Podcasts about neuro icu

In this episode, I take you behind the scenes of my unexpected path—from stepping up as a charge nurse to creating a community of thousands of nursing students and professionals. I share how I started by posting my own notes and podcast episodes, only to realize how deeply my story resonated with others struggling through nursing school. You'll hear how NRSNG rapidly grew, why I left my job in the NEURO ICU, and how I hired a passionate team to meet the skyrocketing demand for our resources. I also recount the exciting leap we made when we rebranded to Nursing.com in early 2020, unveiling an all-in-one platform dedicated to nurses at every stage of their journey.  Plus, I'll give you an inside look at the powerful sense of family and support that blossomed along the way—proving that together, we can change the culture of nursing for the better. Finally, I hint at what was just around the corner: the onset of COVID-19 and how it would impact our evolving mission. Don't miss this heartfelt reflection on building a community that's changing nursing education forever.   Happy Nursing! -Jon, RN  

In this episode, I take you behind the scenes of my unexpected path—from stepping up as a charge nurse to creating a community of thousands of nursing students and professionals. I share how I started by posting my own notes and podcast episodes, only to realize how deeply my story resonated with others struggling through nursing school. You'll hear how NRSNG rapidly grew, why I left my job in the NEURO ICU, and how I hired a passionate team to meet the skyrocketing demand for our resources. I also recount the exciting leap we made when we rebranded to Nursing.com in early 2020, unveiling an all-in-one platform dedicated to nurses at every stage of their journey.  Plus, I'll give you an inside look at the powerful sense of family and support that blossomed along the way—proving that together, we can change the culture of nursing for the better. Finally, I hint at what was just around the corner: the onset of COVID-19 and how it would impact our evolving mission. Don't miss this heartfelt reflection on building a community that's changing nursing education forever.   Happy Nursing! -Jon, RN  

In this episode, I take you behind the scenes of my unexpected path—from stepping up as a charge nurse to creating a community of thousands of nursing students and professionals. I share how I started by posting my own notes and podcast episodes, only to realize how deeply my story resonated with others struggling through nursing school. You'll hear how NRSNG rapidly grew, why I left my job in the NEURO ICU, and how I hired a passionate team to meet the skyrocketing demand for our resources. I also recount the exciting leap we made when we rebranded to Nursing.com in early 2020, unveiling an all-in-one platform dedicated to nurses at every stage of their journey.  Plus, I'll give you an inside look at the powerful sense of family and support that blossomed along the way—proving that together, we can change the culture of nursing for the better. Finally, I hint at what was just around the corner: the onset of COVID-19 and how it would impact our evolving mission. Don't miss this heartfelt reflection on building a community that's changing nursing education forever.   Happy Nursing! -Jon, RN  

In this episode, I take you behind the scenes of my unexpected path—from stepping up as a charge nurse to creating a community of thousands of nursing students and professionals. I share how I started by posting my own notes and podcast episodes, only to realize how deeply my story resonated with others struggling through nursing school. You'll hear how NRSNG rapidly grew, why I left my job in the NEURO ICU, and how I hired a passionate team to meet the skyrocketing demand for our resources. I also recount the exciting leap we made when we rebranded to Nursing.com in early 2020, unveiling an all-in-one platform dedicated to nurses at every stage of their journey.  Plus, I'll give you an inside look at the powerful sense of family and support that blossomed along the way—proving that together, we can change the culture of nursing for the better. Finally, I hint at what was just around the corner: the onset of COVID-19 and how it would impact our evolving mission. Don't miss this heartfelt reflection on building a community that's changing nursing education forever.   Happy Nursing! -Jon, RN  

In this episode, I take you behind the scenes of my unexpected path—from stepping up as a charge nurse to creating a community of thousands of nursing students and professionals. I share how I started by posting my own notes and podcast episodes, only to realize how deeply my story resonated with others struggling through nursing school. You'll hear how NRSNG rapidly grew, why I left my job in the NEURO ICU, and how I hired a passionate team to meet the skyrocketing demand for our resources. I also recount the exciting leap we made when we rebranded to Nursing.com in early 2020, unveiling an all-in-one platform dedicated to nurses at every stage of their journey.  Plus, I'll give you an inside look at the powerful sense of family and support that blossomed along the way—proving that together, we can change the culture of nursing for the better. Finally, I hint at what was just around the corner: the onset of COVID-19 and how it would impact our evolving mission. Don't miss this heartfelt reflection on building a community that's changing nursing education forever.   Happy Nursing! -Jon, RN  

In this episode, I take you behind the scenes of my unexpected path—from stepping up as a charge nurse to creating a community of thousands of nursing students and professionals. I share how I started by posting my own notes and podcast episodes, only to realize how deeply my story resonated with others struggling through nursing school. You'll hear how NRSNG rapidly grew, why I left my job in the NEURO ICU, and how I hired a passionate team to meet the skyrocketing demand for our resources. I also recount the exciting leap we made when we rebranded to Nursing.com in early 2020, unveiling an all-in-one platform dedicated to nurses at every stage of their journey.  Plus, I'll give you an inside look at the powerful sense of family and support that blossomed along the way—proving that together, we can change the culture of nursing for the better. Finally, I hint at what was just around the corner: the onset of COVID-19 and how it would impact our evolving mission. Don't miss this heartfelt reflection on building a community that's changing nursing education forever.   Happy Nursing! -Jon, RN  

In this episode, I take you behind the scenes of my unexpected path—from stepping up as a charge nurse to creating a community of thousands of nursing students and professionals. I share how I started by posting my own notes and podcast episodes, only to realize how deeply my story resonated with others struggling through nursing school. You'll hear how NRSNG rapidly grew, why I left my job in the NEURO ICU, and how I hired a passionate team to meet the skyrocketing demand for our resources. I also recount the exciting leap we made when we rebranded to Nursing.com in early 2020, unveiling an all-in-one platform dedicated to nurses at every stage of their journey.  Plus, I'll give you an inside look at the powerful sense of family and support that blossomed along the way—proving that together, we can change the culture of nursing for the better. Finally, I hint at what was just around the corner: the onset of COVID-19 and how it would impact our evolving mission. Don't miss this heartfelt reflection on building a community that's changing nursing education forever.   Happy Nursing! -Jon, RN  

In today's episode, I'm taking you through a pivotal part of my nursing journey—from my early days in the Neuro ICU to precepting students, becoming a charge nurse, and the moment I realized nursing education was broken. This realization is what fueled me to start NURSING.com (formerly NRSNG). I wanted to fill the gaps I saw in nursing education and give you the tools I never had. I share my struggles with imposter syndrome, the pressure of caring for patients, and why never feeling fully ready actually makes you a better nurse. If you've ever doubted yourself, this one's for you.

In today's episode, I'm taking you through a pivotal part of my nursing journey—from my early days in the Neuro ICU to precepting students, becoming a charge nurse, and the moment I realized nursing education was broken. This realization is what fueled me to start NURSING.com (formerly NRSNG). I wanted to fill the gaps I saw in nursing education and give you the tools I never had. I share my struggles with imposter syndrome, the pressure of caring for patients, and why never feeling fully ready actually makes you a better nurse. If you've ever doubted yourself, this one's for you.

In today's episode, I'm taking you through a pivotal part of my nursing journey—from my early days in the Neuro ICU to precepting students, becoming a charge nurse, and the moment I realized nursing education was broken. This realization is what fueled me to start NURSING.com (formerly NRSNG). I wanted to fill the gaps I saw in nursing education and give you the tools I never had. I share my struggles with imposter syndrome, the pressure of caring for patients, and why never feeling fully ready actually makes you a better nurse. If you've ever doubted yourself, this one's for you.

In today's episode, I'm taking you through a pivotal part of my nursing journey—from my early days in the Neuro ICU to precepting students, becoming a charge nurse, and the moment I realized nursing education was broken. This realization is what fueled me to start NURSING.com (formerly NRSNG). I wanted to fill the gaps I saw in nursing education and give you the tools I never had. I share my struggles with imposter syndrome, the pressure of caring for patients, and why never feeling fully ready actually makes you a better nurse. If you've ever doubted yourself, this one's for you.

