, it's just changing the perspective understanding what is delirium? why should we be panicked about it? What causes it? We are practices are some of the biggest risk factors and culprits of delirium in the ICU, and to learn doubles that are in hours required for care. So, when we're short staffed, why would we create a delirium factory? When it doubles our workload? It doesn't make sense, but when that's all we know, we don't understand that there's a better way to do it. So, my approach when I go to help a team have culture change is to, again explain the ‘why' give a perspective of what could be, here's what patients can be like, when we don't sedate them. If they when they wake up after intubation, it's like coming out of a colonoscopy. Endotracheal tubes not comfortable. Here are some tools to help make it more comfortable. Here's how we can talk to them. Give them a pen and paper, I would get agitated and panicked. I couldn't communicate. Here's how you involve the family, here's the toolbox to help you succeed and have that patient be calm & compliant. And they will protect their tubes. I've had patients write ‘please be careful my tube' That's what I need to experience. So, when you find a couple of case that isn't so easy hits, easy wins. Allow your team to see a patient awake, communicative, calm in even more while on the ventilator, the perspective starts to shift. Then they start to ask, okay, that was easy. That was fun. That changed outcomes. They walked up the ICU. Who else can we do this on and it starts to have a domino effect. So suddenly, we expect him to just shut up and do it. That's, that's not going to cut it. I don't think that I think that's partially why the ABCDEF bundle rollout, years ago was not has kind of gone away, because we didn't provide the why. We also, again, I think starting sedation, and then taking off later, is a lot of work. We should only do that if it's absolutely necessary. Otherwise, I mean, I have an episode with a hospital in Denmark, they do the same thing and that allow patients to wake up right after intubation. They are so much easier, more compliant, because they don't have delirium, we have to understand that that agitation is usually rooted in delirium, we have to come to really be terrified of delirium.KK: I'm really enjoying this, I'm really liking this because it's even at that added perspective of saying, ‘Hey, your workload is going to be worse if people are delirious, so let's avoid going delirious in the first place' Let's just get a grip on this bad boy, out of the gate.KD: You're all about preventative and it's like, Let's prevent one of the biggest culprits of mortality. Delirium doubles the risk of dying in the hospital. So, people say we don't have time to mess with all sedation practices, like let's just sedate them and like, save their lives and figure it out later. No. By doing that, by increasing the risk of delirium, we could double their chances of dying. So, if we care about mortality, then we will care about our sedation practices. We also know that ICU acquired weakness is really laborious. When people imagine mobilizing patients on ventilators. What they're imagining is taking off sedation days to weeks later when they're delirious. They can barely lift a finger and now we're trying to mobilize these, you know, 200 plus pound adults to the side of the bed. That's dangerous, laborious, it takes so many people. If a patient walks into the ICU or into the hospital, hypoxic hypotensive, whatever. We have moments later, we haven't stabilized. Why can't they walk? Did we cut their legs off? Right? So, once we have oxygenated, perfused, what's the harm in sitting outside of the bed and seeing how they do when they're not delirious, they can tell us how they're feeling. We can provide more support on the ventilator; they can probably walk better than they did come in and hypoxic. Once they're stabilized hours later, or even 24 hours later. So that is so much easier when they maintain their ability to walk. So, in the COVID ICU, many patients were standby assists to the chair with a nurse while they were on a ventilator, because they're alone in the room, right? Physical therapy could go in and work with a patient, just scoot the ventilator wall to wall as they're stuck in their rooms, help them stand or sit, step on steps, they were alone in that room with these patients, because they were strong enough to do it, because we didn't allow them to be under myotoxic sedation and I would say rot in the bed. So, all of that plays into an ease of workload. Then obviously the get off the ventilator sooner, get out of the ICU sooner. It makes the workload easier. So, it's a little bit of an exchange and efforts in some ways. Yes, you must talk to a patient. Yes, you must assess them a little bit more. But also, could during COVID, I was hearing about swapping out propofol bottles every hour, picking up to go in and out to titrate vasopressors that we were getting just because of the sedative and hypotensive effects. All of that is effort but wasn't necessary and wasn't beneficial.KK: I'm telling you, you are changing the boogie. Yeah, changing the conversation and perspective. This is something that can dramatically impact patient care. If we could get the buy in, in the culture. Wow.KD: You know, people will say ‘Well, we don't have we're trying to save $25 million this year. We can't afford to pay our payer clinician some extra time for education or whatnot' The ABCDEF bundle, even in their spectrum of compliance, decreased healthcare costs by 24 to 30%. KK: Oh, yeah. KD: ICU acquired weakness increases healthcare costs by I want to say 30-40%. Delirium increases healthcare costs by 40%. ICU acquired weakness increases healthcare costs by 30.5%. So, by having a process of care that prevent those complications with decreased healthcare costs. So why wouldn't we, right? KK: 100%. We even we had a paper out last year showing the financial impacts of ICU delirium. We always think to have the opportunity cost, that money could be diverted into more staffing, more resources for physio, optimizing nutrition, all these things can be enhanced. If we, if we make it a priority. KD: I think it's one of our one of our strongest cards to play for staff, safe staffing ratios. To say staff is better, we'll get better care in this using this protocol. We will save you so much money so it's investing thousands to save millions or billions.KK: I love it. You're speaking my language. We are definitely going to have you back in some capacity. I don't know that for some reason. It's not just gonna be the show. I really want to get you talking to our group. Maybe regional rounds, or something. I don't know what it's gonna be. It's something that we need to hear more of talked about the patient experience, your own experience and the drive like what's pushing this. Knowing my people a lot of intensivists and an ICU nurses and allied health professionals, we want to achieve this, get our patients to a point where they are better. Really better, not just alive, but thriving. This starts here. I really do believe it starts here. So I just want to give number one, Kali some mad love on what you're doing and continue to hustle, it's paying off. Second. How do people get to know you a little bit more? and about the show and the consulting and so forth?KD: So, have a website www.daytonicuconsulting.com. There's more information about consulting services available, the podcast is on there, the podcast has transcriptions and citations organized by topics. KK: So organized folks. KD: 116 episodes, and I really didn't even know how much of a what's called a rabbit hole that this would become. There's so much to learn about the science behind what we're doing as well as the patient and clinician perspective. So, check that out, find the topics. If nothing else start at the beginning. I think the beginning lays a foundation, I was very intentional about how I organized it at the beginning to lay a foundation of ‘why' and ‘how' comes later. I'm on Instagram @daytonicuconsulting, Twitter, Tik Tok. Go ahead and set up a consultation with me send me an email and we can chat about your team, your barriers, even your family members what's going on? I'm obviously obsessed. So, I'm here for you! let me know.KK: So good. So good. Thank you so much for joining us. Those on the chat group or that are watching live. You want a piece of this episode just tap NL into the chatbox will give you a copy the video and the end the podcast when it's released. Awesome work. Congratulations.KD: Thanks for caring about this.KK: 100% KK: Kwadcast nation that's exactly what I'm talking about changing the boogie right here in ICU care. Follow us on Instagram, YouTube Tiktok Facebook @Kwadcast Leave any comments at kwadcast99@gmail.com, subscribe to our newsletter. Essentially, it's like a membership you want to know more about Kwadcast nation. Go to Kwadcast.substack.com Check it out. Leave that five-star rating and continue to allow us to change boogie in unison. Take care, peace. We love you.Solving Healthcare Media with Dr. Kwadwo Kyeremanteng is a reader-supported publication. To receive new posts and support my work, consider becoming a free or paid subscriber. Get full access to Solving Healthcare Media with Dr. Kwadwo Kyeremanteng at kwadcast.substack.com/subscribe

