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Kali Dayton, DNP, ACNP-BC, is an ICU nurse practitioner and consultant on a mission to create Awake and Walking ICUs. She hands the microphone to ICU survivors and bedside caregivers to reveal the realities of ICU experience and patients' journeys after discharge. The big picture of sedation and immobility is discussed and we explore how to improve short and long-term patient outcomes. We shift the vision from transferring out of the ICU to walking straight home after the ICU. www.DaytonICUc ...
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Heavy Lies the Helmet

Mike Boone, Dan Rauh, & Dr. Amanda Humphries

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"Heavy lies the crown" is a common misquote of "uneasy lies the head that wears a crown" from Shakespeare's Henry IV, Part 2. It refers to the responsibility and insecurity of governing an entire kingdom. Likewise, "heavy lies the helmet" refers to the responsibility we face as critical care transport providers working in an autonomous and often unpredictable environment. Our minds are eased with education that better prepares us for any situation that we may encounter. That is exactly what ...
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The Critical NP Podcast

Sean P. Dent, DNP, ACNP-BC, CCRN

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Micro-learning all things critical care medicine. The transition to practice is overwhelming. We’re here to educate, entertain, inform, and support new nurse practitioners as they cross the divide from seasoned nurse to novice nurse practitioner. Thoughts, stories, and perspectives from an expert ICU nurse practitioner, Dr. Sean P. Dent.
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Nursing Uncensored

Adrianne Behning

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Nursing Uncensored features candid conversations with nurses about topics that range from educational to explicit, from scholarly to scatological. NU will make you laugh, make you think, and might even make you blush with our bold opinions and dark humor. At the core of our mission is the education, advocacy, and empowerment of nurses and students. We believe in creating a space that uplifts and supports all individuals, highlighting what makes them unique and interesting. We honor HIPAA but ...
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The Nurse Niche Podcast

All things Nursing Podcast by Sean Dent

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The Change of Shift Podcast offers a unique learning perspective on the nursing profession. We all learn the hard way that nursing is not easy. Each episode Sean hears from Nurses, students, educators, and professional influencers who have learned to survive the real world of nursing and its big brother the healthcare community at-large. As a profession, the “change of shift” is a moment Nurses have transformed into a malleable coping mechanism and buffering tool. A tool created to not only ...
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show series
 