In today's episode, I'm taking you through a pivotal part of my nursing journey—from my early days in the Neuro ICU to precepting students, becoming a charge nurse, and the moment I realized nursing education was broken. This realization is what fueled me to start NURSING.com (formerly NRSNG). I wanted to fill the gaps I saw in nursing education and give you the tools I never had. I share my struggles with imposter syndrome, the pressure of caring for patients, and why never feeling fully ready actually makes you a better nurse. If you've ever doubted yourself, this one's for you.

In today's episode, I'm taking you through a pivotal part of my nursing journey—from my early days in the Neuro ICU to precepting students, becoming a charge nurse, and the moment I realized nursing education was broken. This realization is what fueled me to start NURSING.com (formerly NRSNG). I wanted to fill the gaps I saw in nursing education and give you the tools I never had. I share my struggles with imposter syndrome, the pressure of caring for patients, and why never feeling fully ready actually makes you a better nurse. If you've ever doubted yourself, this one's for you.

In today's episode, I'm taking you through a pivotal part of my nursing journey—from my early days in the Neuro ICU to precepting students, becoming a charge nurse, and the moment I realized nursing education was broken. This realization is what fueled me to start NURSING.com (formerly NRSNG). I wanted to fill the gaps I saw in nursing education and give you the tools I never had. I share my struggles with imposter syndrome, the pressure of caring for patients, and why never feeling fully ready actually makes you a better nurse. If you've ever doubted yourself, this one's for you.

Oh man . . . it's hard to believe that about 14 years ago I was sleeping on a mattress I'd found in the dumpster - not even sure if nursing school would ever end.  It did.  I survived.  I passed the NCLEX.  And I got a job in the Neuro ICU right out of nursing school.  Today I want to share part IV of my journey. Happy Nursing Jon Haws, RN

Oh man . . . it's hard to believe that about 14 years ago I was sleeping on a mattress I'd found in the dumpster - not even sure if nursing school would ever end.  It did.  I survived.  I passed the NCLEX.  And I got a job in the Neuro ICU right out of nursing school.  Today I want to share part IV of my journey. Happy Nursing Jon Haws, RN

Oh man . . . it's hard to believe that about 14 years ago I was sleeping on a mattress I'd found in the dumpster - not even sure if nursing school would ever end.  It did.  I survived.  I passed the NCLEX.  And I got a job in the Neuro ICU right out of nursing school.  Today I want to share part IV of my journey. Happy Nursing Jon Haws, RN

Oh man . . . it's hard to believe that about 14 years ago I was sleeping on a mattress I'd found in the dumpster - not even sure if nursing school would ever end.  It did.  I survived.  I passed the NCLEX.  And I got a job in the Neuro ICU right out of nursing school.  Today I want to share part IV of my journey. Happy Nursing Jon Haws, RN

Oh man . . . it's hard to believe that about 14 years ago I was sleeping on a mattress I'd found in the dumpster - not even sure if nursing school would ever end.  It did.  I survived.  I passed the NCLEX.  And I got a job in the Neuro ICU right out of nursing school.  Today I want to share part IV of my journey. Happy Nursing Jon Haws, RN

Oh man . . . it's hard to believe that about 14 years ago I was sleeping on a mattress I'd found in the dumpster - not even sure if nursing school would ever end.  It did.  I survived.  I passed the NCLEX.  And I got a job in the Neuro ICU right out of nursing school.  Today I want to share part IV of my journey. Happy Nursing Jon Haws, RN

Oh man . . . it's hard to believe that about 14 years ago I was sleeping on a mattress I'd found in the dumpster - not even sure if nursing school would ever end.  It did.  I survived.  I passed the NCLEX.  And I got a job in the Neuro ICU right out of nursing school.  Today I want to share part IV of my journey. Happy Nursing Jon Haws, RN

On episode 492 of The Nurse Keith Show nursing and healthcare career podcast, Keith interviews Rosa Hart, BSN, RN, SCRN, a Stroke Certified Registered Nurse, leader, speaker, consultant, and award-winning podcaster who seeks to inspire others to be curious, open to opportunity and serendipity, and willing to embrace novel solutions whenever and however they present themselves. Rosa got her start in Neuro ICU in 2013, first as a nurse's aide and then as a bedside nurse. In the hospital, she emphasized interdisciplinary care with the whole team, including dietary, rehab and music therapy leading to a nomination for Nurse of the Year. After experiencing burnout at the bedside, she transitioned to an outpatient role as Stroke Nurse Navigator, and created the award winning podcast "Stronger After Stroke" for the Norton Neuroscience Institute (NNI). As the Advisory Board Chair for Power Up Nursing, she aims to elevate the quality of life for nurses as well as patients. Now on the Health Podcast Network, on "Nurse Rosa's INsights" she interviews healthcare stakeholders to find out what needs they see in their specialty and learn about their proposed methods to meet them. Anyone can complain, but this podcast is for possibility thinkers who are ready to create solutions. Rosa is also the creator of “The Lou Review” podcast, interviewing local business owners and non-profit leaders about their vision and efforts that make the Louisville, KY area outstanding. Connect with Rosa Hart: Nurse Rosa Speaks website Instagram X TikTok LinkedIn 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.

My first job out of nursing school was in the Neuro ICU at a very large hospital in downtown Dallas.     In this particular hospital, new ICU nurses complete a 13 week internship partnered with an experienced nurse (called a preceptor).  My preceptors name was Vanessa, she was the typical ICU nurse type - a hardcore, type A nurse.   She trained me well . . . but . . . those 13 weeks came to an end and it was time for me to be all on my own - no safety net to fall back on, no babysitter to make sure I did everything by the book - it was just ME.    To be honest . . . I was terrified.   I wish I'd had a tool like NURSING.com   You CAN do this   Happy Nursing!   -Jon

My first job out of nursing school was in the Neuro ICU at a very large hospital in downtown Dallas.     In this particular hospital, new ICU nurses complete a 13 week internship partnered with an experienced nurse (called a preceptor).  My preceptors name was Vanessa, she was the typical ICU nurse type - a hardcore, type A nurse.   She trained me well . . . but . . . those 13 weeks came to an end and it was time for me to be all on my own - no safety net to fall back on, no babysitter to make sure I did everything by the book - it was just ME.    To be honest . . . I was terrified.   I wish I'd had a tool like NURSING.com   You CAN do this   Happy Nursing!   -Jon

My first job out of nursing school was in the Neuro ICU at a very large hospital in downtown Dallas.     In this particular hospital, new ICU nurses complete a 13 week internship partnered with an experienced nurse (called a preceptor).  My preceptors name was Vanessa, she was the typical ICU nurse type - a hardcore, type A nurse.   She trained me well . . . but . . . those 13 weeks came to an end and it was time for me to be all on my own - no safety net to fall back on, no babysitter to make sure I did everything by the book - it was just ME.    To be honest . . . I was terrified.   I wish I'd had a tool like NURSING.com   You CAN do this   Happy Nursing!   -Jon

My first job out of nursing school was in the Neuro ICU at a very large hospital in downtown Dallas.     In this particular hospital, new ICU nurses complete a 13 week internship partnered with an experienced nurse (called a preceptor).  My preceptors name was Vanessa, she was the typical ICU nurse type - a hardcore, type A nurse.   She trained me well . . . but . . . those 13 weeks came to an end and it was time for me to be all on my own - no safety net to fall back on, no babysitter to make sure I did everything by the book - it was just ME.    To be honest . . . I was terrified.   I wish I'd had a tool like NURSING.com   You CAN do this   Happy Nursing!   -Jon

My first job out of nursing school was in the Neuro ICU at a very large hospital in downtown Dallas.     In this particular hospital, new ICU nurses complete a 13 week internship partnered with an experienced nurse (called a preceptor).  My preceptors name was Vanessa, she was the typical ICU nurse type - a hardcore, type A nurse.   She trained me well . . . but . . . those 13 weeks came to an end and it was time for me to be all on my own - no safety net to fall back on, no babysitter to make sure I did everything by the book - it was just ME.    To be honest . . . I was terrified.   I wish I'd had a tool like NURSING.com   You CAN do this   Happy Nursing!   -Jon

My first job out of nursing school was in the Neuro ICU at a very large hospital in downtown Dallas.     In this particular hospital, new ICU nurses complete a 13 week internship partnered with an experienced nurse (called a preceptor).  My preceptors name was Vanessa, she was the typical ICU nurse type - a hardcore, type A nurse.   She trained me well . . . but . . . those 13 weeks came to an end and it was time for me to be all on my own - no safety net to fall back on, no babysitter to make sure I did everything by the book - it was just ME.    To be honest . . . I was terrified.   I wish I'd had a tool like NURSING.com   You CAN do this   Happy Nursing!   -Jon

