Podcasts about emergency departments

In part two of this series, Dr. Stacey Clardy and Dr. John Ney discuss the primary limitation of using claims data to estimate wait times for neurology services, particularly in rural areas or for subspecialty neurology care.  Show citation: Laffargue EK, Van Der Goes DN, Wilson AM, Parziale SD, Sico JJ, Ney J. Neurology Wait Times After Primary Care or Emergency Department Visits Among the Commercially Insured Population in the United States: 2019-2023. Neurology. 2026;106(10):e218008. doi:10.1212/WNL.0000000000218008  

In part two of this series, Dr. Stacey Clardy and Dr. John Ney discuss the primary limitation of using claims data to estimate wait times for neurology services, particularly in rural areas or for subspecialty neurology care.  Show citation: Laffargue EK, Van Der Goes DN, Wilson AM, Parziale SD, Sico JJ, Ney J. Neurology Wait Times After Primary Care or Emergency Department Visits Among the Commercially Insured Population in the United States: 2019-2023. Neurology. 2026;106(10):e218008. doi:10.1212/WNL.0000000000218008  

Listen as hosts Tanner, John and Andy discuss their take on a recently published article in MedPage Today calling for the renaming of the Emergency Department and Emergency Medicine. Don't forget we are the official podcast of the American College of Osteopathic Emergency Physicians. Visit acoep.org today to learn more about an upcoming conference and how you can see your favorite EM Podcast LIVE and in person.

In part one of this series, Dr. Stacey Clardy and Dr. John Ney break down the difference between mean and median wait times for new neurology appointments.  Show citation: Laffargue EK, Van Der Goes DN, Wilson AM, Parziale SD, Sico JJ, Ney J. Neurology Wait Times After Primary Care or Emergency Department Visits Among the Commercially Insured Population in the United States: 2019-2023. Neurology. 2026;106(10):e218008. doi:10.1212/WNL.0000000000218008  

Send us Fan MailHeidi Linhoff, a registered nurse, spoke with Liz Collin about how young patients assault hospital staff without consequences. Heidi Linhoff, a registered nurse at Fairview Riverside Children's Emergency Department in Minneapolis, joined Liz Collin on her podcast. Linhoff spoke about some of the harrowing stories of young patients assaulting nurses and hospital staff without consequences. She explained how some staff members have had their jobs ended due to the injuries they suffered—and how others have chosen to leave out of fear.She detailed stories of nurses and other staff suffering concussions, broken bones, and taking punches from patients. “The injuries have forced a lot of people to leave because they're scared,” she said. “And I was literally dumbfounded that we do nothing, that it seems to be acceptable to, you know, to assault a healthcare worker.”Support the show

Send us Fan MailThere are people in the hospital who walk into the room when everything is falling apart.Not to fix it or rush through, but simply to be there.Today's guest, Mark Wilson, lives in that space—right in the emergency room, where life can change in a single moment. Where nurses are moving fast, families are trying to make sense of the unthinkable, and patients are meeting some of the hardest moments of their lives.But what makes his story different… is that he's been on the other side of the bed.After a severe bicycle accident, Mark suffered a traumatic brain injury and spent months in a rehabilitation hospital, learning how to walk again, relearning his body, his independence—his life. And somewhere in that process, something shifted.What started as survival… became a calling.Now, he shows up for patients and families in crisis as an emergency room chaplain, bringing a kind of presence that only comes from someone who truly understands what it feels like to be vulnerable, uncertain, and afraid.His experience as a former EMT, firefighter and lead pastor, gives him a unique lens on faith, meaning, and what people actually need in moments of crisis—whether they consider themselves spiritual or not.This conversation is for those on the frontlines of healthcare—the nurses and others who journey through the tough times and often carry unprocessed burdens. It's for anyone seeking insight into what truly matters when life hangs in the balance. Mark offers a message of comfort and compassion, encouraging us to embrace the uncertain and the deep insights that occur in moments of crisis.In the five-minute snippet: a shop teacher with a messy garage? Find Mark Wilson here:pastormarkwilson@sbcglobal.netmwilson@kaweahhealth.orgSierra Baptist ChurchContact The Conversing Nurse podcastInstagram: https://www.instagram.com/theconversingnursepodcast/Website: https://theconversingnursepodcast.comYour review is so important to this Indie podcaster! You can leave one here!  https://theconversingnursepodcast.com/leave-me-a-reviewWould you like to be a guest on my podcast? Pitch me! https://theconversingnursepodcast.com/intake-formCheck out my guests' book recommendations! https://bookshop.org/shop/theconversingnursepodcast I've partnered with RNegade.pro! You can earn CE's just by listening to my podcast episodes! Check out my CE library here: https://rnegade.thinkific.com/collections/conversing-nurse-podcastThanks for listening!

Rachel Oblath, Ph.D., joins Dr. Dixon and Dr. Berezin, with guest host Dr. Matt Hirschtritt, to discuss repeated utilization of emergency psychiatric services among youths in both emergency department and alternative settings. Transcript 01:10   Emergency psychiatric services utilization 03:57   Previous studies and unanswered questions 07:01   Emergency room and urgent care 08:39   BEST program 10:53   Findings and considerations 13:46   Results 15:56   Repeat utilization 19:03   Effectiveness of inpatient care 20:06   Non-ED settings 21:46   Implications 25:52   If you could change one thing … 27:56   Stones left unturned 29:12   Variables Subscribe to the podcast here. Check out Editor's Choice, a set of curated collections from the rich resource of articles published in the journal. Sign up to receive notification of new Editor's Choice collections. Browse other articles on our website. Be sure to let your colleagues know about the podcast, and please rate and review it wherever you listen to it. Listen to other podcasts produced by the American Psychiatric Association. Follow the journal on Twitter. E-mail us at psjournal@psych.org

Dr. Stacey Clardy talks with Dr. John Ney about wait times for new neurology office visits among commercially insured persons in the United States.  Read the related article in Neurology®.  Disclosures can be found at Neurology.org.  

The Pitt enjoyed an outstanding first season run. It was critically acclaimed, scooped up a number of significant accolades, and also amassed a passionate fan base that came to care deeply for the characters. It's an undeniably wonderful opportunity to get the chance to join the cast of a proven hit, but it also comes with a significant amount of pressure. Not only are you jumping aboard a fast-moving train on set, but you're also challenged to craft a character that fans will come to love just as much as their Season 1 favorites. Laëtitia Hollard managed to do just that as nurse Emma in The Pitt Season 2.The Pitt enjoyed an outstanding first season run. It was critically acclaimed, scooped up a number of significant accolades, and also amassed a passionate fan base that came to care deeply for the characters. It's an undeniably wonderful opportunity to get the chance to join the cast of a proven hit, but it also comes with a significant amount of pressure. Not only are you jumping aboard a fast-moving train on set, but you're also challenged to craft a character that fans will come to love just as much as their Season 1 favorites. Laëtitia Hollard managed to do just that as nurse Emma in The Pitt Season 2.Emma Nolan (Hollard) is fresh out of nursing school and is assigned to shadow the nurses at Pittsburgh Trauma Medical Center's Emergency Department. Emma is essentially thrown into the deep end on July 4. Her first day on the job throws a vast array of challenges her way, including the task of preparing Louie (Ernest Harden Jr.) to be laid to rest, caring for a sexual assault victim, being attacked by a patient herself, and then some, and Emma navigates it all with a staggering amount of grace and kindness. Hollard turned Emma into an impossibly lovable character, leaving many with fingers crossed tight that she'll return for Season 3.While attending the 2026 Overlook Film Festival in New Orleans for her feature film debut, Larry Fessenden's Trauma or, Monsters All, she took the time to sit down for a Collider Ladies Night interview to discuss the remarkable things she accomplished a mere year after graduating from the Juilliard School, Emma's biggest moments in The Pitt Season 2, and her hopes for the character's Season 3 storyline. Hosted on Acast. See acast.com/privacy for more information.

In this episode of The Visible Voices Podcast, I sit down with Dr. Scott Weiner, emergency physician, associate professor at Harvard Medical School, and founder of system-wide substance use disorder programming.  Dr. Weiner shares the patient cases that set his life's work in motion, including a fatal overdose on Boston Common that changed how he understood both medicine and advocacy.  Scott addresses the troubling gap in opioid education in American schools, the promise of wearable technology for monitoring patients in recovery, and the real reasons overdose deaths are finally starting to decline. Opioid use disorder is not a moral failure — it is a public health crisis. ▶ Subscribe on YouTube @resaelewissmd — new Visible Voices episodes Wednesdays.

In this episode, Lisa Kafer, MD, FAAP, discusses nonemergency acute care delivered outside of the medical home. David Hill, MD, FAAP, and Joanna Parga-Belinkie, MD, FAAP, also speak with Lara McKenzie, PhD, MA, FAAHB, about cleaning product-related injuries treated in U.S. emergency departments. For resources go to aap.org/podcast.

Dr. Danya Khoujah joins GEMCast host Dr. Christina to dive into the first clinical practice guideline in the Geriatric Emergency Department (GED) Guidelines 2.0, which is dedicated to delirium. Delirium is a clinical syndrome characterised by acute and fluctuating disturbances of attention, awareness, perception or consciousness and it commonly affects older adults presenting to the ED. However, it is often missed, which has significant impacts on mortality and functional status of older patients. Khoujah is an attending physician in the Department of Emergency Medicine at AdventHealth Tampa in Florida, and host of GEDC's expert-panel webinars. She is part of the multidisciplinary team that created this GRADE-based clinical guideline, and in this episode, she talks through the development and recommendations arising from the guideline. The group aimed to assess the quality and applicability of direct and indirect evidence, with the goal of providing ED clinicians a patient-centred approach to delirium. To do so they asked 3 key questions: Which older patients in the ED are at higher risk of delirium? Which diagnostic tests are effective at identifying ED delirium? Do older ED patients with delirium need a CT head? Tune in to today's episode to hear more about screening, diagnosing and brain imaging for delirium in the ED, and keep an eye out for upcoming clinical guidelines in the GED Guidelines 2.0 series including medication safety, fall prevention, Find more information about this topic at https://gedcollaborative.com/resource/delirium/delirium-clinical-practice-guidelines-what-do-we-know-and-what-should-we-do/ GEMCAST is a Geriatric Emergency Medicine Podcast created to help clinicians, nurses, or paramedics who take care of older adults, particularly in the Emergency Department setting. GEMCast episodes, show notes and recommended resources can be found on the GEDC website at gedcollaborative.com/resources/?type=podcast.

