What happens to the body at the cellular, neurological, pulmonary, musculoskeletal, and cardiovascular levels when it remains supine for days to weeks? What is verticalization therapy and what does current research reveal about its benefits during critical illness? Verticalization experts, Phillip Gonzalez, MOT, OTR/L, BCPR, Nikki Stephens, DNP, APRN, FNP-C, and Jenna Hightower, PT, DPT,
Walking Home From The ICU Episode 157: Sedation is Sleep-Deprivation
For decades, we have culturally passed on the myth that patients are sleeping while sedated into medically induced comas. We have assured ourselves and each other that sedation “prevents PTSD”. Research has proven that sedation makes true restorative sleep impossible and real recall of the reality of the ICU is protective against post-ICU PTSD. So
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After decades of research and effort, why is there a persistent struggle to truly practice the ABCDEF bundle? Are antiquated sedation practices because nurses are unwilling to change, or is it because they are unsupported and untrained in the risks and realities of sedation? Even when training is provided in the classroom, what do nurses
How ICU Staffing Ratios Relate to the Awake and Walking ICU Approach
The Awake and Walking ICU approach is deeply rooted in science, pathophysiology, and logic. Yet some of the best fruits of this method are humanity, compassion, dignity, and love. We use this approach to humanize the ICU, and I believe that is a desire of most ICU clinicians. But the reality is, no matter how
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Walking Home From The ICU Episode 155: F- Family Engagement and Empowerment with Lito Rama
How do families impact patient outcomes in the ICU? What does it really mean to engage and empower families in the ICU? Have our teams truly recovered from the strict visitation restrictions from COVID? How does an ABCDEF Bundle culture influence our visitation policies? Lito Rama, RN, MBA joins us now to share with us
Walking Home From The ICU Episode 154: E- EARLY Mobility with Heidi Engel
What is EARLY mobility? Why is it so vital that the ICU community advance past passive range of motion for intubated patients? What are the main barriers that prevent us from mastering the E of the ABCDEF bundle? If we’re not doing highest level of mobility for most of our patients, are we truly practicing
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Walking Home From The ICU Episode 153: D- Assess, Prevent, and Treat Delirium with Dr. Adrian Austin
The normality of delirium in the ICU is often mistaken for benign. What does it really mean to “assess, prevent, and treat delirium”? Are we treating a positive CAM score with the same urgency as a positive tropinin? If we are automatically starting deliriogenic medications on every patient immediately upon intubation, are we truly practicing
Walking Home From The ICU Episode 152: C- Choice of Sedation and Analgesia with John Devlin, PharmD
Is the C of the ABCDEF bundle only for avoiding benzodiazepines? How do we fully practice the “C” of the bundle and how does this impact patient care and outcomes? If we are automatically starting sedation without evaluation, are we truly practicing the ABCDEF bundle? John W. Devlin, PharmD, BCCCP, MCCM, FCCP joins us in
What is the purpose of awakening “trials”? When should awakening “trials” be done? How can we have successful awakening “trials”? Dr. Wes Ely joins us in this episode to crack the code on sedation cessation. Episode Transcription Kali Dayton: Last week, I did a little survey on social media. I recognize that my followers
The A of the ABCDEF Bundle is for “Assess, Prevent, and Treat Pain”. How do we truly master this tool and how does this impact patient outcomes? Can we assess, prevent, and treat pain while simultaneously striving to have all possible patients awake, autonomous, and even mobile? Joanna Stollings, PharmD, shares what the A of
I am a nurse leader responsible for improving practices across the intensive care units of a large health system. As an experienced ICU nurse, I know the culture that most often exists in ICUs is one that promotes and accepts over-sedation that often causes unintended harm. While reviewing the literature to better align our liberation practices with the best evidence, one of our bedside nurses discovered Walking Home From The ICU. The combination of poignant stories from ICU survivors with the expertise of some of ICU Liberation’s leading experts became the impetus for a system-wide evidence-based practice improvement project aimed at changing analgesia and sedation management in our ICUs.
After initially being inspired by Kali’s podcast and the incredible stories it provides, we saw an opportunity for more. We brought Kali in to present a webinar to almost 100 of our critical care team members, including nurses, APPs, physicians, and respiratory therapists. Kali’s presentation struck a needed balance between evidence-based practice information and inspiring stories, highlighting real patients who benefited from a practice that is often very different from what occurs in most ICUs today. The webinar was very well-received by all who attended, and the lessons learned have continued to be referenced by our team members as we strive to create an Awake and Walking ICU culture.
Kali offers a refreshing perspective on critical care, and she supports it with a wealth of knowledge garnered from years as a bedside nurse and advanced practice provider. Kali knows how to speak to clinicians because she is one, and she’s still very connected to the daily lived experiences of those on the frontline of critical care. I believe anyone working in critical care will find inspiration in Walking Home From The ICU to change the harmful culture of sedation in their practice. I would even go so far as to recommend the podcast as required listening for all ICU team members, whether experienced clinicians or new residents and nurses. When additional support is needed, I encourage clinical leaders to utilize Kali’s expertise and experiences to further inspire and motivate their teams. Time spent working with Kali is an investment that will pay dividends in the positive impact it has on the lives of the patients we serve.
Patrick Bradley, MSN, RN, CCRN
Virginia, USA
Perception Versus Reality: Debunking The Myths About Medically-Induced Comas
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