My first job out of nursing school was in the Neuro ICU at a very large hospital in downtown Dallas.     In this particular hospital, new ICU nurses complete a 13 week internship partnered with an experienced nurse (called a preceptor).  My preceptors name was Vanessa, she was the typical ICU nurse type - a hardcore, type A nurse.   She trained me well . . . but . . . those 13 weeks came to an end and it was time for me to be all on my own - no safety net to fall back on, no babysitter to make sure I did everything by the book - it was just ME.    To be honest . . . I was terrified.   I wish I'd had a tool like NURSING.com   You CAN do this   Happy Nursing!   -Jon

Hola Hola!  En este episodio hablamos con Núria Montagut Colomer sobre la terapia de grupo con pacientes de Afasia Progresiva Primaria (APP). Núria comparte con nosotros las consideraciones clínicas que utiliza al formar los grupos  y algunas estrategias para apoyar a los pacientes en el trancurso de la progresión de sus síntomas.  Núria Montagut Colomer, es Logopeda e investigadora en el Hospital Clínic de Barcelona.  Ella tiene más de 15 años de experiencia clínica tanto en cuidado intensivo neurológico (Neuro-ICU), como en hospital de día (outpatient). Además, es investigadora y colaboradora en el Laboratorio de Afasia y Demencia Multilingüe de la Universidad de Texas en Austin.  #patologiadelhabla #speechpathology #slp #phl #slpbilingue #bilingualslp #bilingue #bilingual #español #spanish #logopedia #fonoaudiologia #podcast  #Afasia #afasiaprogresiva #demencia

Hola Hola!  Núria Montagut Colomer, es Logopeda y ejerce en el Hospital Clínic de Barcelona.  Ella tiene más de 15 años de experiencia clínica tanto en cuidado intensivo neurológico (Neuro-ICU), como en hospital de día (outpatient). Además, es investigadora y colaboradora en el Laboratorio de Afasia y Demencia Multilingüe de la Universidad de Texas en Austin.  En este episodio hablamos sobre las tres variantes de la Afasia Progresiva Primaria. Describimos la presentación clínica y explicamos como es que debemos abordar este síndrome progresivo.  #patologiadelhabla #speechpathology #slp #phl #slpbilingue #bilingualslp #bilingue #bilingual #español #spanish #logopedia #fonoaudiologia #podcast  #Afasia #afasiaprogresiva #demencia

Several measures of blood pressure (BP) control have been used including time to reach target BP, maintaining BP within target range, reducing BP fluctuation, achieving goals with monotherapy and avoiding multiple anti-hypertensive agents, achieving goals with minimum dose adjustments, avoiding discontinuation due to side effects, and preventing hypotension. There are multiple methods of quantifying these measures. The clinical relevance of various measures particularly relationship with acute kidney injury, and death or disability in patients with acute stroke or traumatic brain injury is not well understood. A better understanding of these measures is essential to identify the ideal therapeutic agent and for comparison of effectiveness between various antihypertensive agents. Dr Nick Morris is joined by Dr Ali Seifi, Director of Neuro ICU at University of Texas Health whose session at the Meeting focused on the need to review existing data to evaluate the relationship between various measures of BP control and acute kidney injury and death or disability in stroke patients.

Tam and Matt chat with Adam Rizvi. Adam and Tam share about being there for people as they die and how it can be a beautiful and healing time. Adam also shares about a time he was lost in the wilderness in a night so dark he could only see inches in front of his face. About Today's Guest: Dr. Adam Rizvi is a board certified Neurologist with more than 9 years of diverse experience. After completing his medical degree with honors at St. George's University, he completed his neurology residency at the University of Minnesota and a Neurocritical Care fellowship at Stanford. He is currently the Neuro ICU director at Carondelet St. Joseph's hospital and a member of the Windbridge Research Center clinical advisory board. Dr. Adam's passion lies in helping people find their unique path to optimum health. In particular, he combines his neurology expertise with an emphasis on spiritual and philosophical teachings to help his patients see themselves as whole and perfect. "Healing is ultimately about becoming whole, or more accurately, remembering we were always whole to begin with.” - Dr. Adam Rizvi Join The Miracle Voices E-mail List at: ⁠⁠⁠⁠https://www.miraclevoices.org/email⁠⁠⁠⁠ Feel Inspired to Make a Love Offering To The Foundation for Inner Peace (Publisher of A Course in Miracles)? Visit: ⁠⁠⁠⁠https://www.miraclevoices.org/donate⁠⁠⁠⁠ Think your Forgiveness Story Might Be a Fit For Miracle Voices? Submit your Forgiveness Story: ⁠⁠⁠⁠https://www.miraclevoices.org/form⁠⁠⁠⁠ Also, Checkout our Youtube Channel: ⁠⁠⁠⁠https://www.youtube.com/@miraclevoices777/videos

How do you design care for patients with Long Covid? Will the pandemic lead to a redesign of medical education? Can design principles create safer standards in healthcare? Dr. Lekshmi Santhosh specializes in adult pulmonary and critical care medicine with a focus on medical education. She attends in the Medical ICU, the Neuro ICU, on the Internal Medicine teaching wards, and has a clinic at the Pulmonary Outpatient Faculty Practice at UCSF-Parnassus. She is the founder and Medical Director of the multidisciplinary OPTIMAL Clinic (pOst-covid-19/PosT-Icu MultidisciplinAry cLinic) at UCSF Health. She serves as the Associate Program Director for the Pulmonary and Critical Care Medicine Fellowship and the Assistant Site Director for the Internal Medicine Residency at Parnassus. She also is the Director of the Department of Medicine Grand Rounds. She obtained her Master's in Health Professions Education from UC-Berkeley. Her primary interests in medical education research are related to ICU transitions of care, women in leadership, clinical reasoning, and subspecialty career choice. Episode Mentions: Interview w Lekshmi: What We Do — and, Frustratingly, Don't — Know About Long Covid Article: Long Covid-19 may remain a chronic condition for millions Article: On the Long Road to Understanding Long Covid, This UCSF Initiative Leads Article: Feeling Dismissed? How to Spot ‘Medical Gaslighting' and What to Do About It. Follow Lekshmi: Twitter | LinkedIn Episode Website: https://mailchi.mp/designlabpod/lekshmisanthosh More episode sources & links Sign-up for Design Lab Podcast's Newsletter Previous Episode Newsletters and Shownotes Follow @DesignLabPod on Twitter Instagram LinkedIn Facebook Follow @BonKu on Twitter & Instagram Check out the Health Design Lab Production by Robert Pugliese Edit by Fernando Queiroz Cover Design by Eden Lew Theme song by Emmanuel Houston Indexed in the Library of Congress: ISSN 2833-2032

In this episode of the podcast, we discuss the management of Acute Ischemic Stroke (AIS). Our guest is Dr. Fred Rincon, a neurologist and critical care specialist with expertise in the resuscitation and management of acute brain injured patients. He is a Professor of Neurology at Cooper Medical School of Rowan University and Director of the Neuro-ICU at Cooper University Health Care in Camden, New Jersey. Additional Resources Management of Acute Ischemic Stroke. F. Herpich and F. Rincon: https://pubmed.ncbi.nlm.nih.gov/32947473/ AHA Guidelines for the Management of Acute Ischemic Stroke (2019): https://pubmed.ncbi.nlm.nih.gov/31662037/ Link to NIHSS Certification Course: https://www.nihstrokescale.org/ The intensive care management of acute ischemic stroke. D. Sharma and M. Smith: https://pubmed.ncbi.nlm.nih.gov/35034076/ Association of Neurocritical Care Services with Mortality and Functional Outcomes for Adults With Brain Injury. Meta-analysis. JAMA Neurology 2022: https://pubmed.ncbi.nlm.nih.gov/36036899/ Book Recommendations: The Servant: A Simple Story of About the True Essence of Leadership. By James C. Hunter: https://amzn.to/3U6u6SI How to Be a Leader: An Ancient Guide to Wise Leadership. By Plutarch: https://amzn.to/3eMBxhU