Contributor: Aaron Lessen, MD Educational Pearls:   UTIs are commonly seen in older women We often see them taking long-term prophylactic antibiotics because of common recurrence. Around 20-30% of older women who develop a UTI have a recurrence due to either diagnostic failure, treatment failure or non-compliance with treatment.  UTI signs and symptoms Burning sensation when urinating Strong urge to urinate Urinating often and passing small amounts of urine.  Pelvic pain    There are currently more guidelines and studies on treatments to prevent these recurrent UTIs in women that we can start in the Emergency Department. Vaginal estrogen has been shown to significantly reduce this issue of recurrence. Very simple prescriptions can be prescribed in the ED It has little systemic absorption and is generally very safe and effective.   References Wells BA, De EJB, Visingardi J, Feustel PJ. IP15-36 IMPACT OF VAGINAL ESTROGEN ON SERIOUS ADVERSE OUTCOMES IN POSTMENOPAUSAL WOMEN WITH RECURRENT URINARY TRACT INFECTIONS: A RETROSPECTIVE STUDY. Journal of Urology [Internet]. 2025 May 1;213(5S):e778. Available from: https://doi.org/10.1097/01.JU.0001109984.67114.74.36 Ackerman AL, Bradley M, D'Anci KE, Hickling D, Kim SK, Kirkby E. Updates to Recurrent Uncomplicated Urinary Tract Infections in Women: AUA/CUA/SUFU Guideline (2025). J Urol. 0(0). doi: 10.1097/JU.0000000000004723 Kaufman MR, Ackerman LA, Amin KA, et al. The AUA/SUFU/AUGS Guideline on Genitourinary Syndrome of Menopause. J Urol. 0(0). doi:10.1097/JU.0000000000004589 Meister MR, Wang C, Lowder JL, Mysorekar IU. Vaginal Estrogen Therapy Is Associated With Decreased Inflammatory Response in Postmenopausal Women With Recurrent Urinary Tract Infections. Female Pelvic Med Reconstr Surg. 2021 Jan 1;27(1):e39-e44. doi: 10.1097/SPV.0000000000000790. PMID: 31725016; PMCID: PMC7737516. Nazarko L. Recurrent lower urinary tract infection in older women [Internet]. Urology & Continence Care Today. Available from: https://www.ucc-today.com/journals/issue/launch-edition/article/recurrent-lower-urinary-tract-infection-in-older-women-ucct   Summarized by Aaryn David & Ahmed Abdel-Hafiz | Edited by Aaryn David & Ahmed Abdel-Hafiz, NREMT-P   Donate: https://emergencymedicalminute.org/donate/   Join our mailing list: http://eepurl.com/c9ouHf

Listener discretion is advised!!! References: Gabayan, G. Z., Gould, M. K., Weiss, R. E., Patel, N., Donkor, K. A., Chiu, V. Y., Yiu, S. C., Jones, J. P., Hoffman, J. R., & Sarkisian, C. A. (2016). Poor Outcomes After Emergency Department Discharge of the Elderly: A Case-Control Study. Annals of Emergency Medicine, 68(1), 43–51.e2. Ganetsky M, Lopez G, Coreanu T, Novack V, Horng S, Shapiro NI, Bauer KA. Risk of Intracranial Hemorrhage in Ground-level Fall With Antiplatelet or Anticoagulant Agents. Acad Emerg Med. 2017 Oct;24(10):1258-1266. Gokhroo, R. K., Ranwa, B. L., Kishor, K., et al. (2015). Sweating: A Specific Predictor of ST‐Segment Elevation Myocardial Infarction Among the Symptoms of Acute Coronary Syndrome: Sweating In Myocardial Infarction (SWIMI) Study Group. Clinical Cardiology, 39, 90–95. Knack SKS, Scott N, Driver BE, Prekker ME, Black LP, Hopson C, Maruggi E, Kaus O, Tordsen W, Puskarich MA. Early Physician Gestalt Versus Usual Screening Tools for the Prediction of Sepsis in Critically Ill Emergency Patients. Ann Emerg Med. 2024 Sep;84(3) Koo, A. (Oct 29, 2024). Putting Clinical Gestalt to Work in the Emergency Department. Available: https://www.acepnow.com/article/putting-clinical-gestalt-to-work-in-the-emergency-department/5/?singlepage=1 Long, B., Keim, S. M., Gottlieb, M., Carlson, J., Bedolla, J., & Reisdorff, E. J. (2024). Can I Discharge This Adult Patient with Abnormal Vital Signs From the Emergency Department? The Journal of Emergency Medicine, 67(4), e487–e493. Milner, K. A., Funk, M., Arnold, A., & Vaccarino, V. (2002). Typical symptoms are predictive of acute coronary syndromes in women. American Heart Journal, 143, 283–288.

Back in June 2024, we highlighted surprising data from JAMA Network Open regarding adolescent care in the ED. Because many adolescents use the ED as their primary care provider, it's a good opportunity for them to have contraception addressed regardless of why they presented. But that's not what was happening. That publication from two years ago showed significant gaps in addressing contraception in the ED to pregnancy vulnerable young women, mainly teens. We covered those results back then and said that that would be a wonderful QI project for any resident or medical students to work with their hospital ED to improve that. Well, now a similar publication, looking at a different target- STI empiric treatment among pregnant women in the ED, has been published with that same vibe. Yep, there are BIG discrepancies in what pregnant women are given- or in this case, NOT GIVEN, in the ED compared to their nonpregnant peers. This was published in mid-April 2026. Two big questions remain unanswered in this data. Listen in for details. 1. Gottlieb M, Moyer E, Slocum GW, et al. Sexually Transmitted Infection Treatment Rates Among Pregnant vs Nonpregnant Patients in Emergency Departments. JAMA Network Open. 2026. 2. Canter H, Reed J, Palmer C, et al. Contraception Use and Pregnancy Risk Among Adolescents in Pediatric Emergency Departments. JAMA Netw Open. 2024;7(6):e2418213. doi:10.1001/jamanetworkopen.2024.18213

Dr Peter Allely from the Australasian College of Emergency Medicine told 3AW Breakfast hosts Ross and Russel EDs were being overwhelmed by people who should be treated elsewhere in the system.See omnystudio.com/listener for privacy information.

