Why ICU Teams Need Expert ABCDEF Bundle Consulting
In my experience, teaching ICU clinicians about the ABCDEF Bundle can sometimes feel like trying to explain water to a fish. Just as a fish has no context to understand the water it’s swimming in, ICU teams may not always clearly see the preventable harm surrounding them. When clinicians are immersed in the daily realities
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Why Gradual ABCDEF Bundle Implementation Often Results in a Failure to Launch
“Let’s introduce the bundle gradually. We don’t want to overwhelm anyone. Let’s see what the team is willing to do. We can start with awakening and breathing trials, then tackle the rest once we have those down.” This kind of conversation has echoed through medical organizations and clinical leadership teams for years. It’s a logical
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What Clinicians Need to Know About Awakening Trials
I have to admit, I wasn’t a fan of awakening trials at first. During my first two years in an Awake and Walking ICU, we rarely initiated sedation, so the need to turn it off wasn’t a struggle for us. When sedation was necessary, we simply turned it off when we deemed it unnecessary. It
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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
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Episode 186: The ICU Revolution at Mercy San Juan Medical Center Part 5 – Respiratory Therapy
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! Episode Transcription Nelya Kapitula, RRT, BSRT 0:00 Candace and Nelya, thank you so
Reviving Core Nursing Values in Critical Care Through the ABCDEF Bundle
Critical care is an extraordinary and complex specialty that’s continually evolving, with a growing capacity to save and extend life in the face of the most extreme perils. Research, knowledge, and technological developments have transformed nursing skills and our ability to care for patients who are critically ill. Unfortunately, the nursing values and ethics, which
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I’ve Been Nominated for the Best of Nursing Awards!
I am incredibly excited to announce that I’ve been nominated for two Best of Nursing Awards. These awards are given out as part of an annual initiative by Nurse.org to “recognize and celebrate dedication and excellence in the nursing industry in the U.S.” And the best part is, all Nursing Awards finalists are nominated by
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Episode 185: The ICU Revolution at Mercy San Juan Medical Center- Part 4 with the Trauma ICU RNs
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? Jessica Williams, BSN, RN, Adrienne Craig, BSN, RN, and Amber Brandt, BSN, RN share
Episode 184: The ICU Revolution at Mercy San Juan Medical Center- Part 3 with Luke Stratigates
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. Episode Transcription Kali Dayton 0:00 This is the
Episode 183: The ICU Revolution at Mercy San Juan Medical Center- Part 2 with Dr. Lawrence Bistrong
What happens when a medical director really sees the reality of “normal practices” and becomes a revolutionist? Dr. Bistrong shares his personal conversion and the key role he has playing in his team’s transformation. Episode Transcription Kali Dayton 0:00 This is the walking home from the ICU Podcast. I’m Kali Dayton, a nurse practitioner and
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
Perception Versus Reality: Debunking The Myths About Medically-Induced Comas
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