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I’ve Won an Award for Best Nursing Innovation!

I am proud to announce that I’ve won an award for the “Best Nursing Innovation” in Nurse.org’s 2025 Best of Nursing Awards.

This award, which highlights the Awake and Walking ICU initiative, is a triumphant recognition of nursing innovation, and all those nurses who’ve worked tirelessly over the years to develop these protocols and advocate for evidence-based ICU practices.

Without them, I couldn’t have won this award, and the idea of an Awake and Walking ICU may have remained in obscurity indefinitely.

With that in mind, this accolade honors the pioneering efforts of dedicated innovators like Polly Bailey, APRN, and Louise Bezdjian, APRN, whose relentless commitment and sacrifices have shaped, studied, and perpetuated this revolutionary approach to ICU patient care.

Polly’s journey began with a poignant realization, after witnessing the profound physical, psychological, and cognitive impacts on a young intensive care survivor.

Guided by her nursing instincts, she sought a transformative solution during a time when the prevailing norm dictated that nurses merely follow physicians’ orders.

Her audacious inquiries challenged the established practices of her day by asking:

  • “Why are we automatically sedating every patient?”
  • “Why not embrace the potential benefits of keeping patients awake and mobile whenever possible?”
  • “What if we facilitated mobility and alertness post-intubation, rather than postponing rehabilitation until later?”

Still, despite the incontrovertible evidence that her approach dramatically improves patient outcomes, Polly faced significant resistance – losing friends, enduring mockery, and battling for support in the face of entrenched skepticism.

Nevertheless, her remarkable perseverance in confronting the status quo speaks volumes about her dedication to improving outcomes for ICU patients.

This award also symbolizes a victory for ICU revolutionists worldwide, who have been fighting for a more humane and evidence-based intensive care environment.

All things considered, the recognition of the Awake and Walking ICU as a nurse-led innovation marks a pivotal moment in our field, as it signifies a growing realization among ICU clinicians that traditional practices are not immutable and should evolve in the name of providing better care.

The tides are changing, and the ICU revolution is underway, bolstered by the ABCDEF Bundle.

Critical care medicine is on an upward trajectory, moving toward the widespread standardization of Awake and Walking ICUs.

And together, we are embracing this paradigm shift, igniting hope for the future of critical care – one in which patient dignity and mobility take center stage in the healing journey.

About the Author, 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.

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Over the last few years I have become aware of the PICS (post-intensive care syndrome) condition and the very serious negative impact that it has on our ICU survivors. I have become much more aware of the potential negative impact of anxiety, depression, PTSD and cognitive dysfunction. Many patients whom we consider saves in the sense they leave the ICU alive have many issues that most people would consider far from a successful experience. Their lives are often dramatically changed in a very negative fashion.

I am a professor of medicine and have been an ICU director for over forty years. What I find very disturbing in my own experience and that of many other intensivists is that this outcome is generally considered acceptable; the patient survived and will get better with time. We have little access to these patients and almost zero information about their condition unless they are unfortunate enough to return to our ICUs. Very few of us have a PICS clinic where we would have a chance to better understand the challenges that some of our patients encounter, and there are very few systems in place to provide feedback to us as ICU clinicians. Therefore, we are blissfully ignorant of the many challenges that a substantial number of our survivors encounter. This is a major problem. The vast majority of ICU survivors and their families will experience cognitive, emotional and physical symptoms which often have devastating impacts on their lives. At this time, with PICS clinics being a rarity, there is no reasonable mechanism for intensivists to have a solid perspective on the frequency and severity of this condition.

How patients and their families are treated in the ICU often has a major impact on how the patient and families survive post discharge. It is generally agreed that most sedation infusions, particularly benzodiazepines, frequently have higher incidences of delirium and post-discharge dysfunction. There are a few hospitals in this country where sedative infusions are rarely used and the incidence of the complications described above are dramatically decreased. I have visited one of these hospitals and was amazed to see how effectively patients on maximum ventilator support can be managed, even walking without sedative infusions. In an effort to explore this treatment option in greater detail I have identified Kali Dayton. She is a nurse practitioner who has practiced in this Awake and Walking ICU for many years and is an amazing source of information on this topic. After extensive discussion with many colleagues, administration and many others, and reviewing the major potential benefits of the program for our patients, we have decided to introduce this program into our hospital.

Peter J. Murphy, MD, FCCP, MRCPI, BSc

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