🧭 REBEL Rundown 🔑 Key Points 🧩 Human Factors: The unseen behaviors, distractions and considerations critical in emergency medicine and the ICU, influencing patient care beyond just medical knowledge.🎯 System Design: Effective system design directly impacts team performance by creating environments that facilitate optimal decision-making. 🏥 Real-world Application: The application of human factors in healthcare leads to better team dynamics, reduced stress, and improved patient outcomes. 👷🏽‍️It’s Everyone’s Job: Building a culture of adaptability and openness to change can lead to better healthcare delivery, communication and interprofessional relationships🛠️ Practical Solutions: Start the conversation in departments for actionable and pragmatic changes to current healthcare environments to enhance practitioner efficiency and patient care quality. Click here for Direct Download of the Podcast. 👀Previously Covered and Related Content: REBEL EM: Titles Don’t Make LeadersREBEL MIND: Moving from Junior to Senior Leadership in Emergency CareREBEL MIND: The Dunning-Kruger EffectREBEL MIND: Growth vs Fixed Mindset 📝 Introduction Welcome back to Rebel MIND, the podcast where we sharpen the person behind the practitioner. MIND stands for Mastering Internal Negativity during Difficulty. This series emphasizes productivity, provider performance, and team optimization to ensure we are at our best during high-pressure situations. In this episode, host Dr. Mark Ramzy chats with special guests and master educators about the concept of human factors.Dr. Chris Hicks is an emergency physician and trauma team leader at St. Michael’s Hospital in Toronto, Assistant Professor in the Department of Medicine at the University of Toronto, and co-founder of Advanced Performance Healthcare Design, a physician-led simulation and design group. Dr. Andrew Petrosoniak is an emergency physician and trauma team leader at St. Michael’s Hospital, and Medical Director of the Unity Health Toronto Simulation Program. He’s an Assistant Professor at the University of Toronto where his research focuses on simulation for systems and design improvement and optimizing the care of the bleeding patient. Along with Dr. Hicks, he’s also President of Advanced Performance Healthcare Design, a consulting firm that works with high-performance teams and uses simulation to enhance and design better healthcare spaces Cognitive Question How can the integration of human factors improve decision-making and performance in emergency medicine and critical care environments? ️What are Human Factors? In the context of healthcare, human factors encompass the interplay between humans, the systems they work within, and the effectiveness of their interactions. It includes elements like communication, system design, environmental conditions, and behavioral patterns affecting individual and team decision-making processes. It’s the collective impact of individual behaviors, team dynamics, and the physical environment on performance and outcomes. The aim is to eliminate issues arising from human error by creating systems and environments that naturally guide and support optimal performance. 🏥How This Applies to the Emergency Department or ICU? Efficient integration of human factors in high-pressure settings like the Emergency Department (ED) or Intensive Care Unit (ICU) helps mitigate the risks associated with stressful and chaotic environments. By focusing on system designs that account for human behavior, healthcare professionals can reduce errors, enhance team coordination, and ultimately improve patient care. This is crucial as teams are often required to make rapid, life-saving decisions in these environmentsThe design of clinical spaces can either hinder or help efficient care. Poorly arranged equipment or cluttered workspaces increase stress and impede decision-making. Implementing structured design principles, such as dedicated equipment zones and clear visual cues, can streamline workflows and enhance team coordinationIt actually helps pave the way for more efficiency because you end up “working smarter instead of harder”.It speaks directly to the Daniel Kahneman’s theory of Type 2 Thinking – which is a slow, analytical cognitive process requiring deliberate thoughtWe’ll likely create a whole dedicated episode to this but if you want to read more ahead of time on it, check out his book Thinking, Fast and Slow ⏩Immediate Action Steps for Your Next Shift **Assess Your Environment**: Take note of any clutter, noise, or layout issues in your workspace that could hinder optimal performance. Identify problem areas that could be optimized.**Recognizable Hard-Stop** – Implement a “Stop-Point” Check for areas or issues that involve more than just patient safety (ie. workflow inefficiencies, sign-out, throughput, etc). Use predefined benchmarks during procedures to ensure clarity and efficiency.**Foster Open Communication** – Encourage an environment where every team member feels comfortable discussing their thoughts and decisions without fear of judgment.**Prototype Solutions** – Work with colleagues to identify problems and brainstorm quick, cost-effective solutions that could be tested in your department.**Role Clarity and Preparation** – Ensure roles are clearly defined and team members are prepared with necessary resources readily available during high-stakes scenarios.**Test and Refine** – Conduct quick pilot tests of new setups or processes during quieter times and gather feedback from your team. Conclusion Human factors play a critical role in shaping healthcare outcomes. Through structured system designs and attention to team dynamics, it is possible to reduce inefficiencies and enhance both patient care and provider well-being. It requires a shift in perspective from seeing design and systems as separate from human behaviors, to seeing them as intricately linked. By incorporating these principles, healthcare professionals can create environments that inherently support better, safer, and more effective patient care. 🚨 Clinical Bottom Line Incorporating human factors into healthcare isn’t just about preventing errors—it’s about creating an ecosystem where the healthcare team is empowered to perform at their best, even under the most challenging conditions. Implementing small, iterative changes can create a meaningful impact, paving the way for improved systems and processes. This starts by redesigning systems and environments with human factors in mind, which can significantly improve both the efficiency of care delivery and the safety of the healthcare environment. Further Reading Petrosoniak A, Hicks C. M&M rounds 2.0: the future of performance improvement. CJEM. Feb 2025PMID: 39979684Petrosoniak A, Hicks CDesign, build, train, excel: Using simulation to create elite trauma systems. International Anesthesiology Clinics. Publish Ahead of Print.Request the Article herePetrosoniak A, Hicks C, et al. Design Thinking-Informed Simulation: An Innovative Framework to Test, Evaluate, and Modify New Clinical Infrastructure. Simul Healthc. 2020 Jun 2020.PMID: 32039946Bleetman A, et al.Human factors and error prevention in emergency medicine. Emerg Med J. May 2012PMID: 21565880Hayden EM, et al.Human Factors and Simulation in Emergency Medicine. Acad Emerg Med. 2018 Feb 2018PMID: 28925571 Meet the Authors Mark Ramzy, DO Co-Editor-in-Chief Cardiothoracic Intensivist and EM Attending RWJBH / Rutgers Health, Newark, NJ Chris Hicks, MD, Med Co-Founder of Advanced Performance Assistant Professor of Emergency Medicine, University of Toronto, Canada Andrew Petrosoniak, MD, MSc Co-Founder and President of Advanced Performance Medical Director of Unity Health Toronto Simulation Program Showing Slide 1 of 3 The post REBEL MIND – Human Factors: The Hidden Architecture of Emergency & Critical Care Medicine appeared first on REBEL EM - Emergency Medicine Blog.

AEM E&T Podcast host Resa E. Lewiss, MD, interviews author Jazmyn Shaw, MD.

What does good care actually look like for adults living with sickle cell disease? In this episode of our What Good Care Looks Like for Adults with Sickle Cell series, lifespan sickle cell expert Dr. Julie Kanter breaks it down. She covers establishing a medical home, working with a sickle cell specialist, navigating the Emergency Department, and building an Individualized Care Plan that works for you.Dr. Julie Kanter is the Co-Director of the Lifespan Comprehensive Sickle Cell Center at the University of Alabama at Birmingham and President of the National Alliance of Sickle Cell Centers (NASCC).This episode is part of Sickle Cell 101's Care and Treatment 101 Educational Initiative, a community resource dedicated to making care information accessible and actionable for the sickle cell community.Thank you to our Care and Treatment 101 sponsors: Vertex, Chiesi, Pfizer, and Medunik.

In Part Two of this TCRN Roundtable, our discussion shifts to the ethical, professional, and personal complexities of trauma nursing. We explore challenging scenarios, pediatric readiness in adult trauma centers, the evolving role of the TCRN, and the experiences that shape leadership, growth, and resilience within trauma systems. Let's dive right back in with Merideth, Ashley and Jamin. Merideth Gradowski is an experienced nursing leader with over 15 years in the field and a strong focus on trauma care. She holds a BSN from Arizona State University and an MSN in nursing administration from Queens University of Charlotte. Currently serving as a Trauma Program Manager, she leads system development and quality initiatives to improve patient outcomes. She is especially passionate about advancing pediatric trauma care within adult trauma centers. Ashley Metcalf began her nursing career in the Emergency Department and has spent more than 20 years dedicated to trauma care. She currently serves as a Trauma Program Performance Improvement Coordinator at a Level I Trauma Center, where she focuses on advancing quality and outcomes. Ashley is also the President of the Trauma Association of South Carolina and co-chairs the Advanced Trauma Care for Nurses Committee through the Society of Trauma Nurses. She brings both deep clinical experience and strong leadership to the trauma nursing community. Jamin Rankin is a dynamic nursing leader with more than a decade of experience spanning emergency, trauma, and air-medical care. He currently serves as Trauma Program Manager and Stroke Program Manager at Ochsner LSU Health, where he leads accreditation, education, and systemwide quality initiatives. His background includes frontline work as a flight nurse and emergency clinician in both rural and Level I trauma settings. Jamin is widely recognized for his leadership and contributions to trauma systems, earning honors such as ENA's 20 Under 40 and BCEN's Distinguished TCRN designation. This episode is titled “TCRN Roundtable: Code Red Activated (Part Two).” Our TCRN Roundtable guests can be contacted on LinkedIn @MeridethGradowski, @AshleyMetcalf, and @JaminRankin BCEN & Friends Podcast is presented by the Board of Certification for Emergency Nursing. Scan the QR Code to sign up for Learn Updates: We invite you to visit us online at bcen.org for additional information about emergency nursing certification, education, and much more. Episode introduction created using elevenlabs.io

Doug sits down with Amy Lee, President and Chief Operating Officer at Nantucket Cottage Hospital, to discuss the hospital's new Orthopedic Walk-In Clinic and how it is expanding access to healthcare services on Nantucket. Amy explains what inspired the launch of the clinic, the types of injuries and orthopedic concerns it will treat, and how same-day care and on-site imaging can help speed up diagnosis and recovery for patients. The conversation also highlights the importance of providing more specialty care on-island, reducing the need for off-island travel, easing pressure on the Emergency Department, and supporting Nantucket's active year-round community. Amy also shares details about the continued growth of orthopedic services at the hospital and what patients should know before visiting the new clinic. 

Everyone's juggling a lot in The Pitt Season 2, but Isa Briones' storyline as Trinity Santos feels especially full. Not only is being a second-year resident at Pittsburgh Trauma Medical Center's Emergency Department especially taxing, but on this particular day, she also faces the return of Dr. Langdon (Patrick Ball), Dr. Robby's (Noah Wyle) pending exit for his sabbatical, and the realization that she might not get precisely what she wants out of her relationship with Dr. Garcia (Alexandra Metz). As is very often the case with The Pitt, the writers do an exceptional job of blending workplace challenges with personal concerns to craft stories about fully realized people giving everything they've got to others, while trying to figure out how to care for themselves in the process.With The Pitt closing in on its Season 2 finale, Briones carved out the time to swing by the Collider Ladies Night studio to discuss everything that's happened through Episode 13, “7:00 PM,” before jetting off to New York City for her run in Just in Time on Broadway. We covered lessons learned from her father, Jon Jon Briones, takeaways from Star Trek: Picard, what it was like joining the cast of The Pitt, and, of course, everything Santos is trying to power through on July 4th. Hosted on Acast. See acast.com/privacy for more information.

Host Aimee Faith Ho, MD, MPH, FACEP, welcomes Dr. Utsha Khatri to discuss the clinical and ethical nuances of caring for incarcerated patients, as also explored in the ACEP Now article, “Carceral Health and the Emergency Department.” Dr. Khatri, an assistant professor of emergency medicine and health services researcher, shares pearls for navigating the presence of correctional officers while re-centering the patient through dignity and medical autonomy. Additional highlights from this episode include coverage of the emergency medicine residency match, preparations for the FIFA World Cup, and updates on Medicaid work requirement changes. Dr. Ho also previews clinical features on endometriosis management, forensic training in the ED, and new guidelines for asymptomatic hypertension.

Host Trevor DaRin is joined by Sg2 experts Ivy Zhu and Tori Richie to explore the evolving role of freestanding EDs, hybrid ED–urgent care models and micro hospitals in health system strategy. Together, they discuss how these sites can improve access, relieve pressure on traditional EDs and support more efficient care delivery—when deployed with clear intent. The conversation also looks ahead to how virtual care, digital transparency, payer pressure and specialty urgent care models may shape the future of emergency and ambulatory access.   We are always excited to get ideas and feedback from our listeners. You can reach us at sg2perspectives@sg2.com, or visit the Sg2 company page on LinkedIn.