As health care professionals, it is our job to advocate for our patients, even if our efforts are not well received initially. Especially when we are deeply concerned, or uncomfortable with the situation. This can be tough, but it is essential for the health of the patient. What happens when we are expressing real urgent concern and the provider on the other end doesn't feel your urgency? On today's episode, our host and rapid response nurse Sarah Lorenzini, tells us about an experience she had when providing care for a patient with critical limb ischemia where she knew the patient needed immediate surgery, but the primary care doctor didn't think it was urgent. Sarah goes through real examples of how she spoke with the doctor, the doctor's responses, intentional language she used to get her urgency across, and what happened thereafter.Sarah also explains the classes of critical limb ischemia, symptoms to look out for in varying severity, how to treat patients in each class, and main takeaways for nurses when they are in a situation where they need to be persistent in their advocacy in a situation like this.Tune in to learn more about critical limb ischemia and what you as a nurse can do to potentially save your patient's life, or limb. Topics discussed in this episode:An example of expressing concern to a medical providerWords and phrases to use that can help express your concern for the patientThe importance of a doctor being physically present to assess the patientDon't neglect the basicsThree classes of critical limb ischemia and what to do in each caseOptions for restoring blood flow (revascularization)Range of symptoms to expect from claudication to amputationWhy waiting too long for revascularization is problematicTakeaways for nurses who find themselves in this type of situationIf you would like to check out the 1hr, 1 CE course, go to: www.rapidresponseandrescue.comTo get the FREE Rapid Response RN Assessment Guide and the coupon code for $10 off the cost of the course, message Sarah on Instagram @TheRapidResponseRN and type the word PODCAST!

