Walking Home From The ICU Episode 41: Crisis Culture During COVID19
What happens to our culture and practice when patient volumes and needs exceed our ICU capacity? How does this impact short and long-term outcomes? Dr. Dixie Harris shares with us the reality of ICU care in NY during the COVID19 pandemic. Episode Transcription Kali Dayton 0:00 You were listening to walking home from the
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Walking Home From The ICU Episode 40: Cultural Revolution
Kali talks with Patty, a nurse, about what was it like in the early phases of the “Awake and Walking ICU” and how the new practice was introduced. We ask how the culture revolutionized in spite of opposition and who rejected the change? How did nurse Patty go from incredulous to emphatic? Episode Transcription Kali
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Walking Home from The ICU Episode 39: Ethical Turmoil
Kali talks to Jim, about what is it like to be “born” into an awake and walking ICU and then be immersed in a different culture. Jim shares with us his culture shock and ethical turmoil as he strives to maintain his best practice in a new environment. Episode Transcription Kali Dayton What is it
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Walking Home from The ICU Episode 38: “THEY’RE AWAKE?!?”
Kali talks to Alex, about what is it like to jump into an awake and walking ICU as a travel nurse. Alex shares with us her first shock and impressions upon entering a different culture and she teaches us the changes and wisdom her practice has gained. Episode Transcription Kali Dayton What is it like
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Walking Home from The ICU Episode 37: Culture Shock
Kali talks about how much of our practice is driven by culture vs. evidence. What role does ICU culture play in our perspective, knowledge, and patient outcomes? How often do we dare to ask “Why?”, “What if?” or, “Why not?” Episode Transcription Kali Dayton The first time I ever stepped into an ICU was as
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Walking Home from The ICU Episode 36: We Need To Talk
Kali discusses what would happen if we expected to be able to communicate with all patients on mechanical ventilation. How would that impact our practices? What role does communication play in patient survival and outcomes? Episode Transcription Kali Dayton What would happen if we expected to be able to communicate with all of our mechanically
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Walking Home from The ICU Episode 35: Mobility is EVERYONE’S job
Kali talks with Christiane Perme, the post-ICU rehabilitation specialist, who shares with us what happens after patients are sedated and immobilized for weeks, what the rehabilitation process for COVID19 survivors will be like, and how long will it take for them to be able to sit, stand, and walk again. Episode Transcription Kali Dayton Today,
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I stumbled upon Kali’s podcast midway through my anesthesia critical care fellowship in February 2021. At our institution, I got the impression that patients in the ICU either got better on their own or had a prolonged and complicated course to LTAC or death. In her podcast, Kali explained that LTAC was rarely the outcome for patients in the Awake and Walking ICU™ in Salt Lake City.
Their ICU survivors hardly ever got trached, PEGed, or sent to LTAC, and literally walked out of the hospital in condition as close to their previous health as they could be. Although the concept of using no sedation on ventilated patients was completely foreign to me, it made sense based on what I had read in the literature. I devoured all of the episodes from the beginning, many of them bringing tears and regret for my ignorance, followed by inspiration and hope in later episodes. Listening to her podcast has been one of the most profound experiences in my short, eight-year career in medicine.
After discovering the no sedation, early mobility practice at the Awake and Walking ICU™, my focus shifted to bringing it to my own institution. I visited Salt Lake City in March to witness it with my own eyes. Since then, I’ve been in touch closely with Kali and Louise to learn the practical approaches to sedation wean and sedation avoidance for newly intubated patients in the ICU.
Mikita Fuchita, MD
Colorado, USA
Perception Versus Reality: Debunking The Myths About Medically-Induced Comas
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