Let's talk about the story of the neuro nurse practitioner... How far are you willing to go to achieve what you believe is your purpose – to be part of a better healthcare practice while helping and educating not only the patients but also the people in this world? Wanting to be a healthcare practitioner – more so a nurse – in a Haitian community is something Haitian people don't usually know a lot about. There are not a lot of Black people in the practice of healthcare. Today's guest even experienced being the only Black nurse practitioner at work! But despite how intimidating it was, how having a DNP drove her to be self-conscious years back, she learned to embrace who she is and showed up for herself in order to do what needs to be done as they provide healthcare. Dr. Kettia Alusma-Hibbert, DNP is a Nurse Practitioner in Boca Raton, South Florida. She's among the advanced practice providers of Boca Raton Regional Hospital's Marcus Neuroscience Institute Team. Dr. Kettia's career started with her being a Neuro-Tele nurse, then transferring to the Neuro ICU, and later on helping comprehensive neuro outpatient clinics. She and Dr. Berry used to walk hallways together during their early years of studying medicine, a history that sums up to around 12 years now. In this episode, Dr. Kettia takes us back to her journey on how she's made it, starting as a nurse to then becoming a nurse practitioner. Join us as she discusses what it's like, to be a healthcare provider while being part of the Black community, and stresses the importance of educating people at large while making sure the treatments they need are accessible to them. Why you need to check out this episode: Understand why it's important that you engage in a discussion with a healthcare practitioner about advance directives and not leave the decision for your family to make; Recognize the need to educate people in general when it comes to healthcare while also making sure that you're having a balanced work and personal life; and Find out why it's a must that administrators treat their nurses well, understand what their needs and wants are, and make sure that they're working within their scope of practice even when their pay and responsibilities aren't as much as the physicians' “People ask this a lot when you're preparing to get into nursing school – it's ‘why do you want to be a nurse?' – and the question is valid. And it's interesting because as my career has evolved and as I've evolved into different roles, I still go back to the fact that I'm here to help patients.” – Dr. Kettia Notable Quotes: “You're not gonna be perfect all the time. You will make mistakes, and that's fine, as long as you do your best and you're honest. If you make a mistake, you just acknowledge it, [and] you try to rectify it the best that you can.” –Dr. Kettia Links/Resources: Dr. Kettia's Instagram Dr. Berry's Social Pages

What does the ABCDEF bundle look like in neurocritical care? When patients suffer conditions such as intracranial hypertension that necessitate sedation and immobility, how does the ABCDEF bundle apply? Neurointensivist, Dr. Neha Dangayach, shares with us her team's strong ABCDEF culture and practices in the neuro ICU. @Drdangayach www.daytonicuconsulting.com --- Support this podcast: https://anchor.fm/restoringlife/support

January 2016 Cerebral Monitoring in the Neuro ICU Setting by SNACC

Fellows' and Residents' Audio Corner Learn from an expert! This is for residents, fellows, students and anyone wanting a quick review of how to manage a neuroanesthesia case. October 2018 Neuro ICU Management of Sub-arachnoid Hemorrhage. Shobana Rajan in conversation with Dr. Andrew Kofke

In this episode we are joined by consultant anaesthetist Dr Jed Smith to discuss common clinical scenarios encountered on the Neuro ICU.

In this 199th episode I welcome Salia Farrokh to the show to discuss pharmacology in the neuro ICU. We discuss treatment for status epilepticus, ICP crisis, reversal of anticoagulants in ICH, neurostimulants in TBI and BP management in stroke. Salia is on LinkedIn at https://www.linkedin.com/in/salia-farrokh-pharm-d-bcps-bcccp-845b1b38/ Advertising Inquiries: https://redcircle.com/brands Privacy & Opt-Out: https://redcircle.com/privacy

In this episode, Ian details a nice paper by McLaughlin, Hartjes, and Freeman who tracked 20 of their own Neuro ICU patients who were receiving the standard hour-by-hour neurological examinations after admission to the Neuro ICU to find out whether sleep deprivation might be related to the potential for seeing increased neurological deterioration or ICU delirium during their tenure on the unit. The proposal is that this effect, if observed, might be mediated or moderated by sleep deprivation. This was a single-arm, prospective, natural history cohort design, designed to look at their pt population prevelance of neurological decline or delirium, and as such is purely descriptive in nature. But these authors did a commendable job in detailing the descriptives and frequencies of their sample, and raise fascinating and important questions which are sure to lay the groundwork for an important experimental literature to follow.

In this “Breathe Easy Critical Perspective” podcast, Dr. Dominique Pepper interviews Dr. Christopher Hughes. They discuss the 2021 NEJM February article that investigated the use of propofol vs. dexmedetomidine for sedation in mechanically ventilated adults with sepsis. Dr. Hughes serves as Chief of the Anesthesia Critical Care Medicine Division, as Medical Director of the Neuro ICU, and as a member of the VUMC Institutional Review Board at Vanderbilt University Medical Center, Nashville TN.

In this episode, Kirsten Peterson joins the podcast to discuss her journey. From following her passion for Tennis to attend Wheaton College (Illinois) and studying Sociology with a minor in Spanish, to a passion in criminology, Kirsten found her path to become a nurse as well as the perfect program within Eastern University. Kirsten has lived and worked in various places including Austin, TX, Hershey, PA, Chicago, IL and Boston, MA. She currently works as a hospice nurse in the community of the western suburbs of Chicago for Seasons Hospice. Before coming to hospice she worked in a Neuro ICU at Central Dupage hospital in Winfield IL, and previous to that worked as a trauma med-surg nurse at Penn State Medical Center. Her first job was spinal cord injury unit at St. Davids Rehab Hospital in downtown Austin, Texas. We discuss everything from these beginnings, to following your spiritual calling and finding faith in nursing as well as exploring different paths and finding your purpose in nursing. Most importantly, we discuss what it is like having Adult ADHD and working as a nurse. Discussions of tactics to handle ADHD, what anxiety is like for two different people and the commonalities that exist. Finally, we go in detail of what compassionate care means and how to deliver it. This is a great conversation for any nurse that sees patients at the various stages of life.