Nurses, for the most part, spend significantly more time with patients compared to physicians. Regardless, it can be difficult for nurses to have their voice heard. For instance, how many times have YOU found yourself apologizing to a physician for just doing your job?The education from nursing school teaches a lot of vital skills, but one that's ignored is the need to effectively communicate with other members of an interdisciplinary team. How do you make a physician take into account your concerns for your patient? And, what if you're dealing with a rude physician?During this episode of Rapid Response RN, Sarah Lorenzini shares multiple communication strategies she uses when trying to advocate for patients. She also discusses the nurse/physician relationship, and the patience required to work with medical residents and interns.Tune in to gain a better understanding of how to deal with this issue through her real-life examples!Topics discussed in this episode:Power dynamics between nurses and doctorsThe SBAR techniqueExamples of non-urgent and urgent communicationHow to deal with an professional or rude physicianUsing the CUS communication methodHow to ask “Why” without putting others on the defensiveIf you would like to check out the 1hr, 1 CE course, go to: www.rapidresponseandrescue.comTo get the FREE Rapid Response RN Assessment Guide and the coupon code for $10 off the cost of the course, message Sarah on Instagram @TheRapidResponseRN and type the word PODCAST!This episode was produced by Podcast Boutique http://podcastboutique.com

One Sunday during football season, after being pressured by his wife, a reluctant patient gave in and decided to finally come into the ER. His calcium levels were high, but his EKG came back normal, he was experiencing no pain, and seemed healthy and responsive — until he wasn't.Telling her story of treating this patient is host Sarah Lorenzini's friend and fellow nurse, Kisha RN, CEN. She details her experience with this patient, starting from convincing him to stay for further tests, to shocking him 19 times after he coded, and reuniting months later.Tune in to learn why it wasn't obvious this patient was about to experience cardiac arrest, and how medical professionals should address similar cases. You'll also hear from Kisha and Sarah about the emotional impact of working on a patient who has coded as they fight for their life that is in your hands.Kisha has helpful takeaways and advice from this case to share, so don't miss this episode!Topics discussed in this episode:What drew Kisha to ER nursingKisha tells an ER story of a seemingly healthy patientThe moment Kisha's patient codedHow Kisha was affected by this patientSkills that nursing school can't teachExplaining hypercalcemia and what causes it“Stones, bones, groans, moans, and psychiatric overtones”Routine treatments for hypercalcemiaWhy this patient was so memorableKisha's biggest lessons from this caseIf you would like to check out the 1hr, 1 CE course, go to: www.rapidresponseandrescue.comTo get the FREE Rapid Response RN Assessment Guide and the coupon code for $10 off the cost of the course, message Sarah on Instagram @TheRapidResponseRN and type the word PODCAST!

Managing Atrial Fibrillation is common on all critical care units! In this episode, we dive into not only clinical considerations for the management of Atrial Fibrillation but also communication in urgent and emergent situations. Join us in the Confident Care Academy membership for more in-depth lectures on all things pathophysiology! CRAVING MORE IN DEPTH NEW GRAD ICU EDUCATION? JOIN THE NEW TO ICU MEMBERSHIP! https://confidentcareacademy.com/p/ne... MORE CONFIDENT CARE ACADEMY: Podcast: https://open.spotify.com/show/7bElMXU... Website: https://www.confidentcareacademy.com Anna's Youtube: https://www.youtube.com/channel/UCY5d... Anna's Instagram: https://www.instagram.com/annasrna_/ Chrissy's Instagram: https://www.instagram.com/chrissycrna PRODUCTS WE LIKE (AMAZON STOREFRONT): https://www.amazon.com/shop/chrissycrna CONTACT: For potential business inquiries and partnerships: confidentcareacademy@gmail.com