In this episode, we're joined by three exceptional Trauma Certified Nurse Leaders for an in-depth roundtable discussion. Merideth Gradowski is an experienced nursing leader with over 15 years in the field and a strong focus on trauma care. She holds a BSN from Arizona State University and an MSN in nursing administration from Queens University of Charlotte. Currently serving as a Trauma Program Manager, she leads system development and quality initiatives to improve patient outcomes. She is especially passionate about advancing pediatric trauma care within adult trauma centers. Ashley Metcalf began her nursing career in the Emergency Department and has spent more than 20 years dedicated to trauma care. She currently serves as a Trauma Program Performance Improvement Coordinator at a Level I Trauma Center, where she focuses on advancing quality and outcomes. Ashley is also the President of the Trauma Association of South Carolina and co-chairs the Advanced Trauma Care for Nurses Committee through the Society of Trauma Nurses. She brings both deep clinical experience and strong leadership to the trauma nursing community. Jamin Rankin is a dynamic nursing leader with more than a decade of experience spanning emergency, trauma, and air-medical care. He currently serves as Trauma Program Manager and Stroke Program Manager at Ochsner LSU Health, where he leads accreditation, education, and systemwide quality initiatives. His background includes frontline work as a flight nurse and emergency clinician in both rural and Level I trauma settings. Jamin is widely recognized for his leadership and contributions to trauma systems, earning honors such as ENA's 20 Under 40 and BCEN's Distinguished TCRN designation. Trauma nursing lives at the intersection of standards, systems, and bedside decision-making, and in Part One we explore regulatory expectations, performance improvement, trauma program structure, and gaps across the trauma care continuum. This episode is titled “TCRN Roundtable: Code Red Activated (Part One).” Our TCRN Roundtable guests can be contacted on LinkedIn @MeridethGradowski, @AshleyMetcalf, and @JaminRankin BCEN & Friends Podcast is presented by the Board of Certification for Emergency Nursing. Scan the QR Code to sign up for Learn Updates: We invite you to visit us online at bcen.org for additional information about emergency nursing certification, education, and much more. Episode introduction created using elevenlabs.io

It's hoped the Health Minister will be able to experience Clare's health service deficits for herself today. Jennifer Carrol MacNeill is visiting this county today, where she'll be travelling to Kilkee and Ennis Hospital. Although the proposed hospital campus at Raheen will likely result in a new Emergency Department for the MidWest, over 40% of Clare's population will still be living over an hour's drive away from their nearest ED. Friends of Ennis Hospital Chairperson Angela Coll believes the only solution is an acute facility in Clare.

It's one of the most common—and most frustrating—complaints in the Emergency Department: the patient covered head-to-toe in hives, miserable, itching, and desperate for relief. In this episode of EM Pulse, we welcome back ED Clinical Pharmacist Haley Burhans to tackle the “uncomfortable” topic of urticaria. We move past the myths of one-and-done doses and explore why your standard allergy dosing might be leaving your patients itching for more. The Power of Second-Generation Antihistamines Haley explains why second-generation antihistamines (cetirizine, levocetirizine, fexofenadine) should be your first-line ED therapy, rather than the old school standard, diphenhydramine (Benadryl). Xyzal vs. Zyrtec: We break down the L-enantiomer (levocetirizine) and whether it actually beats its predecessor in preventing drowsiness. The “Double Dose” Pearl: For acute urticaria in the ED, 10mg of cetirizine isn’t enough. Haley recommends starting with 20mg for adults (or doubling the weight-based dose for kids) to see relief within 20–60 minutes. The 4x Rule: Guidelines now support up to four times the standard daily dose for refractory cases (usually split BID). We discuss the safety data behind these higher regimens and why they are tolerated so well. The Steroid Trap and the Rebound Effect Patients often come in requesting steroids but they are NOT the primary cure for urticaria. The Antihistamine Backbone: Steroids treat inflammation, but the antihistamine treats the underlying stimulus. If a patient stops their antihistamines and only takes a steroid burst, they are set up for a miserable rebound. Dosing Strategies: If you do use steroids, keep it to a burst or taper of 10 days or less. We discuss the utility of methylprednisolone (Medrol Dosepak) versus a simple prednisone burst/taper or a course of longer-acting dexamethasone. Beyond the Basics: Benadryl and the MABs The Danger of “Dirty” Drugs: Why diphenhydramine has fallen out of favor due to its sodium channel blocking side effects, anticholinergic toxicity, and psychiatric risks. The Future of Itch: A look at emerging biologics like omalizumab. While these IgE-blockers shouldn't be started in the ED, it's important to know about them to treat patients who are taking them, or who present with rebound urticaria after recently stopping them. Key Takeaways Go Big on Second Generation Antihistamines: Start with a double dose of cetirizine in the ED. It's safe, effective, and less sedating than first-generation alternatives. Discharge patients on that double dose twice a day. Think Long-Term: Urticaria pathways need time to “cool down.” Advise patients to stay on the prescribed meds/doses for 1–2 months, not 1–2 days. Steroids are Adjuncts: Use a short burst (

There's hope that the ACT Party's latest election promise will alleviate pressure on the wider health sector. David Seymour recently announced ACT would expand pharmacists' powers, including letting them treat more minor ailments, manage long-term medications and monitor some conditions. Seymour says most of the world is looking to better utilise their health professionals to take the load off GPs and Emergency Departments. "What's happened around the world is that pharmacists have got much greater use of robotic prescribing, so there's a lot less - as one pharmacist said to me - counting and pouring. And as a result, all of these countries are starting to make greater use of having a pretty well-trained health professional, usually in your community." LISTEN ABOVESee omnystudio.com/listener for privacy information.

🧭 REBEL Rundown 📌 Key Points Parallel Tasking: Transitioning from junior to senior roles in medicine involves both personal growth and the development of leadership skills, often simultaneously. Psychological safety: Creating this within teams is critical for fostering an environment where all members feel empowered to speak up and share insights. Big and Small Picture View: Effective leadership requires the ability to zoom in on specific tasks and zoom out to manage the big picture, ensuring comprehensive patient care. Timing is Everything: The act of asking the right questions at the right time can significantly enhance team dynamics and patient outcomes in high-pressure situations. Talk the Talk: Creating and practicing clear, structured communication strategies can assist in smooth transitions and effective leadership during medical emergencies. Click here for Direct Download of the Podcast. 👀Previously Covered and Related Content: REBEL EM: Titles Don’t Make LeadersEM Cases: Four Key Learnings from a Career in Emergency Medicine Leadership 📝 Introduction Welcome back to REBEL MIND, where MIND stands for Mastering Internal Negativity during Difficulty. Here we sharpen the person behind the practitioner by focusing on things that improve our performance, optimizing team dynamics and the human behavior that embodies the hidden curriculum of medicine. Hosted by Dr. Mark Ramzy, with special guest Dr. Dan Dworkis, an emergency physician and author of “The Emergency Mind,” this episode dives into the complex journey from junior to senior leadership in medical settings.You can learn more about Dan’s work and the Emergency Mind Project hereHe has a phenomenal book called “The Emergency Mind: Rewiring Your Brain for Performance Under Pressure“ that you can purchase here! Cognitive Question How do medical professionals effectively transition from junior to senior roles, and what mental shifts are necessary to manage these evolving responsibilities? 🏥How This Applies to the Emergency Department or ICU? Transitioning from a junior to a senior role in the emergency department or ICU is akin to stepping onto a new stage where the performance demands are higher, and the stakes significantly greater. While juniors focus on learning their craft and understanding themselves, seniors are expected to manage and lead entire teams, often making life-saving decisions under pressure. This transition challenges not only their clinical skills but also their ability to lead effectively and maintain psychological safety within their teams.By fostering an environment where every team member feels valued and heard, senior leaders can harness the collective intelligence of the group, ensuring better patient outcomes and a more effective response to emergencies. ⏩Immediate Action Steps for Your Next Shift **Exercise Intentional Questioning**: Start your next shift by focusing on how you ask questions. Aim to frame queries in a way that invites discourse and challenges assumptions.**Develop Peripheral Awareness**: As you conclude critical tasks, practice expanding your focus from the immediate to the wider context, considering broader departmental needs. **Promote Inclusive Participation**: Encourage junior team members to share their observations and insights by specifically inviting their input during debriefs and planning.**Conduct Leadership Experiments**: On your next shift, try altering your leadership approach—whether it’s how you communicate or delegate—and reflect on its effectiveness with colleagues. **Create Psychological Safety**: Work towards fostering a safe environment for open communication, ensuring that all team members feel comfortable speaking up without fear of retribution. Conclusion Transitioning from a junior to a senior leadership role in the medical field is not just about honing your clinical skills but also about growing as a leader who can guide a team under intense pressure. By focusing on intentional communication, fostering psychological safety, and keeping an eye on both the details and the bigger picture, you can enhance your effectiveness as a leader. Continuous reflection and feedback are essential to mastering these skills, ensuring that both you and your team provide the highest level of care for your patients. 🚨 Clinical Bottom Line Leadership in medicine is about more than making decisions—it’s about creating an atmosphere where every voice is heard, ensuring optimal functioning of the team. As you grow into your senior role, remember that fostering psychological safety and practicing strategic communication can make all the difference in patient outcomes and team dynamics. Further Reading Collins-Nakai R. Leadership in medicine. Mcgill J Med. 2006 Jan;9(1):68-73. PMID: 19529813Chen TY. Medical leadership: An important and required competency for medical students. Tzu Chi Med J. 2018 Apr-Jun. PMID: 29875585 Meet the Authors Mark Ramzy, DO Co-Editor-in-Chief Cardiothoracic Intensivist and EM Attending RWJBH / Rutgers Health, Newark, NJ Dan Dworkis, MD, PhD Founder of Emergency Mind Project Assistant Professor at Keck School of Medicine at USC and Chief Medical Officer at Mission Critical Team Institute Showing Slide 1 of 2 The post REBEL MIND – The Mental Jump: Moving from Junior to Senior Leadership in Emergency Care appeared first on REBEL EM - Emergency Medicine Blog.

