About Kali Dayton
Kali Dayton, DNP, AGACNP, is a critical care nurse practitioner, host of the Walking Home From The ICU and Walking You Through The ICU podcasts, and critical care outcomes consultant. She is dedicated to creating Awake and Walking ICUs by ensuring ICU sedation and mobility practices are aligned with current research. She works with ICU teams internationally to transform patient outcomes through early mobility and management of delirium in the ICU.
Kali’s Story
Starting her nursing career in an Awake and Walking ICU, and then being exposed to how things are typically done in intensive care units as a travel nurse, Kali Dayton has witnessed some of the best and worst outcomes for patients on ventilators in the ICU.
This opened her eyes to the harm being caused by standard ICU sedation and mobility practices, and she knew she had to do something about it. From this point forward, several experiences seemed to be pushing Kali further in this direction, filling her with an even greater sense of urgency.
While she was studying for her doctorate of acute care nursing practice, the latest research on ICU sedation and mobility was conspicuously absent from the curriculum. When she tried to suggest taking intubated patients off of sedation, her colleagues looked at her like she was crazy. She even met a man on a flight who broke down in tears explaining the trauma and damage he experienced from being sedated in the ICU.
So, after digging into the scientific literature and becoming even more aware of the ICU community’s ignorance of modern evidence-based practices for sedation, mobility, and the management of delirium in the ICU, she decided to start a podcast to share information and spread awareness by interviewing clinicians and ICU survivors.
That decision has led Kali on a journey to where she is now – continuing to affect positive change in the ICU community and working with ICU teams around the world to improve patient outcomes by modernizing standard ICU practices.
Her mission is to ensure every ICU clinician understands the “Why” and “How” of practicing the ABCDEF Bundle.
Our Team
Heidi Engel
Heidi Engel has been a physical therapist for 36 years and works at the University of California San Francisco Medical Center. She has worked in the ICU at UCSF since October 2008, and over the course of her career has worked in every Acute Care PT service, as well as Outpatients and Home Health settings. She received the UCSF Outstanding Colleague of Nursing Award in 2012, a Presidential Citation from the Society of Critical Care Medicine in 2013, and the American Physical Therapy Association Jack Walker Award for Research Excellence in 2014. She currently teaches at UCSF, conducts research into ICU Rehabilitation, has given over 100 presentations outside of UCSF, and is an author on 14 peer-reviewed publications. She is also a founding member of the Society of Critical Care Medicine ICU Liberation campaign.
Jenna Hightower
Jenna is an American Board of Physical Therapy Specialties certified Cardiovascular and Pulmonary Clinical Specialist and Critical Care Physical Therapist who specializes in early mobility in the ICU, specifically for patients on mechanical circulatory support such as ECMO, IABP, Impella, and LVAD, as well as various forms of mechanical ventilation. She works with populations suffering from end organ failure and/or various forms of shock requiring invasive support and has a special passion for pre and post heart and lung transplant patients.
Critical care knowledge and skills are not offered to physical therapy candidates in school, so it is a career goal of Jenna’s to use her unique specialty to help this field of physical therapy grow. She enjoys teaching these skills to other clinicians to assist them in practicing at the top of their license and help them to create the best outcomes for their patients in the ICU.
She is especially interested in working to further research on mobilizing patients who are supported on various forms of mechanical circulatory support. She has given several guest lectures for entry-level DPT programs, spoken at national level conferences, produced webinars for various healthcare institutions and has been featured in publications aimed at helping to improve ICU skill development for entry level physical therapists and future specialist candidates.
As an RN in the Medical-Surgical ICU at the hospital I work at, I began my interest in ICU Liberation through an Evidence-Based Practice project.
While I was initially grabbed by what the literature has to say about over-sedation and patient outcomes, it wasn’t until I discovered Kali’s Walking Home From The ICU podcast that a culture of sedationless ICU care sounded tangible. The group I worked with on the project was both inspired, devastated, and intrigued by the stories Kali illuminates on the podcast, and we were able to bring her to our hospital for a virtual Zoom Webinar, where she presented on the practices in the Awake and Walking ICU.
This webinar was an incredible way to draw attention toward this necessary culture shift as Kali shared stories of patients awake and mobile in the ICU despite the complexity of their illness. The webinar inspired our final draft for the new practice guideline on analgesia and sedation management in the ICU, and since then we have seen intubated COVID patients playing tic tac toe on the door with staff members on the other side, taking laps around the unit, performing their own oral care using a hand mirror, and most importantly, keeping their autonomy and integrity while fighting to leave the ICU to resume the life they had before coming in.
Nora Raher, BSN, RN, MSICU
Virginia, USA
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