We are all praying for Buffalo Bills' safety, Damar Hamlin, after he was hit, causing a cardiac event, sending him to the ICU. This is a nightmare for any athlete, and disheartening for family, friends and fans.As nurses, medical students, even parents, when viewing these types of tragic events, it is natural to think about what you would do in an emergency situation like this. Especially a parent attending a child's sporting event, having the knowledge and ability to help out in an emergency can start to feel more important than ever.On today's episode, rapid response nurse and our host, Sarah Lorenzini, has invited guest Dr. Jeremy Alland, the official physician for the Chicago Bulls basketball team, to help us unravel what happened to Damar Hamlin on the football field, and how we can better prepare ourselves for cardiac events as medical professionals in non-medical settings.We go over sports medicine doctor's roles, common cardiac events that occur in sporting events, how to treat them, and how to stay vigilant (not paranoid) in situations where there is a possibility of a cardiac event.This episode isn't only for medical professionals or students, this is also for anyone who wants to be prepared and helpful in emergency situations.Tune in today to hear practical information and advice that could potentially help save someone's life. Topics discussed in this episode:Dr. Alland's role as the Chicago Bulls team physicianWhat happened to Damar Hamlin?What is commotio cordis?Explanation of the how sports related cardiac events occur for non-nursesA possibility of what happened to Damar HamlinWhat happens when a player collapses on the field? What is an emergency action plan in sports medicine?Why AEDs are important in an emergencyHow was Damar Hamlin able to stand up and collapse again after he was hit?Advice for lay people and medical professionals witnessing a sports emergencyA free app to download to locate AEDs in your area: Pulse Point AEDhttps://apps.apple.com/app/id867150971Who is the best person to do CPR in an emergency?To connect with Dr. Jeremy Alland, head to his instagram page @JeremyAllandMD or check out his podcast by visiting www.yourdoctorfriendspodcast.com!

The most concerning type of syncope!  When a patient suddenly passes out from either an arrhythmia or a structural abnormality of the heart... this needs to be investigated and treated... next time they might not wake up from it!If you love learning from other people's mistakes, you will love this episode of when I didn't realize my patient was in V-tach and walked him back to his room!We discuss all of the reasons the heart might cause you to pass out and a little about the challenges of being an ER Triage Nurse in this final episode of the year and the last episode in a 4 part series on syncope.  So make sure you also check out episode #32, #33, and #34 to learn seizure vs syncope, reflex syncope, and orthostatic syncope. If you would like to check out the 1hr, 1 CE course, go to:www.rapidresponseandrescue.comyou can use coupon code: PODCAST22To get $22 off the cost of the course now until the end of 2022

This episode covers the two types of orthostatic syncope:Neurally mediated orthostatic syncope (from conditions with autonomic dysfunction)and"non-neurally mediated" orthostatic syncope which is from medications or hypovolemia.We discuss the diagnostic value and dangers of orthostatic vital signs and how to determine what type of orthostatic syncope your patient has had.This is part 3 of a 4 part series on syncope so make sure you check out episode #32 and #33. If you would like to check out the 1hr, 1 CE course, go to:www.rapidresponseandrescue.comyou can use coupon code: PODCAST22To get $22 off the cost of the course now until the end of 2022

Nancy Perpall is a former critical care nurse who used conflict resolution to get her patients the best care. As a practicing divorce attorney for the last 30 years, she's used conflict resolution to get her clients the best results. As a former Chair of The Supreme Court of Pennsylvania's Domestic Relations Rules Committee, she championed rules to promote conflict resolution through mediation as an alternative to litigation.Nancy's upcoming how-to book, The Malnourished Marriage – 5 Essential Emotional Nutrients for a Healthy Relationship, is a conflict resolution buffet of food for thought to help couples bilge a diet of discontent and feed their hunger for love. Nancy's novel, Around Which All Things Bend, is a story about relationships and how far we're willing to bend for love.Nancy began her professional career as a critical care nurse working in the Emergency Room and the Intensive Care Unit. While practicing nursing, she published articles in nursing journals and co-authored a textbook, Advanced Concepts in Clinical Nursing (J.B. Lippincott, 1974).She entered Villanova Law School in her early 30's, and after graduating, Nancy practiced Family Law. Nancy was appointed by the Supreme Court of Pennsylvania as Chair of the State's Domestic Relations Rules Committee and presented seminars to lawyers and judges and published widely in that field.www.nancyperpall.com

Part 2 of a 4 part series on  syncope.Syncope is one of the top reasons why a rapid response is called... but the question is, what precipitated the syncope?In this episode we discuss a classic case of vasovagal syncope, in which Annie's patient had a six second pause on his ECG in response to some overwhelming news.  We break down why atropine might not be the best intervention for this patient and some of the treatment options for bradycardia. 