AEM Podcast host Ken Milne, MD, and guest skeptic Christina Shenvi, MD, PhD, MBA. Learn more in the accompanying Hot Off the Press article available in The Skeptics' Guide to Emergency Medicine.

Heather Bartlett, BSN, RN, CEN, CNML, is a nurse educator and supervisor in the Emergency Department at MyMichigan Medical Center Midland in Midland, Michigan. She is the person responsible for orienting every nurse, ED tech, and unit assistant who joins their team, equipping each one with the confidence, competence, and humanity to show up for patients on their worst days. Her mission is deeply personal. When Heather was 15, her father died of a massive heart attack at age 42. In the immediate aftermath, an emergency department nurse was her rock and her ally. That nurse's compassionate, honest, and unshakeable presence planted the seed for everything that followed.  Heather reflects on what it means to truly see your patients: to hear what they're saying, to notice what they aren't, and to stand with them in the hard spaces as their bridge, their advocate, and their confidant.    For more information on the podcast bundles, visit ANA's Innovation Website at: https://www.nursingworld.org/practice-policy/innovation/education. Have questions or feedback for the SEE YOU NOW team? Future episode ideas? Contact us at: hello@seeyounowpodcast.com.

Thank you Joseph 'The Hitman Jones' Davenport, OMS III, for developing this podcast! Thank you Katie 'The Voice' Werman, OMS III, MS for being a great sidekick. This podcast contains personal anecdotes about the benefit of spaced repetition. The podcast then discusses the challenges of mental health treatment in ED settings and possible solutions. We enjoyed our discussion and hope you do too!Thank you to the medical students physicians that have blazed the podcast pathway over the last half decade. Thank you to the new students that carry the torch! Thank you to the immortal Jordan Turner for creating the perfect bumper music! Most of all, thank you to everybody that listens and learns with us.

Thank you Katie 'The Voice' Werman, OMS III, MS for developing this podcast! Thank you Joseph 'The Hitman Jones' Davenport, OMS III, for being a great sidekick. This podcast contains high yield content regarding emergency room aspects of the shelf exam. The podcast then discusses the the management of patients with schizophrenia in the ED with respect to agitation and suicide. This is an update on a distant podcasts! We enjoyed our discussion and hope you do too!Thank you to the medical students physicians that have blazed the podcast pathway over the last half decade. Thank you to the new students that carry the torch! Thank you to the immortal Jordan Turner for creating the perfect bumper music! Most of all, thank you to everybody that listens and learns with us.

Pediatric agitation in the Emergency Department is one of those presentations that can escalate quickly and leave even experienced clinicians feeling on edge. It is high-risk, resource-intensive, and often unfolds in an already overstimulating environment where small missteps can make things worse. At the same time, agitation is not a diagnosis, it is a clinical presentation that may reflect anything from psychiatric illness to delirium, intoxication, trauma, or simply a child overwhelmed by the ED itself. So how do we approach these patients in a way that is safe, systematic, and effective? In this episode with guest experts, Dr. Susan Duffy and Dr. Thomas Chun, we tackle the questions that come up at the bedside: How do we rapidly distinguish mild, moderate, and severe agitation in a way that actually changes what we do next? Which patients are most likely to escalate, and how can we intervene early to prevent that? When should we be worried about a medical or toxicologic cause rather than assuming this is “behavioural”? What does effective verbal de-escalation actually look like in a busy ED, and why does it so often fail? When is a "code white" for emergency security measures truly indicated, and how do we avoid turning it into an escalation trigger? How should we be thinking about medications: what to choose, when to give them, and how to avoid over-sedation? And once the patient is finally calm, how do we make sure we aren't missing the underlying diagnosis? and many more... Please consider a donation to EM Cases to support ongoing high quality Free Open Access Medical Education https://emergencymedicinecases.com/donation/

Dr. Ron Clark handled "On the Board" duties this morning with "The Worst Smells in the Emergency Department." Pro tip: Don't listen to this while eating , trust us! (0:00)Chaz and AJ spoke with Professor Brantley Hall, of the “Human Flatus Atlas” - what can farts tell us about our health? More than you'd think! (10:03)A Dumbass News story about a couple's failed attempt to enter the Mile High Club got the phones ringing with Tribe Members sharing their own stories of flying the very, very friendly skies. (16:15)

Dr. Andy Southerland and Dr. Layne Dylla discuss the trends in head CT use in US emergency departments from 2007 to 2022, highlighting disparities, regional variations, and the potential role of AI in optimizing imaging decisions.  Show citations:  Dylla L, Krothapalli N, Tu L, et al. Trends in Head CT Use in US Emergency Department Patients From 2007 to 2022: A Nationwide Analysis. Neurology. 2025;105(12):e214347. doi:10.1212/WNL.0000000000214347

Dr. Andy Southerland talks with Dr. Layne Dylla about the trends in head CT use in US emergency departments from 2007 to 2022, highlighting disparities, regional variations, and the potential role of AI in optimizing imaging decisions.  Read the related article in Neurology®.  Disclosures can be found at Neurology.org. 

In this episode, Kate Remick, MD, FAAP, discusses pediatric readiness in the emergency department. David Hill, MD, FAAP, and Joanna Parga-Belinkie, MD, FAAP, also speak with Joseph Wright, MD, MPH, FAAP, and Elyse Portillo, MD, MPH, FAAP, about operationalizing equity in clinical guidance. For resources go to aap.org/podcast.

The Nurses Organisation says violence in emergency departments will worsen if systemic issues aren't addressed. Figures released under the Official Information Act show more than 7,500 reports of violence against healthcare staff were logged last year, matching the year before, but up significantly on 2023. Just over 1000 reports came from emergency departments. Organisation Chief Executive Paul Goulter told Mike Hosking it comes down to understaffing and people waiting too long to get treated, and it often escalates from there. LISTEN ABOVE See omnystudio.com/listener for privacy information.

Date: April 2, 2026   Reference: Lee et al. GRADE-Based Clinical Practice Guidelines for Emergency Department Delirium Risk Stratification, Screening, and Brain Imaging in Older Patients With Suspected Delirium. AEM Feb 2026 Guest Skeptic: Dr. Christina Shenvi is a board-certified emergency physician, educator, keynote speaker, coach, and academic leader. She is widely recognized for her work […] The post SGEM#507: Till Everybody Got Delirious – Geriatric Patients in the Emergency Department first appeared on The Skeptics Guide to Emergency Medicine.

Dr. Stephen Gamboa is an Adjunct Associate Professor at UNC and medical director of UNC Health Pardee's emergency department in Hendersonville, North Carolina. In today's GEMCast episode, he shares his first-hand experiences from two major natural disasters: the 2017 Tubbs Fire in Northern California and Hurricane Helene, which hit Western North Carolina in 2024. As he joins host Dr. Christina Shenvi, the two talk about how these events have a disproportionate impact amongst our frail older patients, which can be attributed to age-related comorbidities, reduced mobility, and higher care needs. Tune in and hear a variety of innovative solutions brought about by the various challenges that these major events can pose. The immediate impacts of natural disasters, such as smoke inhalation and needing to rapidly evacuate homes and skilled nursing facilities (SNFs), are just the tip of the iceberg. Older patients with decompensation or exacerbations of chronic conditions made up a large proportion of the increased demand on EDs following these disasters. Coupled with power outages, electricity shortages, no internet connectivity, and pharmacies closing, Dr. Gamboa describes how his team had to adapt quickly and how system-level support from UNC during Hurricane Helene, including staff, equipment and transport, was crucial to providing care to these vulnerable patients. Find more information about this topic at https://gedcollaborative.com/resource/falls/fire-flood-and-fragility-disasters-through-a-geriatric-lens/ . GEMCAST is a Geriatric Emergency Medicine Podcast created to help clinicians, nurses, or paramedics who take care of older adults, particularly in the Emergency Department setting. GEMCast episodes, show notes and recommended resources can be found on the Geriatric Emergency Department Collaborative (GEDC) website at https://gedcollaborative.com/resources/?type=podcast.