Click here for a transcript generated by Microsoft Word on the Web. High Intensity Gait Training is a new research-based approach to Physical Therapy. Rather than focusing on the details of walking, it focuses more on the volume of steps — even if they’re not the cleanest steps.  It’s not just the steps, though. It’s also about getting the heart rate up safely. This therapy drives heart rates up to 65-85% of the max. And you know what? It works. Patients who go through this therapy walk faster. They walk further. Their sit-to-stand performance is better. It turns out the intensity primes the brain for the neuroplastic changes that work with the repetitions we need to do to acquire or re-acquire skills like walking. You can read one of the studies here. This week we learn about High Intensity Gait Training from Dr. Meghan Larson, PT, DPT, NCS. Not only is Meghan specially trained in this therapy, she is also the woman who taught me to walk at age 46. She was my inpatient PT back in 2017. And she continues to be an utter delight. Bio Dr. Meghan Larson, PT, DPT, NCS is a board certified Neurological Clinical Specialist Physical Therapist who completed her doctoral work at Columbia University and undergraduate degree at Gonzaga University. Currently, Meghan is a staff Physical Therapist at Swedish Medical Center Cherry Hill Campus in the Acute Rehabilitation Unit. She has previous experience in Neuro ICU, Neuro Telemetry, Long Term Acute Care and outpatient orthopedics therapy. Currently areas of interest and specialty are Stoke Rehabilitation, Vestibular Rehab, gait training and balance re-training. Meghan lives with her husband, two kids and dog in Seattle, WA. She enjoys cooking, running, hiking, traveling and spending time with her growing family. Education Doctorate Degree- Columbia University Undergraduate Degree- Gonzaga University Board Certification- Neurological Clinical Specialist Work Experience Current- Staff Physical Therapist at Swedish Medical Center- Cherry Hill Campus in the Acute Rehabilitation Past- Highline Medical Center- Regional Hospital Lead Therapist and Physiotherapy Associates Staff Physical Therapist Two Things Successful Patients Do Meghan works with a lot of patients. Some are more successful than others. What drives that difference? Meghan sees two things that the successful patients do First, they trust the process and the therapists. The therapists spend years studying this stuff. They push us. And sometimes we develop an intense dislike of them because they are pushing us so hard. But the thing I, most of them know what they are doing. They’re pushing us because pushing us works. So trust the therapists and the work they are making us do. The second thing successful folks do is they are kind to themselves. That doesn’t mean treating therapy as a vacation or not trying hard. It means trying and working and when failing, not beating themselves up. This stuff is hard. We are going to fail. That’s how we know we are trying. But thinking of ourselves as failures or getting angry with ourselves or engaging in negative self talk doesn’t help. We have to forgive ourselves for the things we can’t do — yet. Would you talk to another survivor the way you talk to yourself? Would you call someone the names that you call yourself? If not, then don’t treat yourself that badly either. Be kind to yourself.   Caffeinated Comics A couple weeks ago, I joined visited the Caffeinated Comics. We talked about the insurrection at the US Capitol and a lot about Star Trek. We also talked about Voice Over Artist Tom Kane who recently survived a stroke and now lives with aphasia. You can learn more about and listen to the episode here.   Hack of the Week If there is something you want to do after stroke, let your therapist know. If something gave you joy before your stroke, talk about it and dive into the resources available to help with it. Whether it’s a hobby, skill, or other passion, ask your therapists about it. They can help tune your therapy in that direction. They also just know stuff. They may be familiar with gear or techniques that can help. If you’re no longer in therapy, they may still be able to help. So shoot them a quick email. There’s help out there. Sometimes you just need to ask. Give it a shot. And here’s the thing — they want to hear from you even after you’ve finished therapy with them. Especially when they worked with you in the early days after your stroke. They saw you at the very early stages, and they are thrilled to see the progress you’ve made after a month, 6 months, a year, or more.   Links eghan (Fuchs) Larson, PT, DPT, NCS https://www.linkedin.com/in/meghan-larson-pt-dpt-ncs-6aa70940/ Academy of Neurological Physical Therapy http://neuropt.org Intensity Matters Campaign https://www.neuropt.org/practice-resources/locomotor BORG Scale https://www.sralab.org/rehabilitation-measures/borg-rating-scale-perceived-exertion Shirley Ryan Ability Lab https://www.sralab.org/ High Intensity Interval Training in Chronic Stroke (HIT) https://clinicaltrials.gov/ct2/show/NCT01958606 Variable Intensive Early Walking Poststroke (VIEWS): A Randomized Controlled Trial https://pubmed.ncbi.nlm.nih.gov/26338433/ Importance of specificity, amount, and intensity of locomotor training to improve ambulatory function in patients poststroke https://pubmed.ncbi.nlm.nih.gov/21914594/ Clinical Practice Guideline to Improve Locomotor Function Following Chronic Stroke, Incomplete Spinal Cord Injury, and Brain Injury https://journals.lww.com/jnpt/Fulltext/2020/01000/Clinical_Practice_Guideline_to_Improve_Locomotor.8.aspx Emilee Mason on Strokecast http://Strokecast.com/Emilee Other Swedish team members on Strokecast http://Strokecast.com/TeamSwedish Bill on Caffeinated Comics https://radiomisfits.com/cc209/   Where do we go from here? To learn more about, or connect with Meghan, find her on LinkedIn here. Do you know a PT, physiatrist, or survivor who you think would be interested in High Intensity Gait Training? Share this episode with them by giving them the link http://Strokecast.com/HIT. Let your therapists know how you’re doing. Don’t get best…get better. Strokecast is the stroke podcast where a Gen X stroke survivor explores rehab, recovery, the frontiers of neuroscience and one-handed banana peeling by helping stroke survivors, caregivers, medical providers and stroke industry affiliates connect and share their stories.    

How Is Ozone Therapy Being Used To Treat COVID-19 in Europe? | This episode is brought to you by Simple Mills, Paleovalley, and ApeelWhen we read the local headlines and stick to our own quarantine routines, it might be easy to forget that this virus is affecting the entire world. And as scary as that is, it also means we can collaborate with other countries to gain the best possible understanding of how to treat COVID-19. Since the spring, I’ve been reaching out to different doctors across the world to learn about their various COVID protocols. One of the most valuable contacts I’ve had, Dr. Paolo Tordiglione, has been seeing amazing results with ozone therapy and he is my guest on this episode of The Doctor’s Farmacy. Dr. Tordiglione is a Senior Consultant in Neuroanesthesia in the Neuro-ICU at Policlinico Umberto I University of Rome Sapienza, Italy. He is a specialist in pain medicine and an expert in ozone therapy. He is the former President of Doctors of the World Italy, founder of Physicians for Human Rights Italy, Vice President of the Academy of BioRegenerative Medicine, and a member of the Molecular Medicine Academy. He is currently developing a company called PLEYO, with the goal of scientifically improving the quality of human life, and has been researching ozone therapy since 2000.This episode is brought to you by Simple Mills, Paleovalley, and Apeel.Right now, Simple Mills is offering Doctor’s Farmacy listeners 20% off. Just head over to simplemills.com and use code HYMAN20 to try their Artisan Bread Mix and other amazing products to stock up for the holidays. Paleovalley is offering 15% off your entire first order. Just go to paleovalley.com/hyman to check out all their clean Paleo products and take advantage of this deal.Apeel, a family of plant-derived coatings that, when applied to the outside of produce, keeps it fresh two times longer, is doing amazing things to extend the shelf life of fruits and vegetables. To learn more about Apeel, check out their frequently asked questions page at apeel.com/faqs. Here are more of the details from our interview: Where are we now in our understanding of COVID-19 and treatment for it? (7:32)What is ozone therapy and what is its history of use? (13:41)The rationale for using ozone therapy to treat COVID-19 (20:42)Various methods of ozone therapy and how Dr. Tordiglione uses ozone therapy in the treatment of COVID-19 patients (24:15)Dr. Tordiglione’s research using ozone therapy in women undergoing chemotherapy for breast cancer (34:46)Case reports, studies, and clinical trials from around the world looking at ozone therapy in the treatment of COVID-19 (37:39)Preliminary results from Dr. Tordiglione’s study of patient outcomes from ozone therapy in the treatment of COVID-19 (43:40)How the FDA’s ruling on inhaled ozone in the ‘90s has blocked the use of ozone therapy in the United States (52:00)My personal healing experience with ozone therapy (55:20)Adjunctive nutritional and supplemental therapy for COVID-19 (1:00:08) Learn more about Dr. Tordiglione at https://www.paolotordiglione.com/. Find his study, “Ozone as Adjuvant Support in the Treatment of COVID19: A Preliminary Report of Probiozovid Trial” here: https://onlinelibrary.wiley.com/doi/epdf/10.1002/jmv.26636Additional research:Oxygen-Ozone as Adjuvant Treatment in Early Control of COVID-19 Progression and Modulation of the Gut Microbial Flora (PROBIOZOVID) https://clinicaltrials.gov/ct2/show/NCT04366089?term=oxygen+ozone&draw=2&rank=2Oxygen-ozone (O2-O3) immunoceutical therapy for patients with COVID-19. Preliminary evidence reportedhttps://www.sciencedirect.com/science/article/pii/S1567576920314946?via%3DihubPotential Role of Oxygen–Ozone Therapy in Treatment of COVID-19 Pneumoniahttps://pubmed.ncbi.nlm.nih.gov/32804917/ See acast.com/privacy for privacy and opt-out information.

Applying research in the Neuro ICU; Marketing and Branding; follow up after critical illness. For more head to: codachange.org/podcasts

Multimodal monitoring (MMM) in the neurointensive care unit is increasingly utilized in patients with devastating neurologic injuries and has been advocated as an important feature of neurocritical care. In this episode, Christopher Newey, DO, discusses the challenges of integrating multiple monitoring inputs, the quest for real-time data display and the current and emerging MMM efforts in Cleveland Clinic’s Neuro ICUs.

In this episode we chat with Dr Jonathan Russin. Dr Russin is Assistant Professor of Neurosurgery and Assistant Director of the Neurorestoration Center, at University of Southern California Keck School of Medicine. Over the past 5 years, he has become an avid runner after joining me at the 2016 Los Angeles Marathon to build RunLAwithKathy, through which we have raised over $81,000 to fund neurorestoration research at USC. Please enjoy our candid conversation with Dr Russin as he shares with us his remarkable journey to becoming a neurosurgeon and equally uncommon path to the marathon finish line. This interview was recorded on June 11, 2020. You can find articles from many of our contributors, on werunwithyou.org. We are @werunwithyou on Instagram and Facebook. You can reach out to Dr. Russin via email at jonathan.russin@med.usc.edu or on Facebook at Neuro ICU-to-26.2. Until next time, keep doing good! Intro music is by Tyler Alvarez. Outro music is Alive by Nekzlo.