We discuss the basics of evaluation for tracheostomy placement, periprocedural care, and post-procedure complications with Vinciya Pandian, PhD, ACNP, FCCM, tracheostomy nurse practitioner and researcher. Learn more at the Intensive Care Academy! Find us on Patreon here! Buy your merch here!By Brandon Oto, PA-C, FCCM and Bryan Boling, DNP, ACNP, FCCM
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Do certifications accurately reflect an individual's qualifications? This is an ongoing argument depending on what side of the exam you are on. How much value should we on that piece of paper? And, regardless, how do we work towards obtaining and maintaining qualifications? In this podcast episode, we discuss it all including Dunning-Kruger Effect …
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We discuss assessment, monitoring, medical stabilization, and when to consider transplant of the patient with acute liver failure. We are joined by Dr. Sergio Navarrete, anesthesiologist and intensivist with fellowship training in transplant anesthesia. Learn more at the Intensive Care Academy! Find us on Patreon here! Buy your merch here! Takeaway…
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When the harm of “normal practices” shifts the perspective of an ICU revolutionist and medical director, what is the next course of action? Dr. Jodi Coates shares how her personal convictions inspired her to lead her trauma ICU to radically transform their sedation and mobility practices. Want to help your ICU become an Awake and Walking ICU? Sched…
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What is the role of the critical care director in leading ICU teams to become Awake and Walking ICUs? How can directors use the evidence to win executive leadership support for their teams to have what they need to succeed? Ginger Manss, DNP shares with us her key role as senior director of critical care in the revolution at MSJMC. Check out their …
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We talk about the phenomenon of airway closure during mechanical ventilation, with Thomas Piraino, RRT, FCSRT, FAARC, adjunct lecturer for the Department of Anesthesia at McMaster University, editor of The Centre of Excellence in Mechanical Ventilation Blog, and a member of the editorial board of Respiratory Care. Learn more at the Intensive Care A…
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Previously, we recorded a podcast episode about the utility surrounding Point of Care Ultrasound (POCUS). In this episode, we apply that knowledge to specific case scenarios as a continuation of our "Breaking the Case" series. We also ask the question, is POCUS really all it's cracked up to be, or should we be re-thinking our approach, particularly…
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What role do respiratory therapists play in creating Awake and Walking ICUs? How did Candace Wistrich, RRT, BSRT and Nelya Kapitula, RRT, BSRT lead their respiratory therapy department to move the revolution forward? They join us now to share their team’s journey! Vote for “Awake and Walking ICUs” as “best nurse innovation” and Kali Dayton as “best…
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How does the Awake and Walking ICU approach apply to the trauma ICU? How did education, training, leadership support, and deep compassion empower these experience trauma nurses to transform their ICU culture and practices? What successes have they had and how has keeping patients awake and mobile impacted their career fulfillment and team dynamics?…
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We chat about the post-op transition of care from the OR to the ICU, including questions to ask, workflows, and pitfalls. Check out the Intensive Care Academy here! Bryan’s textbook: Concepts in Surgical Critical Care Find us on Patreon here! Buy your merch here!By Brandon Oto, PA-C, FCCM and Bryan Boling, DNP, ACNP, FCCM
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Safe patient handling(SPH) is a fairly new and rapidly growing field. Mercy San Juan Medical Center is fortunate to have a strong SPH department and leadership. Luke Strategates, DPT shares with us the key role he plays in the ICU Revolution as the safe patient handling leader. Want to bring the revolution to your ICU? Schedule a consultation at ww…
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Humans are easy. That's why we are able to do what we do as prehospital providers. But what happens when your patient is a canine? These working dogs are highly regarded by their handlers and require care just like anyone else that may be ill or injured. Considering that, are you equipped to care for them? If not, how can you successfully start and…
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We talk about diagnosis, treatment, and subsequent care of the patient with bacterial meningitis, with Emory neurointensivist Casey Albin, MD (@caseyalbin). Learn more at the Intensive Care Academy! Find us on Patreon here! Buy your merch here! Takeaway lessons ResourcesBy Brandon Oto, PA-C, FCCM and Bryan Boling, DNP, ACNP, FCCM
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Standardized sedation and immobility are rooted in a gap in education. What is the power of a nurse educator in transforming knowledge, culture, and practice in the ICU? Jeana Flakes, MSN, RN shares how she helped lead the ICU Revolution as a nurse educator at Mercy San Juan Medical Center. Www.DaytonICUConsulting.com…
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We chat with Nick Ghionni, pulm/crit attending at MedStar Baltimore Hospital, about identifying and combating cognitive biases in our clinical decision-making. Check out the Intensive Care Academy here! Find us on Patreon here! Buy your merch here!By Brandon Oto, PA-C, FCCM and Bryan Boling, DNP, ACNP, FCCM
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What do physicians understand of the ABCDEF bundle? What are their perceptions of early mobility? How are their teams practicing the ABCDEF bundle in their own units? What do physicians need to be able to lead an Awake and Walking ICU approach in their units?I interviewed physicians while attending the CHEST conference to find answers to these ques…
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It can be difficult to determine whether you should treat undifferentiated hypertension or not. Many clinicians are distracted the number rather than focusing on the patient in front of them. Asymptomatic hypertension, in particular, is often benign. In fact, treating asymptomatic hypertension in a patient who a primary medical history of hypertens…
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What happens when a visionary physician in a low-resource hospital in Bangledash leads his team to practice the ABCDEF bundle? How did this passionate team of ICU clinicians transform their care from automatic sedation and immobility to standardized mobility three times a day? How did they come to treat mobility as important and optional as an anti…