🧭 REBEL Rundown 🔑Key Points 🌱 Growth mindset transforms learning – Residents and students who believe skills can be developed are more open to feedback, more resilient after failure, and more engaged in practice.🧠 Language matters in feedback – Simple reframes such as “You’re developing procedural skills” instead of “You’re not strong at procedures” encourage persistence and normalize the learning curve.🤝 Mindset shapes team culture – Growth mindset leaders foster psychological safety, invite input, and create collaborative teams. Fixed mindset hierarchies, on the other hand, silence voices and can compromise patient care.🔥 Growth mindset protects against burnout – By reframing mistakes as part of the process, clinicians reduce perfectionism and shame, bolstering resilience and wellness.🔍 Practical steps start with self-talk – Add the word “yet” to limiting beliefs (“I’m not good at X…yet”) and shift feedback questions toward improvement (“What’s one thing I can do better next time?”).🛠️ Embracing mistakes with a growth mindset – Leads to more effective feedback loops and improvement do this by building a culture of psychological safety is crucial for growth and reducing medical errors. Click here for Direct Download of the Podcast. 👀Previously Covered and Related Content: REBEL EM: The EM MindsetREBEL EM: Titles Dont Make LeadersREBEL EM: Mind of the Resuscitationist with Scott WeingartEM Crit: Making Things Happen with Cliff Reid 📝 Introduction Welcome to this episode of REBEL MIND, where MIND stands for Mastering Internal Negativity during Difficulty. Here we sharpen the person behind the practitioner by focusing on things that improve our performance, optimizing team dynamics and the human behavior that embodies the hidden curriculum of medicine. Mindset shapes everything we do in medicine—from how we teach and learn to how we show up for patients at the bedside. Drawing from Carol Dweck’s influential book Mindset, this episode of REBEL MIND explores the critical difference between a fixed mindset (believing abilities are innate and static) and a growth mindset (seeing skills as things that can be developed through effort and feedback). We sat down with Dr. Kim Bambach, an emergency medicine physician and medical educator, and Dr. Frank Lodeserto, a dual-trained intensivist and internal medicine program director, to unpack how mindset influences medical education, bedside performance, and physician wellness. In this episode, we delve into how the mindset of clinicians can profoundly influence their performance, professional growth, and ultimately patient care Cognitive Question How does adopting a growth versus a fixed mindset influence clinical performance, medical education and patient outcomes? 🌱What is Growth vs Fixed Mindset? In Carol Dweck’s research, two primary mindsets are highlighted: Fixed mindset: Which sees intelligence and skills as staticIn the medical field, adopting a fixed mindset might lead a clinician to avoid complex cases due to fear of failure.Growth mindset: Which views abilities as improvable through dedication and effort. In contrast, a growth mindset encourages embracing challenges as opportunities for learning and development. 🏥How This Applies to the Emergency Department or ICU? In high-stakes environments like the ICU or the ED, the mindset adopted by healthcare providers can distinctly shape patient care and team dynamics. A fixed mindset might lead to defensive behaviors and a reluctance to engage in challenging cases, potentially stunting personal and professional growth. Conversely, a growth mindset not only fosters resilience and adaptability but also enhances team collaboration and patient outcomes by encouraging open communication, continuous learning, and acceptance of constructive feedback. ⏩Immediate Action Steps for Your Next Shift  **Monitor Self-Talk**: Notice your internal narrative when faced with challenges. Replace negative, fixed-mindset thoughts with growth-oriented ones like “Not yet” or “What can I learn from this?”**Promote a Culture of Inquiry**: Challenge yourself and your team to engage in constructive questioning and explore alternative diagnoses or treatment plans to encourage a growth-centered environment.**Model Vulnerability**: Share personal learning experiences and mistakes with colleagues to normalize the growth process and reduce the stigma of imperfection.**Reframe Feedback**: Instead of broadly asking, “How did I do?” inquire, “What’s one thing I can improve on next time?” This shift helps maintain focus on growth rather than performance validationFeedback is a whole another topic that we plan to have dedicated episodes and blog posts. This is an area where sometimes faculty struggle and often learners are asking for more/improved feedback. 💬Conclusion Cultivating a growth mindset in medicine isn’t merely about staying positive; it’s about embracing continuous learning in the face of challenges. It involves creating supportive environments that encourage vulnerability, experimentation, and resilience. By adopting these practices, clinicians can improve not just personal competencies but also enhance patient care quality and safety. 🚨 Clinical Bottom Line Clinicians who embrace a growth mindset not only enhance their skills but also contribute to a more dynamic, adaptive, and error-resilient healthcare environment. Remember, the best clinicians are those who never stop learning, not the ones who never make mistakes. Episode Audio Edited By: Kim Bambach, MD and Mark Ramzy, DO (Twitter/X/IG: @MRamzyDO)Post Peer Reviewed By: Marco Propersi, DO (Twitter/X: @Marco_Propersi) Further Reading and References Claro S, Paunesku D, Dweck CS. Growth mindset tempers the effects of poverty on academic achievement. Proc Natl Acad Sci U S A. 2016 Aug 2. Epub 2016 Jul 18. PMID: 27432947Blackwell LS, et al. Implicit theories of intelligence predict achievement across an adolescent transition: a longitudinal study and an intervention. Child Dev. 2007 Feb; PMID: 17328703Hopkins SR, et al. Trainee growth vs. fixed mindset in clinical learning environments: enhancing, hindering and goldilocks factors. BMC Med Educ. 2024 Oct 23 PMID: 39443909Memari M, Gavinski K, Norman MK. Beware False Growth Mindset: Building Growth Mindset in Medical Education Is Essential but Complicated. Acad Med. 2024 Mar 1. Epub 2023 Aug 30. PMID: 37643577 Meet the Authors Mark Ramzy, DO Co-Editor-in-Chief Cardiothoracic Intensivist and EM Attending RWJBH / Rutgers Health, Newark, NJ Kimberly Bambach, MD Assistant Professor of Emergency Medicine The Ohio State University Wexner Medical Center, Columbus, OH Frank Lodeserto, MD Internal Medicine Residency Program Director Cape Fear Valley Medical Center, Fayetteville, NC The post REBEL MIND – Growth vs Fixed Mindset in Medicine appeared first on REBEL EM - Emergency Medicine Blog.

Welcome to PsychEd, the psychiatry podcast for medical learners, by medical learners.This episode covers Working with Borderline Personality Disorder in the Emergency Department with Dr. Bruce Fage, a psychiatrist in Toronto working in emergency and acute care psychiatry, and an Assistant Professor at the University of Toronto. His interests include the relational and systems issues that shape psychiatric care in crisis settings. He is also a former founding member of PsychEd!The learning objectives for this episode are as follows:Explain how the emergency department environment influences presentations of borderline personality disorderKnow when to apply the diagnosis of borderline personality in the emergency settingDemonstrate effective management strategies for patients with BPD in the EDEvaluate appropriate use of emergency and inpatient care for BPD presentationsGuest:Dr. Bruce FageHosts:Sara Abrahamson (MS3)Shelly Palchik (MS4)Angad Singh (PGY2)Audio editing:Angad Singh (PGY2)For more PsychEd, follow us on Instagram (⁠@psyched.podcast⁠), Facebook (⁠PsychEd Podcast⁠), X (⁠@psychedpodcast⁠), and Bluesky (⁠@psychedpodcast.bsky.social‬⁠). You can email us at ⁠psychedpodcast@gmail.com⁠ and visit our website at⁠ psychedpodcast.org⁠.

“If you read this book on a Friday, we promise you will be better at your job on Monday.” In the high-stakes environment of the Emergency Department, we often focus on the “big saves,” but what if the secret to a thriving career lies in the tiny details? In part one of this special two-part series, we sit down with Dr. Resa Lewiss, an emergency and lifestyle medicine physician, TEDMED speaker, and co-author of the hit book Micro Skills: Small Actions, Big Impact. We dive into why the “workplace playbook” isn’t always handed to us and how breaking down overwhelming professional goals into small, actionable behaviors can transform your trajectory. What Exactly Are “Micro Skills”? Dr. Lewiss defines Micro Skills as the small, actionable behaviors and steps that serve as the building blocks for achieving massive goals. Whether it's tackling an overwhelming project or building a habit you thought was “just for other people,” almost everything can be broken down into these manageable units. For Dr. Lewiss and her co-author, Dr. Adaira Landry, these skills are the “missing playbook” they wish they'd had earlier in their careers. Early Career: The Micro Skills of Self-Care For those just entering the workforce—from residents to new attendings—the focus must be on sustainability. Become an “Award-Winning Sleeper”: Stop wearing exhaustion as a badge of honor. Dr. Lewiss highlights why sleep is a professional necessity, not a luxury. The Personal Board of Directors: Create a “round table” of go-to people—mentors, peers, and sponsors—who can help you navigate professional and personal hurdles. Mid-Career: Navigating Conflict & Team Dynamics As physicians gain competence and move into leadership, the challenges become more interpersonal. The “Paper Tiger” Colleague: Learn how to identify coworkers who project authority they don't actually have by trusting your “Spidey sense”, checking organizational charts, asking established leadership. Inquiring Carefully: When navigating workplace tension, focus on avoiding gossip and seeking clarity from trusted supervisors. Late Career: Modeling Culture & Professionalism Seasoned physicians have the greatest power to shift the culture of a department. The Scheduled Send: Protect your team's “deliberate rest” by scheduling emails to arrive during standard business hours. From Bystander to Upstander: Use your seniority to shut down unprofessional behavior with simple scripts like, “I don't understand the joke, can you explain it to me?” Coming Up in Part 2… The conversation continues! In the next episode, we explore the “Power of the Pause,” why Dr. Lewiss advocates for the “Joy of Missing Out” (JOMO), and a simple three-question framework (Start, Stop, Continue) to get the meaningful feedback you actually need to grow. We want to hear from you! Which of these micro skills resonated with you? Have you been able to apply these to your daily life and medical practice? Connect with us on social media @empulsepodcast or on our website ucdavisem.com. Hosts: Dr. Julia Magaña, Professor of Pediatric Emergency Medicine at UC Davis Dr. Sarah Medeiros, Professor of Emergency Medicine at UC Davis Guest: Dr. Resa E. Lewiss, Emergency Medicine and Lifestyle Medicine Physician, Adjunct Professor of Emergency Medicine at the Warren Alpert Medical School of Brown University, TEDMED speaker, educator and mentor. Resources: Micro Skills: Small Actions, Big Impact, by Adaira Landry, MD and Resa E. Lewiss, MD The Visible Voices Podcast, hosted by Dr. Resa Lewiss Lewiss on Lifestyle Medicine, column on Healio by Dr. Resa Lewiss *** Thank you to the UC Davis Department of Emergency Medicine for supporting this podcast and to Orlando Magaña at OM Productions for audio production services.