Did you know that your gut microbiome starts in your mouth? We're told that the key to good oral health is to follow the recommendations set out by the ADA, but is this the best way? Trina Felber, the creator of Primal Life Organics, joins me today to discuss natural oral health. About Trina Felber Born in 1968, the second of five daughters in Toledo, Ohio, Trina grew up amongst a house full of skin and beauty products. As a youth, Trina was always health conscious and science-driven. In 1992 Trina obtained her RN diploma from St. Vincent Medical Center in Toledo, Ohio. Over the next decade, she worked as a Registered Nurse in specialty areas including Burn ICU, Neuro ICU, Medical ICU, and Surgical ICU. Trina spent a year as a traveling nurse before committing to furthering her education. Trina studied and obtained her BSN in 2004 from The University of Akron. She continued her studies and received her Masters of Science in Nursing with a specialty in Nurse Anesthesia in 2007. In 2010, Trina was introduced to Crossfit and the Paleo lifestyle by her husband, box owner Josh Felber. True to her “Type A” personality, Trina researched and perfected her Paleo lifestyle. She and her husband easily adapted to the Paleo diet and raise their three young children Paleo.  Living proof that Paleo equals health, Trina takes the Paleo world beyond the diet and applies it to the food for the skin. After all, to truly reap the benefits, all aspects - including skincare, must be as nutrient-dense as possible. Trina is committed to providing nutrient-dense, 100% Paleo Skin-Food that is made from fresh, organic ingredients.   Each Creation is extensively researched for specific skin types and conditions. No product is made until it is ordered ensuring the freshest, most nutrient-dense Paleo Skin-Food is delivered. Trina continues to work as a Certified Registered Nurse Anesthetist, as well as Paleo Advocate, Educator, and Skincare Expert. On this episode of The Girlfriend Doctor, Trina shares how the dental products recommended by the ADA might actually be creating more disease in your mouth than they're solving. When these products contain triclosan, SLS, fluoride, and other harsh chemicals, they disrupt your mouth's natural pH balance. Trina explains how your mouth, specifically your saliva, is the first line of defense against infections, diseases, and harmful bacteria that exists in our modern world. This is especially prevalent in our American soil is lacking so many of the vitamins and minerals due to factory farming and harmful chemical treatments. By changing your dental products to natural, chemical-free ones, Trina says that you can help create a more alkaline environment for your mouth. An alkaline mouth has a direct impact on your gut health and microbiome.  Trina gives us the information we need to make informed choices about the dental products we choose. She tells us what the problem with most ADA recommended dental products is. And finally, Trina gives us a definite answer to why we should be scraping our tongue every day. How confident are you in your dental hygiene? Do you scrape your tongue every day? As always, you can ask me anything and let me hear your thoughts in the comments on the episode page. If you have questions, email team@drannacabeca.com. In This Episode: Where a good, healthy microbiome starts How dental products could be creating more disease in your mouth How American soil is impacting our overall health, starting with our dental hygiene What happens when your mouth is an alkaline environment What the problem with most dental products is Why it's so important to scrape your tongue Quotes: “One of the best ways that you can protect yourself is by keeping your mouth healthy. But if you're using harsh ingredients or triclosan, SLS, or even fluoride, inside your mouth and body, you're destroying your body's first line of defense against all bacteria and all bad viruses.” (5:59) “I think that the ADA really has us all brainwashed into believing that we are supposed to brush our teeth to clean them when in reality, your saliva is meant to do that as you eat.” (10:03) “I know a lot of people that have not gotten the flu or a cold since they switched their oral care products because it's such a drastic change when you use what's good for you and something that allows your saliva, your body's natural way to defend you, to actually work the way it's supposed to. It's a powerful thing.” (21:43) Resources Mentioned Buy Mighty Maca Plus Get the 21 Day Oral Detox Kit Buy the LED Teeth Whitener Buy Natural Hand Protectors Buy The Gemstone Face Collection Find Trina Felber and Primal Life Organics Online Find Primal Life organics on Facebook | Twitter | YouTube | Pinterest | Instagram   Check out the full episode page Find Dr. Anna Online Follow Dr. Anna on Facebook | Instagram | Twitter

Did you know that your gut microbiome starts in your mouth? We’re told that the key to good oral health is to follow the recommendations set out by the ADA, but is this the best way? Trina Felber, the creator of Primal Life Organics, joins me today to discuss natural oral health. About Trina Felber Born in 1968, the second of five daughters in Toledo, Ohio, Trina grew up amongst a house full of skin and beauty products. As a youth, Trina was always health conscious and science-driven. In 1992 Trina obtained her RN diploma from St. Vincent Medical Center in Toledo, Ohio. Over the next decade, she worked as a Registered Nurse in specialty areas including Burn ICU, Neuro ICU, Medical ICU, and Surgical ICU. Trina spent a year as a traveling nurse before committing to furthering her education. Trina studied and obtained her BSN in 2004 from The University of Akron. She continued her studies and received her Masters of Science in Nursing with a specialty in Nurse Anesthesia in 2007. In 2010, Trina was introduced to Crossfit and the Paleo lifestyle by her husband, box owner Josh Felber. True to her “Type A” personality, Trina researched and perfected her Paleo lifestyle. She and her husband easily adapted to the Paleo diet and raise their three young children Paleo.  Living proof that Paleo equals health, Trina takes the Paleo world beyond the diet and applies it to the food for the skin. After all, to truly reap the benefits, all aspects - including skincare, must be as nutrient-dense as possible. Trina is committed to providing nutrient-dense, 100% Paleo Skin-Food that is made from fresh, organic ingredients.   Each Creation is extensively researched for specific skin types and conditions. No product is made until it is ordered ensuring the freshest, most nutrient-dense Paleo Skin-Food is delivered. Trina continues to work as a Certified Registered Nurse Anesthetist, as well as Paleo Advocate, Educator, and Skincare Expert. On this episode of The Girlfriend Doctor, Trina shares how the dental products recommended by the ADA might actually be creating more disease in your mouth than they’re solving. When these products contain triclosan, SLS, fluoride, and other harsh chemicals, they disrupt your mouth’s natural pH balance. Trina explains how your mouth, specifically your saliva, is the first line of defense against infections, diseases, and harmful bacteria that exists in our modern world. This is especially prevalent in our American soil is lacking so many of the vitamins and minerals due to factory farming and harmful chemical treatments. By changing your dental products to natural, chemical-free ones, Trina says that you can help create a more alkaline environment for your mouth. An alkaline mouth has a direct impact on your gut health and microbiome.  Trina gives us the information we need to make informed choices about the dental products we choose. She tells us what the problem with most ADA recommended dental products is. And finally, Trina gives us a definite answer to why we should be scraping our tongue every day. How confident are you in your dental hygiene? Do you scrape your tongue every day? As always, you can ask me anything and let me hear your thoughts in the comments on the episode page. If you have questions, email team@drannacabeca.com. In This Episode: Where a good, healthy microbiome starts How dental products could be creating more disease in your mouth How American soil is impacting our overall health, starting with our dental hygiene What happens when your mouth is an alkaline environment What the problem with most dental products is Why it’s so important to scrape your tongue Quotes: “One of the best ways that you can protect yourself is by keeping your mouth healthy. But if you’re using harsh ingredients or triclosan, SLS, or even fluoride, inside your mouth and body, you’re destroying your body’s first line of defense against all bacteria and all bad viruses.” (5:59) “I think that the ADA really has us all brainwashed into believing that we are supposed to brush our teeth to clean them when in reality, your saliva is meant to do that as you eat.” (10:03) “I know a lot of people that have not gotten the flu or a cold since they switched their oral care products because it’s such a drastic change when you use what’s good for you and something that allows your saliva, your body’s natural way to defend you, to actually work the way it’s supposed to. It’s a powerful thing.” (21:43) Resources Mentioned Buy Mighty Maca Plus Get the 21 Day Oral Detox Kit Buy the LED Teeth Whitener Buy Natural Hand Protectors Buy The Gemstone Face Collection Find Trina Felber and Primal Life Organics Online Find Primal Life organics on Facebook | Twitter | YouTube | Pinterest | Instagram   Check out the full episode page Find Dr. Anna Online Follow Dr. Anna on Facebook | Instagram | Twitter