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We chat with Noelia Bischoff, recently off orientation in the medical ICU at Johns Hopkins as a nurse practitioner, about the transition from her role as a bedside ICU nurse. Check out the Intensive Care Academy here! Find us on Patreon here! Buy your merch here!By Brandon Oto, PA-C, FCCM and Bryan Boling, DNP, ACNP, FCCM
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Fear of “liabilities” is often a barrier to keeping patients awake and mobile in the ICU. Yet, we know that the ABCDEF is evidence-based best practices. So what are the legal liabilities to a hospital, leadership, and bedside clinicians of current cultural practices? Maggie Ortiz, MSN, RN joins us now to share her expert perspective. Find Maggie at…
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The principles of preoxygenation and passive oxygenation should be familiar to any experienced intubator. Best practice recommends the use of a nasal cannula in conjunction with either a non-rebreather mask or bag-valve mask (BVM) to prevent hypoxemia during the apneic phase of Rapid Sequence Intubation (RSI). In the PREOXI Trial, the authors pushe…
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We discuss transfusion reactions, risks, and management, including infection, consent, TRALI, TACO, and hemolytic reactions—with Dr. Joe Chaffin (@bloodbankguy), the “Blood Bank Guy” and transfusion medicine specialist. Learn more at the Intensive Care Academy! Find us on Patreon here! Buy your merch here! Takeaway lessons…
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The ICU is an overwhelming and daunting environment to start a new career. While learning so many new skills from experienced mentors, how did Michael Glade, RN, BSN also see past “what is done” to “what should be done” in his ICU? Michael shares with us what led him to help lead the revolution in his ICU. Www.DaytonICUConsulting.com…
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Not all cardiac arrests are created equal. Whether the presenting rhythm is asystole, ventricular fibrillation, or PEA, these patients require tailored interventions beyond "blanket" protocol and ACLS/PALS algorithms. When refractory to conventional therapy, the pulseless V-Tach/V-Fib patient, in particular, requires critical thinking "outside the …
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We talk the nitty-gritty of assessing the right heart using echocardiography, with our friend Matt Siuba (@msiuba), intensivist at the Cleveland Clinic and master of zentensivism. Learn more at the Intensive Care Academy! Find us on Patreon here! Buy your merch here! Takeaway lessonsBy Brandon Oto, PA-C, FCCM and Bryan Boling, DNP, ACNP, FCCM
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We explore the fascinating world of artificial intelligence and its role in medicine, with Nawar Shara (@NawarShara), PhD, Chief of Research Data Science at Medstar Health Research Institute and cofounding director of the AI Collab between Medstar and Georgetown. Check out the Intensive Care Academy here! Find us on Patreon here! Buy your merch her…
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Ilija Klipa MS, ACSM-CEP,ACSM-EP,ACSM EIM III, AACVPR-CCRP is a cardiac/pulmonary physiologist a high-acuity cardiac ICU. He shares his journey in pioneering physiology in the ICU as well as leading the revolution to create an Awake and Walking ICU. Check out Ilija's upcoming 30-credit ECMO mobility courses here: https://cme.ahn.org/content/extraco…
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We discuss the practicalities of using airway pressure release ventilation (APRV) with Dr. Rory Spiegel (@EMnerd_), emergency physician and intensivist at MedStar Washington Hospital Center (and EMNerd at Emcrit). Find us on Patreon here! Buy your merch here! Takeaway lessonsBy Brandon Oto, PA-C, FCCM and Bryan Boling, DNP, ACNP, FCCM
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When patients have a primary language other than English (LOE), how does this impact their access to the ABCDEF bundle? Is it standardized to provide nonverbal communication in other languages in the hospital? Emily Ahrens, MS, RN, CCRN joins us now to dive deep into her post-doctoral studies dedicated to this gap in critical care medicine. Episode…
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Interfacility transfers are not always indicated at the time and place of which they are being requested. Whether it's referring provider misinformation or a lack of advocacy by the transport agency, these transfers can result in unnecessary risk for crew members and patients. Specifically, weather conditions, time of day, crew fatigue, and other i…
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We know that for each additional 10 minutes of early mobility in the ICU, hospital length of stay decreases by 1.2 days. What else do we know about the relationship between dose of mobility and time on the ventilator? Sarina Fazio, PhD, RN, shares with us her exciting discoveries in her latest research. Episode transcripts and citations at: Www.day…
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We discuss the field of rehabilitation psychology, and how it can help patients with persistent critical illness, with Dr. Megan Hosey (@DrMeganHoseyPhD), clinical psychologist and assistant professor at Johns Hopkins School of Medicine, where she practices in the medical ICU. Find us on Patreon here! Buy your merch here! Takeaway lessons Resources…
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Constance Dahlin, MSN, ANP-BC, ACHPN®, FPCN, FAAN is a consultant to the Center to Advance Palliative Care, a palliative nurse practitioner at North Shore Medical Center and co-director of the Palliative APP Externship. Vincent Jay Vanston, MD FAAHPM HMDCB has been working in the field of Hospice and Palliative Medicine for over 25 years. His work …
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We explore the profession of respiratory therapy in the US, including their role and training and how to optimize our clinical relationships, with Keith Lamb (@kdlamb1), RRT, RRT-ACCS, FAARC, FCCM. Keith is an RT at the University of Virginia in Charlottesville, working clinically in neuro/surgical/trauma critical care, who has been active in resea…
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We discuss the principles and application of automatic tube compensation (ATC) on modern ventilators, with its creator Ben Fabry. Dr. Fabry is a professor and chair of biophysics at University of Erlangen-Nuremberg, originally trained as an electrical engineer, who originally developed ATC as part of his PhD program. Find us on Patreon here! Buy yo…
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