In the second part of this series, Dr. Tesha Monteith and Dr. Jennifer Robblee discuss updates to the emergency room recommendations for the acute treatment of migraines.  Show citations:  Robblee J, Minen MT, Friedman BW, Cortel-LeBlanc MA, Cortel-LeBlanc A, Orr SL. 2025 Guideline Update to Acute Treatment of Migraine for Adults in the Emergency Department: The American Headache Society Evidence Assessment of Parenteral Pharmacotherapies. Headache. 2026;66(1):53-76. doi:10.1111/head.70016 Robblee J, Khan FA, Marmura MJ, et al. Reaching International Consensus on the Definition of Refractory Migraine Using the Delphi Method. Cephalalgia. 2025;45(9):3331024251367767. doi:10.1177/03331024251367767 Show transcript:  Dr. Tesha Monteith:   Hi, this is Tesha Monteith with the Neurology Minute. I've just been speaking with Jennifer Robblee about her exciting work, defining refractory migraine with an international consensus, as well as her work with the American Headache Society on a guideline update for parental pharmacotherapies for migraine in the emergency department. So Jennifer, we've just been chatting on the podcast about all the great work out of the American Headache Society, updating the emergency room recommendations for acute treatment of migraine. Can you give a summary of those findings? Dr. Jennifer Robblee:  We looked at all of the new data for randomized control trials in the emergency room. We found 26 new trials, and several of those were actually a class one study that we felt had a low risk of bias. And from that, we applied the grading. So we actually have two grade A medications where it is that you must offer, of course, to the appropriate patient. And that's prochlorperazine IV, and greater occipital nerve blocks. Now, there's also a grade A must not offer, and that's IV hydromorphone. Then we have some grade B, which is should offer, and that's dexketoprofen, ketorolac, metaclopramide, sumatriptan subcutaneous, and supraorbital nerve blocks. So really exciting that we have lots of things that we can now say we have pretty good evidence or very good evidence to offer them to our patients. Dr. Tesha Monteith:  Great. It's always nice to see this update based on evidence. Dr. Jennifer Robblee:  Yes, I think it's so important, because right now when we see patients, and I'm sure you get this all the time, they come back, say they were in the emergency room for a severe headache and they got a migraine cocktail. And you're like, "Do you know what you were given?" And they say, "I don't know. I was just told it's a migraine cocktail." And as you know, that mean many, many different things. And when you are able to pull the records, it is many, many different things that a migraine cocktail can mean. So I'm hoping that this can start to standardize what we're actually giving our patients as we await more trials in the future that might start to tell us what that combo of treatments really should be. For right now, these at least tell us what individual treatments have the best evidence. Dr. Tesha Monteith:  Thanks so much, Jennifer.  

Contributor: Aaron Lessen, MD Educational Pearls: How long do we need to watch patients with a presumed overdose who were treated with naloxone in the field? A 2025 study in the Annals of Emergency Medicine took a look at this question Methods Prospective, multi-institutional cohort study Included ED patients with suspected acute opioid overdose with biologic testing to confirm substances. This paper performed a secondary analysis evaluating the risk of "delayed intubation," defined as intubation occurring >4 hours after ED arrival. Results 1,591 patients with presumed opioid overdose were included. Delayed intubation occurred in only 9 patients (0.6%). 8 of the 9 cases had non-respiratory causes contributing to intubation. Only 1 patient had respiratory-related deterioration, presenting with respiratory acidosis after receiving 6.4 mg naloxone prior to intubation. Key Takeaway Delayed respiratory deterioration requiring intubation after 4 hours of ED monitoring is extremely rare, suggesting prolonged monitoring may not be necessary for most stabilized overdose patients. How else can we mitigate risk? Give patients take-home naloxone at discharge and educate them on how to use it (See Episode 673: Leaving the ED with Naloxone). When are naloxone drips necessary? If a patient requires repeated naloxone boluses, consider a drip To get the dose, take the total naloxone dose that restored adequate breathing and give two-thirds of that dose per hour Typically these patients are admitted to the ICU References McCabe DJ, Gibbs H, Pratt AA, Culbreth R, Sutphin AM, Abston S, Li S, Wax P, Brent J, Campleman S, Aldy K, Falise A, Manini AF; ToxIC Fentalog Study Group. Risk of Delayed Intubation After Presumed Opioid Overdose in the Emergency Department. Ann Emerg Med. 2025 Jun;85(6):498-504. doi: 10.1016/j.annemergmed.2025.01.022. Epub 2025 Mar 4. PMID: 40047773; PMCID: PMC12955731. Summarized and edited by Jeffrey Olson MS4 Donate: https://emergencymedicalminute.org/donate/ Join our mailing list: http://eepurl.com/c9ouHf

In part one of this series, Dr. Tesha Monteith and Dr. Jennifer Robblee discuss an international consensus definition for refractory migraine and why clearer criteria are needed.  Show citations: Robblee J, Minen MT, Friedman BW, Cortel-LeBlanc MA, Cortel-LeBlanc A, Orr SL. 2025 Guideline Update to Acute Treatment of Migraine for Adults in the Emergency Department: The American Headache Society Evidence Assessment of Parenteral Pharmacotherapies. Headache. 2026;66(1):53-76. doi:10.1111/head.70016 Robblee J, Khan FA, Marmura MJ, et al. Reaching International Consensus on the Definition of Refractory Migraine Using the Delphi Method. Cephalalgia. 2025;45(9):3331024251367767. doi:10.1177/03331024251367767 Show transcript:  Dr. Tesha Monteith: Hi, this is Tesha Monteith with the Neurology Minute. I've just been speaking with Jennifer Robblee about her exciting work defining refractory migraine with an international consensus, as well as her work with the American Headache Society on a guideline update for parental pharmacotherapies for migraine in the emergency department. Hi, Jennifer. Thanks again for coming on our Neurology Minute. Dr. Jennifer Robblee: Thank you so much for having me. I'm delighted to be here. Dr. Tesha Monteith: You've done a lot of work in the area of refractory migraine. Why don't you tell us why you felt there need to be clarification on the definition? Dr. Jennifer Robblee: Well, this is a patient population that I'm really passionate about. There's not enough research out there. We don't really know who these patients are, why they're not responding to treatment, and we don't know how to help them because we have no guidelines, obviously, since they're refractory to what we use for treating. So I thought it was really good to get an international group to standardize our definition and hopefully help move the research forward. Dr. Tesha Monteith: Why don't you tell us a little bit about the consensus definition Dr. Jennifer Robblee: So we came up with an international consensus definition for refractory migraine that was laid out the same way that migraine is, say, laid out in the ICHD-3 diagnostic manual, if you want to call it that. So we have different criteria on. So criterion A basically allowed for it to be episodic or chronic migraine. Criterion B had three subcriteria, so you needed to have at least two out of three of severe to very severe disability and/or a constant background headache and/or at least eight monthly migraine days. Criterion C was about the lack of response to treatment. And basically it says that you needed to have failure of all medication categories, and there is an extra one for an other in case any new treatments emerge before the diagnostic criteria get updated. And what we considered a, quote, unquote, failure was that you did not have a 50% improvement in monthly migraine days, or you had intolerable side effects, or you had an absolute contraindication. There is a caveat that you need to have at least four true lack of efficacies. And then the CGRP monoclonal antibody or gepant category and the onabotulinumtoxin toxin category both had to be a true lack of response. And of course, there's a criterion B to say that this should not be from another diagnosis. Dr. Tesha Monteith: Thanks so much, Jennifer.

Dr. Tesha Monteith talks with Dr. Jennifer Robblee about the latest consensus on refractory migraine, its definition, and management strategies, including new guidelines for emergency treatment.  Read the related article in Cephalalgia.  Read the related article in Headache. Disclosures can be found at Neurology.org. 

PeaceHealth Oregon has decided to use the Atlanta-based company ApolloMD to staff its emergency departments in Lane County, ending a decadeslong contract with Eugene Emergency Physicians. The decision led the group to hold a no-confidence vote in PeaceHealth leadership, which the hospitals’ medical staff supported overwhelmingly. In a statement, PeaceHealth said it selected ApolloMD based on “Lane County’s future emergency medicine needs and the type of resource required to meet increasingly high patient volumes and medical complexity.” Margaret Pattison is the emergency department medical director at PeaceHealth RiverBend in Springfield and a member of Eugene Emergency Physicians. She joins us to talk about the decision and how the group is responding.