Get the inside scoop of what it takes and exactly what it is like to be in CRNA school. We discuss the interview process, work/life balance, finding the right program, tips on amplifying your application, necessary experience, the importance of the GRE/certification in your field, what a shadow day consists of and what her first intubation was like. We then go into some of Shelbi's most important lessons of being an ICU nurse, her worst days, some of her best days and what it is like to treat someone that is in the dying process-a very important and tough clinical skill to learn. Student's ask questions in this info packed session! Shelbi earned her ADN from HACC in 2003 and then her BSN from California University of PA in 2016. She is certified as a CCRN and while working at Penn State Hershey was on the clinical ladder as a clinical ladder IV. Her first job was at Holy Spirit Hospital MICU from 2003-2006 and then worked for Hershey Med in the Neuro ICU from 2006-2019. She has served as a preceptor, charge nurse and was involved in several councils including quality of worklife, practice council and nursing professional practice council. She is also a former board member of the regional AACN Chapter, The Susquehanna Valley Chapter of the AACN. She is one of the best ICU nurses I have ever learned from and is one of the reasons I am so detailed oriented in my care. She is now a student (CRNA/DNP) at York College of PA.

Last week we looked at neurologic presentations of COVID-19; this week we’ll look more closely at strokes in young people with COVID. A letter published 2 days ago in the NEJM with lead author Thomas Oxley, the Neuro ICU director at Mt Sinai, presents five case studies of relatively young patients who had strokes at home and presented to Mt Sinai between 23 March and 7 April. In pre-COVID days, Mt Sinai saw on about 3 patients under the age of 50 with strokes per month, so 5 in 2 weeks represents a 7-fold increase. The authors call this one of the clearest and most profound correlations” they’ve come across. Though strokes in other COVID case reports are also occurring in older pts, other centers are reporting similar increases in young people with few or no risk factors presenting with major strokes. Right now there are at least 3 US centers preparing to publish data on the stroke in young people phenomenon. Host: Elizabeth Esty, MD Research By: Elizabeth Esty and Nate Novotny Sound Editing By: Stephen Bahmani References: Oxley TJ, Mocco J, Majidi S, et al. Large-Vessel Stroke as a Presenting Feature of Covid-19 in the Young. New England Journal of Medicine. 2020;0(0):e60. doi:10.1056/NEJMc2009787 Cha AE. Young and middle-aged people, barely sick with covid-19, are dying of strokes. Washington Post. https://www.washingtonpost.com/health/2020/04/24/strokes-coronavirus-young-patients/. Published April 25, 2020. Klok FA, Kruip MJHA, van der Meer NJM, et al. Incidence of thrombotic complications in critically ill ICU patients with COVID-19. Thromb Res. April 2020. doi:10.1016/j.thromres.2020.04.013

We will unpack the real-life implementation of bedside patient management concepts derived from over 40 NEJM, JAMA, and LANCET papers that went into the ABCDEF Bundle that has now been shown to save lives, reduce LOS, reduce bounce backs, and ICUs globally revamp their service to the world's sickest patients. You will leave able to make a difference in your own ICU.

MedFlight Radio is at The Ohio State University Medical Center talking Traumatic Brain Injury (TBI) with Dr. Shraddha Mainali.  In this episode we review a case study, along with all the information you will need and more on recognition and management of TBI patients.   Dr Mainali is a Neurologist at the Ohio State University in Columbus, OH. She specializes in taking care of patients with stroke and other severely ill patients with Neurological conditions in the Neuro ICU, including traumatic brain injury, brain hemorrhage, brain and spine infection, brain tumor, spinal cord injury, seizures and coma etc. Dr Mainali joined The Ohio State University as an Assistant Professor of Neurology in August 2016. Dr Mainali is currently the Director of Neurovascular Ultrasound Lab at the Ohio State University, She is also the medical director of Stroke at Springfield regional medical Center-an affiliate hospital in Springfield OH. She is a research scientist with primary research interest in stroke and TBI. She is currently leading 2 NIH funded TBI trials at the Ohio State University and is the OSU CO-PI for SIREN (Strategies to Innovate Emergency Care Clinical Trials Network), a research network dedicate towards discovering new strategies to improve acute and emergent medical conditions. Come Join in on the fun..