This episode is Part 1 in a 4 part series on syncope.Syncope and seizure can both present with unresponsiveness.  It can be difficult to differentiate between the two very different causes for an unresponsive episode.  Fortunately, there are some things to look for to help rule out seizure or confirm that it is the culprit... and they probably aren't the ones you thought you knew.

If you are a cardiac nurse, this is your nightmare case!  Cardiac Tamponade is a surgical emergency that requires you know more than ACLS to save this patient.  The signs and symptoms are subtle and takes an astute clinician to figure it out.In this episode we discuss all the classic textbook assessment findings from Beck's Triad to pulsus paradoxus as well as some of the more subtle clues of declining cardiac output. We talk through when you need a pericardiocentesis and when it's time to crack the chest and perform an open arrest.And who better to discuss this case than the person who taught me about cardiac tamponade, my boss and former Cardiac ICU Nurse; Brian McCain.If you want to be prepared for the absolute worst case scenario for your post cardiac surgery patient, than you're gonna want to take notes on this one.

This patient was so backed up, his abdomen looked like he was 9 months pregnant!  It was so bad that he was tachycardic and hypotensive.  In this episode we talk about common post-surgical complications from constipation, to an ileus, to a small bowel obstruction.  We break down diagnostics, pharmacological interventions, and surgical options.Ever given neostigmine?  Then you are gonna want to hear this episode.Ever heard of Ogilvie's syndrome... if you care for post-surgical patients this is another one you want to be familiar with.Do you want to listen to an entire episode about poop... than you will love this episode!It's amazing how inability to poop can cause such severe and even life threatening complications!

Nursing pre-shift anxiety is a thing!  Many of us stress ourselves out so much leading up to our shift that we don't sleep or eat well or we feel overwhelmed by the thought of another 12 hour shift and we haven't even stepped foot in the hospital yet.  But there is hope...This episode does not have any hacks for erasing pre-shift anxiety... but rather how to face it.Sarah discusses the 3 things that she has done to work through the  anxiety associated with being a Nurse.So, if you find yourself dreading your shifts, losing sleep over worry about work, or overly consumed with what could happen, you might want to give this episode a listen.

Do you want to grasp ABGs more?  Arterial Blood Gases are tricky! It's one thing to memorize the normal ranges for each value, but an astute clinician is able to see the combination of abnormal values and determine what led to this derangement and what to do about it.In this episode, guest Christian Guzman, Critical Care APRN shares an interesting case of...SPOILER ALERT: Necrotizing FasciitisThe patient's presentation was concerning but not very clear what was going on initially.  But the Nurse's intuition which led to an ABG helped guide the team towards a diagnosis, prompted Christian to upgrade the patient to the ICU, and ultimately led to the patient making a full recovery.If you love nerding out with a deep dive into pathophysiology, then you will love this episode.

This episode is jam packed with everything you need to know for your next stroke alert!I was interviewed by Annie Fulton from the Up My Nursing Game Podcast and we got to talk about all things stroke from differentiating between ischemic and hemorrhagic stroke to the life saving interventions of tPA, thrombectomy, ventriculostomies, and the pharmacological interventions for stroke.  We discuss the role of the Rapid Response Nurse and the bedside Nurse during a stroke alert. What to assess for first, what information the stroke team is going to need, what are the priorities, and why all the hustle to get to CT?! If you want to be prepared, not only to recognize the signs and symptoms of stroke, but also anticipate what is next in this patient's course of care from diagnostics to interventions and recovery, this episode is for you! You can listen to more of Annie's podcasts at https://www.upmynursinggame.com/ and on Apple Podcasts at https://podcasts.apple.com/us/podcast/up-my-nursing-game/id1527032817You can also find Annie on Instagram @UpMyNursingGame If you would like to check out my course, you can find it at:www.RapidResponseandRescue.com

Is work life balance even possible as a nurse?I would say yes... absolutely!  But it takes some effort and intentionality.  As a full time nurse, wife, mother of 5, and podcast host, I get to do a lot of juggling.In this episode, I share 2 nuggets of wisdom that have helped me achieve work/life balance.  Find me on Instagram @TheRapidResponseRNFacebook: Rapid Response RN PodcastOnline Course:  www.RapidResponseandRescue.com