🧭 REBEL Rundown 🔑Key Points Try the coffee nap! Where you combine caffeine and a 30-minute nap to then have that boost energy and alertness by the time it kicks in.💤 Sleep isn’t optional—it’s crucial for memory, mood regulation, and physical recovery. It is fundamentally different from rest❌ Replacing sleep with caffeine isn’t effective and can have negative health impacts. Make getting enough sleep a priority🌞 Sunlight exposure is important for maintaining circadian rhythms and sleep quality. This applies even if you work as a nocturnist💡 Creating a personalized sleep system enhances quality and consistency. It gives you back control of a schedule that you may feel like is out of your hands.🧩 If you’ve tried these strategies and you’re still struggling, consider true sleep pathology (insomnia, shift work disorder, sleep apnea) and get help—this is not a “be tougher” problem.🩺 Better sleep isn’t just about feeling good; it’s directly tied to error reduction, patient safety, and longevity in EM/ICU careers. Click here for Direct Download of the Podcast. 👀Previously Covered and Related Content: REBEL Core Cast: Sleep HygieneREBEL MIND: Rest Is Not Sleep: The Seven Dimensions of True RecoveryRebellion in EM: Care For Yourself – Sleep HygieneFirst10EM: Some Evidence For Working Night ShiftsREBEL MIND: Dunning Kruger Effect 📝 Introduction Welcome to this episode of REBEL MIND, where MIND stands for Mastering Internal Negativity during Difficulty. Here we sharpen the person behind the practitioner by focusing on things that improve our performance, optimizing team dynamics and the human behavior that embodies the hidden curriculum of medicine. Today we are exploring the imperative topic of rest and why it’s not just about sleeping. The second of a two part series, hosted by Dr. Mark Ramzy with guests Dr. Maureen Aiad and Dr. Amil Badoolah, continue our discussion but this time on the multifaceted nature of sleep, how it serves as medicine and how we can use our tools deliberately to get more of it! Cognitive Question How would your clinical performance, patience with families, and long-term career sustainability change if you treated sleep as a non-negotiable clinical intervention rather than a flexible “nice-to-have”? 💤How is Sleep Different From Rest? 1. Rest reduces load; sleep repairs systemsWe previously talked about the 7 types of rest and you can check that out hereExamples of physical rest include: pausing tasks, stepping away from the monitor, taking a walk, stretching, breathing, journaling, connecting with a colleague. This lightens your cognitive/emotional burden.Sleep is fundamentally different in that it’s an active biologic process that helps:Consolidates memory and learning (yes, including the tough cases from last night).Regulates mood, impulse control, and emotional reactivity.Supports immunity, metabolic health, and cardiovascular function.Repairs tissue, replenishes neurotransmitters, and fine-tunes neural networks.You can have “rested but underslept” days (you took breaks but got 4 hours in bed), and “slept but unrested” days (you got hours, but all junk sleep). Both matter, but they are not interchangeable.2. Sleep architecture vs. “knocking out”True restorative sleep cycles through NREM and REM in predictable patterns.Alcohol, late caffeine, and fragmented nights may help you fall asleep faster but:Suppress REM.Shorten deep sleep.Increase awakenings and light sleep.The result: you technically slept, but your brain didn’t get the “software updates” it needed.Biology isn’t built for your scheduleCircadian rhythms were designed for light-day / dark-night cycles, not:10 pm–7 am ED shifts.24-hour calls.6 nights in a row followed by days.Your body can adapt partially, but not instantly and not perfectly. That’s why:You can feel “jet-lagged” even when you haven’t traveled.Sleep before and after nights feels odd and fragile.Recognizing that “this is biologically unnatural” is key: you’re not weak; you’re fighting physiology. 🏥How This Applies to the Emergency Department or ICU? Performance & safetySleep deprivation:Slows reaction time and increases error rate.Impairs risk assessment and complex decision-making.Drops your frustration tolerance with consultants, families, and staff.In both emergency medicine and critical care, that translates into:Anchoring on the wrong diagnosis.Missing subtle clinical changes.Snapping at a tech, nurse or resident and damaging team culture. Chronic health for chronic shift workLong-term sleep disruption is associated with:Hypertension, diabetes, obesity.Depression, anxiety, burnout.Arrhythmias (e.g., AFib) and increased stroke risk.Possibly increased all-cause mortality.You’re already in a high-stress, high-exposure specialty. Chronically poor sleep amplifies that risk profile and can end a career early—or make you miserable while you’re still in it.Culture of “heroics” vs. healthSkipping sleep to pick up extra shifts, late meetings, or “just one more note” is often praised.We rarely celebrate:The attending who says “no” to a 2 pm meeting post-nights.The resident who defends their blackout-curtains-and-earplugs routine. 🛏️Different Ways to Improve Your Sleep Clarify your “sleep non-negotiables”Decide how many hours you realistically need to function (e.g., 7–9 on off days, realistic blocks on nights).Treat those hours as you would a procedure time—blocked, protected, and respected.Use caffeine like a drug, not a reflexAim for ≤ 2 cups equivalent on most days.Avoid caffeine within 4–6 hours of your planned sleep time (remember: it can hang around up to 12 hours).Consider scheduling caffeine for:Early in the shift for alertness.Strategic “coffee naps” (see below), not late-night chugging.Respect alcohol’s impact on sleepRecognize that even small to moderate doses degrade sleep architecture.Avoid using alcohol as a “sleep aid”—you’ll fall asleep faster but sleep worse.If you do drink, separate it from bedtime and keep it modest.Optimize food and fluid timingHydrate consistently on shift, but taper fluids ~4 hours before bed to reduce nocturnal bathroom trips.Avoid heavy, spicy, or large meals within 2–3 hours of sleep to decrease reflux and discomfort.Plan a light, balanced “pre-sleep” snack if going to bed hungry keeps you awake.Move your body (but not right before bed)Regular exercise improves sleep depth and latency.Try to avoid intense workouts within 2 hours of bedtime.On shift: micro-movement (stairs, brisk walks between pods, quick stretch sessions) can help alertness without wrecking sleep later.Control light exposureMaximize sunlight or bright light after waking (even if that’s 3–4 pm after a night).Minimize bright light and screens before sleep:Dim lights.Use night mode/blue-light filters if you must scroll.For daytime sleep:Use blackout curtains, tinfoil, cardboard, or sleep masks.Yes seriously use tinfoil if you have to, we talk about it on the podcast episode!Aim for “I might be blind” darkness—so dark you can’t see your hand in front of your face.Dial in your sleep environmentCool room temperature (fan or AC if possible).White noise or sound machine to mask household/traffic noise.Earplugs and eye masks as needed.Bed used primarily for sleep (and sex)—not for charting, doom scrolling, or email.Strategic power napsKeep naps ≤ 20–30 minutes to avoid sleep inertia.Prefer early-afternoon or pre-night-shift naps.Coffee nap strategy:Drink a small coffee.Immediately lie down for a 20–30 min nap.Wake up as the caffeine kicks in, combining nap benefit + stimulant.Thoughtful melatonin useRemember melatonin is a hormone, not a vitamin gummy.Lower doses often work as well as (or better than) large OTC doses.Use it intentionally and intermittently, not as a crutch every night.Over-reliance may reduce your own natural production and its effectiveness over time.Build pre-sleep ritualsRepeated, calming habits signal your body it’s time to downshift:Warm shower, gentle stretching, or yoga.Guided breathing or body scan.Brief journaling or “brain dump” of tasks to get them out of your head and onto paper.Protect from pathologic patternsIf despite consistent effort you:Snore heavily, stop breathing, or gasp in sleep.Feel excessively sleepy driving home or at work.Cannot fall asleep or stay asleep for weeks to months.Consider evaluation for sleep apnea, insomnia, or shift-work sleep disorder with your physician or sleep specialist. ⏩Immediate Action Steps for Before/During/After Your Next Shift 1. **Before the Shift**: Plan a 20–90 minute nap before your first night shift (many clinicians find 3–5 hours earlier in the day is ideal).I treat ED and ICU shifts very differently. I always sleep 3-5 hours before my night shifts aiming for the full 5 (sometimes 6 or more) hours for my ED shifts because you always have to be “on”. Depending on the ICU I’m working in, I may have a bit more downtime so 3 to 5 hours is plenty.Set a caffeine plan: decide in advance when your last dose will be (e.g., none after 2–3 am if sleeping at 8–9 am).Tell your household, “This is my sleep block” and agree on a plan for kids, pets, deliveries, etc.On my calendar, I completely block off time called “Pre-call sleep” so no meetings can be scheduled and then put my phone in airplane mode2. **During the Shift** Hydrate early; taper fluids in the last 3–4 hours of your shift Eat something light but adequate; avoid “last-minute” heavy meals right before sign-out.Build in micro-breaks and movement: one or two short walks, a few stretches, even a quick stair run if safe.Get outside or near a window for a few minutes of light exposure if possible.3. **After the Shift**On the way home:Use sunglasses to reduce bright morning light if you’re aiming for sleep soon.Avoid “just checking” email or messages; shift into wind-down mode.At home:Do a brief, calming decompression (shower, light snack, 10–15 minutes of low-stimulation TV or reading).Make your room cold, quiet, and dark (blackout curtains, tinfoil/cardboard, white noise, fan).Put your phone on Do Not Disturb and physically place it away from the bed.On my calendar, I completely block off time called “Post-call sleep” so again no meetings can be scheduled and then I personally don’t just put my phone on Do Not Disturb but rather in airplane mode and WIFI OFF If you can’t sleep after ~20–30 minutes:Get out of bed, do something calming in dim light (breathing, gentle stretching, journaling).Return to bed when sleepy—this trains your brain to associate bed with sleep, not frustration. Conclusion Rest and sleep are both critical—but they’re not interchangeable. Rest helps you step out of the constant “on” of our jobs, while sleep is the biological intervention that restores your ability to show up safely and sustainably. Rest ≠ sleep. Rest reduces load; sleep repairs your brain and body. You need both, on purpose.As EM and ICU clinicians, we’re trying to perform formula-one-level medicine with engines that often only see half their maintenance. You won’t fix shift work. You can build a sleep system that respects your biology, your schedule, and your life at home.That system starts with valuing sleep, then prioritizing it, personalizing it, trusting the process when it’s imperfect, and actively protecting both your routine and your mindset. 🚨 Clinical Bottom Line Sleep is medicine. Shift work is biologically unnatural. Struggling does not mean you’re weak; it means you’re human fighting physiology. Use your tools deliberately. Caffeine, naps, light, food, movement, melatonin, and environment can be leveraged—or can quietly sabotage you. Build and defend a personalized sleep routine. Communicate it, normalize it, and protect it from casual encroachment. You can’t control every trauma, code, or admission—but you can control how seriously you take your own recovery. Your patients, your team, and your future self all benefit when you do. Further Reading Espie CA. The ‘5 principles’ of good sleep health. J Sleep Res. 2022 Jun; PMID: 34676592Solodar, J“Sleep hygiene: Simple practices for better rest.” Harvard Health, 31 January 2025 Link is HereSuni, E.“Mastering Sleep Hygiene: Your Path to Quality Sleep.” Sleep Foundation, 7 July 2025, Link is Here Meet the Authors Mark Ramzy, DO Co-Editor-in-Chief Cardiothoracic Intensivist and EM Attending RWJBH / Rutgers Health, Newark, NJ Maureen Aiad, DO Assistant Professor of Emergency Medicine NYU Grossman Long Island School of Medicine, New York Amil Badoolah, DO Assistant Professor of Emergency Medicine NYU Grossman Long Island School of Medicine, New York REBEL Core Cast 119.0 – Sleep Hygiene REBEL Core Cast 119.0 – Sleep Hygiene Click here for Direct Download of ... Read More The post REBEL MIND – How to Sleep When the World Says You Can't appeared first on REBEL EM - Emergency Medicine Blog.