Session 101 Dr. Patrick Myers joins us to talk about what he looks for as a fellowship program director, what makes a good neonatologist, and his own unique journey to this specialty. Out of training for about eight years now, Patrick also shares what they’re looking for in candidates if this is something you’re interested in. Meanwhile, be sure to check out all our other episodes on Meded Media. [01:30] Interest in Neonatology and Real-Life Experience Patrick realized he wanted to be in Neonatology until after his entire residency class matched into Neonatology. He spent a year being a peds hospitalist as he experienced a ton of deliveries. He thinks the fellowship match is helpful in terms of streamlining and getting everybody a chance to get their application out to several people.  A big downside is if you decide you want to do something else when you're already two years in.  For residents taking an extra year to figure things out to become a better applicant, Patrick thinks doing a chief or hospitalist year is great. Being to able to work with other people in an actual, real setting allows you to understand your work skills. In fact, Patrick considers having this kind of real-life experience as a gold mine.  This shows programs that these people really love the field and they're going to have so many more skills than people who just went straight through. Patrick started medical school when he was 29 years old. He was a Theater major. He just got married at that time and had to work. Desire is another thing he looks for in applicants. [05:55] Traits that Lead to Becoming a Great Neonatologist The ability to solve problems is very important so you really have to love problem-solving. Especially in Neonatology, there is a variety of illnesses so you always have to be solving problems.  Other essential traits include exceptional communication skills and empathy. Moreover, you'd be working with a lot of other specialties. You should know how to negotiate and pull divergent views together and still come up with a really good plan. [07:45] Common Cases in Neonatology Except for rheumatology, all of medicine is in neonatology. In NICU, the kids are sick and a lot of them are ventilated and unstable.  What differentiates it from PICU or Neuro ICU or medical or surgical ICU is that a lot of their really sick kids stay for a long time. It's not unusual for kids to stay at their unit for 100-200 days. Some of their kids have even stayed with them since birth to a year. The hardest thing to manage is children with underdeveloped lungs so there's that balancing act. Either help the lungs and keep the kid alive, but mechanical ventilation for 10 to 100 days is actually bad for you.  [10:10] Letters of Recommendation To figure out whether an applicant for residency is a good communicator, Patrick explains they try to 2-3 very open-ended questions to let people be comfortable and talk. He personally evaluates how people treat his support staff. These are his section administrators, the people touring you, the fellows. Patrick also highly values letters of recommendation from fellowship directors you have a personal relationship. He further shares this tip to ask a director if they could write you a really good or superior letter of recommendation. If you get any hint of body language that it isn't an equivocal, enthusiastic yes, then do not take that letter. There's medical literature on interviews that talk about a lot of the code phrases in letters of recommendation. It tells you of phrases that program directors look for. Already two years as a program director, Patrick admits it took him a while to write good letters. Because you want these people to go out, be successful, and get a really good fellowship.  But sometimes when you're selling somebody the way you want them to, you actually aren't. You could say one thing but others may read it in a different way. So it takes a bit of skill to get this down. Nevertheless, the letter of recommendation is just a tiny piece of the application so you can make it up in so many different ways. [14:24] What They're Looking for in Applicants: There are about a hundred NICU fellowships and what he does is different than other directors do. But first things first, know your audience. You don't want to apply to a hundred programs. Around 10-15 that fit you would already be good. It has to fit you and your goal. Patrick comes from an academic program and his goal is to generate leaders in the field of neonatology over the next 5, 10, or 20 years. So he's looking for that capability to be a very good clinician. This is hard to prove but essentially, just do well on all your rotations in residency. Patrick actually looks all the way back to your medical school rotations. He also looks for that potential in research. Although not mandatory, you should at least be able to spark their interest. He's looking for someone who is able to demonstrate interest, curiosity, and the desire to solve problems. Some people could come in with really good publications and that's an easy one to show them you're interested. But that's rare. So you have to be able to show them at least some interest.  [17:10] Writing Personal Statements The personal statement is also very crucial. Patrick says that out of the 100+ applications and personal statements they've read, 95 said they love neonatology because they love babies and this baby and this family changed their life. But he admits his brain just hurts reading them because everybody says the same thing. Tell them a unique story and what fires you up. Tell a story of something you've done and done well.  For instance, you love dancing and been doing it since you were three. Then you've got great grades despite dancing 15 hours a week. You kept doing it in college and you're still going to do it now. But you've discovered your passion is being a doctor in neonatology. This shows the admissions committee your commitment, work ethic, and balanced life. The hardest applications for them to read are those that are trying to build their application. They've done a hundred things for one week each. There's so much stuff on the paper that they can actually tell what's meaningful and what's not. They simply want to know about you. But instead of them knowing you, they might just think you have a very busy CV. Instead of saying so much stuff, tell a story that demonstrates your longevity. Being a subspecialist, you're going to be doing this even when you're 65. Investment is what Patrick is looking for. [20:00] What the Residency Application Looks Like The application comes in different chunks. The personal statement is a letter that's 500-1000 words long. You can put anything you want in there. Patrick recommends you do research if you're interested in an academic place. Otherwise, if you apply and not say anything about research, people could get confused. You have to give 3-4 letters of reference. You can also get more than that. The important thing here is to get good people that are known in the community. More importantly, these are people who can enthusiastically talk about you. In one of those references, there's a summary letter of your pediatric program director with a very specific language that they will use. They will also look at all your medical school transcripts. Most medical schools make a summary statement about who you are. They will probably have a paragraph that would say what you did and what's unique about you during medical school. All in all, it ends up being around 40 pieces of paper on an average person. This would also include your hobbies, posters, presentations, papers you wrote, visa status, permanent address, languages spoken, etc. If you're looking for programs, look at their websites and reach out. Work those connections you have with the nurses. They should know stuff about the program directors and the programs. Patrick personally wants applicants to know his worst before they get to the program. Talk to the junior people. [25:00] Procedures in Neonatology: Should You Have a High Level of Dexterity? Patrick is 100% convinced that they can teach students every skill they need to have. You need to have some manual dexterity but you don't need to be able to play the classical piano for two hours. The level is relative. Moreover, the biggest thing in neonatology is intubations. In neonates, the airway is very different than even kids or adults. Some of their kids are very tiny, the smallest kid they've intubated is 275 grams. The airway changes all the time. That's one of the hallmarks of neonatology is you're constantly developing underneath. All that being said, you've got to have the skill level to intubate along that spectrum. They also put in test tubes. They catheterize the umbilical, arterial, and venous lines. This takes a little bit of time. Nevertheless, Patrick is never worried about people's ability to do procedures. [27:40] What Makes Neonatology Fellows Stand Out the Most Patrick explains there's a variety of ways for people to be successful. And the people who are successful as a fellow are sometimes different who become ultimately successful down the road.  The ability to be curious is another great trait. What's unique about Neonatology is you're going to be working relatively hard and putting in a fair amount of time, like a ton of weekends. The people who are successful are those that are willing to do the work, communicate well, and are good problem-solvers. [29:12] Audition Rotation Patrick explains you've got to get the program letter of agreement with regard to insurance, among other things. It's doable though. And it's useful. But this is not something Patrick would personally look for because especially for those coming from a small place, it's hard for them. Hence, an audition rotation doesn't help them too much. [30:15] Osteopath Applicants Patrick's doctor is always an osteopathic doctor. He applied 50-50 when he applied to medical school. What he really likes to see is the research aspect. However, he feels that a lot of the osteopathic residents that apply to him don't have the research chops or don't demonstrate their interest in research. This is unique to the top 15-20 programs in neonatology. They're all big centers and people are doing a fair amount of research. Hence, if you're an osteopath and interested in neonatology, you've got to be able to show to them that you're interested or have that experience. This can be a summer lab or finding somebody wherein you can do some type of research. Some interest or experience in bench research is also something that's desirable as this is rare in pediatrics. This is so hard to pull off, but if you do, this makes you incredibly desirable especially to the big programs. At the end of the day, Patrick really just looks at your ability to be a leader in the long run and curiosity. [32:42] Easy No-Go's An easy no-go for applicants would be felony conviction. This would be logistically challenging for him in terms of the level of additional work he would have to do in order to get the person approved. Some programs have a hard cut-off for board scores. They don't have it though at Patrick's program. Instead, he looks for long-term potential. Moreover, when you fail your boards, this can be problematic. This is hard for any program director to swallow. It's not just about being mean.  If you fail peds boards, they would then have to set a chunk of time out of your second and third year of fellowship so that you can pass your peds board. And if you fail peds board enough, then you're not boards-eligible for neonatology.  And if you fail neo boards, even though you're working somewhere else, they're still your responsibility so they have to find ways to remediate you with the American Board of Pediatrics or the ACGME. Whatever you do, figure out what you need to do to pass those exams or it will just hurt. And it will keep hurting forever. Or this will have negative consequences on the people hiring you. [36:00] Measuring the Metrics of Medicine: Getting Accreditation Patrick adds that if enough people fail your peds board, the ACGME becomes extremely interested in your program. They're interested in hard metrics.  If enough people fail, they're going to lose their accreditation. They could either get on probation or they could get citations. Each of those things has adverse effects on the program. And they can't recruit as well obviously. It then potentially becomes a bigger problem. [36:55] Day-to-Day Life of Neonatologists Patrick recommends that if you're interviewing, really find out what the day-to-day life is. There is a fair amount of heterogeneity among the programs. You have to do a minimum of 12 months of clinical service. You typically show up between 6 or 7. Do rounds and sign out and manage the unit and the myriad of problems that show up. You'd be teaching residents and then signing out again. There would be calls and weekend calls but these vary a lot. You've got to have a research project in some way, shape, or form. And there are a couple of ways to meet that. You could get a master's degree. You can do a QI project or administrative stuff. You also have to do a followup clinic. Every major center that does neonatology has a follow-up clinic. They measure the developmental outcomes of their kids that are really tiny and high-risk. At the end of the day, what Patrick is worried about is the output. So he really doesn't care how you do it. That said, he makes sure you have the help you need and he can step in when necessary. You will be taking care of babies a lot and you'd be in the hospital a lot. But the rest of your life will vary depending on the program and what your research interests are. [39:50] Final Words of Wisdom Know what you're getting into. What Patrick sees a lot is that people get attracted to the field by a dynamic mentor or a dynamic faculty member. And people don't think about the lifestyle very much. Think about what you're going to be doing as a resident, as a fellow, or as an attending for the next thirty years. What you could be doing as a resident is way different than what you're going to be doing as an attending. So try to cultivate those relationships with attendings in the middle of the night. Ask them what life is like raising kids or how it feels when you're taking calls at 65 years old. If you don't like doing night calls and being in the hospital for a good chunk of your life, it probably isn't for you. If this is something you’re interested in, Patrick drops some resources you could look into. Check out ONTPD and TECAN for more NICU-related resources. Links: Meded Media ONTPD TECAN

Neuro ICU: DEBATE: Currently randomised controlled trials are of no use in advancing the care of patients with severe traumatic brain injury

Neuro ICU: Organ Donation: Ethical issues including ECMO and organ donation

Neuro ICU: Organ Donation: Preserving organs for donation (temp, fluids)

Neuro ICU: SAH: Cerebral salt wasting (real or imaginary)

Neuro ICU: SAH: Diagnosis/vasospasm (prevention and management)

Neuro ICU - ICH: To operate or not

Neuro ICU: TBI: The elderly: decrying nihilism

Neuro ICU: TBI: Using MRI as a prognostic tool by Virginia Newcombe

Neuro ICU: TBI: When would I decompress? by Mark Wilson

Neuro ICU: TBI: Still more questions than answers by Simon Finfer

Neuro ICU: EEG - Brain monitoring beyond seizure detection by Brandon Foreman

Neuro ICU: ICH: BP management (ATACH-2 trial) by Celia Bradford

Neuro ICU: ICH: Reversal of anticoagulation (PATCH trial, NOACs, TPA) by Jordan Bonomo

Neuro ICU: TBI: Using physiology as a target

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Pierre Janin talks targets in neuro-icu, zoning in on blood pressure management in patients with ICH. This resource was recorded at Bedside Critical Care Conference 4.