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Walking Home From The ICU

Walking Home From The ICU

By Kali
Kali Dayton, ACNP-BC, is a nurse practitioner in a medical surgical intensive care unit (ICU). She hands the microphone to ICU survivors and bedside caregivers to reveal the realities of ICU experience and patients' journeys after discharge. The big picture of sedation and immobility is discussed and we explore how to improve long-term patient outcomes. We shift the vision from transferring out of the ICU to walking straight home after the ICU.
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Episode 43: Trapped In My Body As An ARDS Survivor

Walking Home From The ICU

Episode 68: PICU UP!
We know that sedation causes and worsens ICU delirium, post-ICU PTSD, post-ICU dementia, and ICU-acquired weakness in adults. The research is vast and compelling. What does this mean for children? What does research reveal about the harm children suffer from drug-induced comas? Is there a different way to treat our children? Can we preserve their futures by changing our practices in the ICU? What will it take to protect our children?
May 9, 2021
Episode 67: On to LTACH?
If you were to come out of a medically-induced coma after weeks of delirium and atrophy with a new tracheostomy, only to find yourself unable to hold your head up...would you want to be discharged to an LTACH? Do other countries have LTACHs? Are there other options to survival after the ICU for survivors? Patrik shares with us his experience and role in guiding family and survivors out of the ICU.
May 6, 2021
Episode 66: Trach and Peg
Why do tracheostomy rates fluctuate so drastically between ICUs? What is the true reason for so many tracheostomies? What are the long-term effects of tracheostomies?
May 4, 2021
Episode 65: "Create Survivors, Not Victims"
Jeroen Molinger, MSc brings the research to the bedside. He ties together the importance of muscle maintenance, nutrition, and how to create survivors not victims.
April 20, 2021
Episode 64: Nutrition
What role does nutrition play in improving outcomes in the ICU? How can we help preserve muscle through appropriate nutrition during critical illness? Jeroen Molinger, MSc continues to upgrade our approach to critical care through exercise physiology.
April 16, 2021
Episode 63: Muscles Matter
Why is ICU acquired weakness an independent predictor of mortality? What role does muscular atrophy play in multi-organ failure? When we unnecessarily sacrifice muscles for other organs, how badly do we damage patients’ chances to survive and thrive? Jereon Molinger, MSc, brings eye opening information to the discussion.
April 12, 2021
Episode 62: The Right To Know
We say we respect patient autonomy. We provide informed consents prior to intubation. Should patients be warned of the risks and repercussions of sedation and immobility? When sedation is nonessential, should patients be given the choice to be comatose or awake and moving?
April 9, 2021
Episode 61: Real Talk
What barriers do we have in our ICU culture that prevent us from appropriately addressing delirium? What can we do to foster a better approach to helping delirious patients that are difficult to care for? Dr. Swamy gets real as we discuss the reality of delirium from our side of the bed.
April 7, 2021
Episode 60: "Just Let Them Sleep"
For decades we have sedated patients with the belief that it is more humane to “sleep” through critical illness. Survivors have told us their experiences were not “sleep” to them. What do neurologists and research say about the quantity and quality of sleep during medically-induced comas? Dr. Williams Roberson shares with us her research and invaluable insights into sedation and sleep.
April 1, 2021
Episode 59: Hope On The Horizon
What can happen when a team catches the vision? How can a team transition their culture from deep sedation and immobility to awake and walking? Nora tells us about igniting her team's fire and the changes they are celebrating.
March 26, 2021
Episode 58: Deadly Treatment for a Deadly Virus?
Louise, ACNP, has dedicated her career to preserving lives in the Awake and Walking ICU. So what was it like for her to have her own loved one die from sedation and immobility? She tells it like it is and gives us a sobering insight into both sides of the bedside during COVID19.
March 19, 2021
Episode 57: Not In Kansas Anymore
When all you’ve ever known is walking patients on ventilators, what is it like to enter a time-machine and go back to sedation and immobility? What did Tara learn taking care of COVID19 patients outside of her “Awake and Walking ICU”? She shares with us her reaffirmed empowerment to change patients’ outcomes through evidence based practice. Instagram:
March 14, 2021
Episode 56: Minding Your Own Business
What does it mean to you to be able to toilet yourself? What happens to patient dignity when they are deprived of the capacity to “mind their own business”? Rachel shares with us what is happening to patients even when they are not on mechanical ventilation.
March 9, 2021
Episode 55: Walking Around the World
Where in the world do patients walk on ventilators and ECMO? Providers from 22 countries share with us their experiences with helping patients walk home from the ICU.
February 25, 2021
Episode 54: Back To Harmful Practices From the 90's
After decades of research revealing the price patients pay from benzodiazepines, where are we now in the ICU? Dr. Wes Ely and Brenda Pun share with us the latest COVIDD study and how COVID19 patients are being cared for around the world. What do you want to know about the Awake and Walking ICU? Join our Facebook group for more discussion! Twitter: @HomeICU Instagram: @Walkinghomefromtheicu
February 5, 2021
Episode 53: Dare to Dream
How do we bring changes to the ICU? What barriers impede the progress of our culture? Heidi Engel, PT, DPT, shares with us her continuous journey to humanizing her ICU. What do you want to know about the Awake and Walking ICU? Join our Facebook group and Instagram for more discussion! Twitter: @HomeICU Instagram: @walkinghomefromtheicu
November 30, 2020
Episode 52: Haunted Beyond the ICU
What truly happens during delirium? When do the hallucinations and terror stop? Survivors give us a sobering reality check of what caused the deep psychological trauma during their ICU stays and how their lives are forever impacted. What do you want to know about the Awake and Walking ICU? Join our Facebook group for more discussion! @HomeICU
October 25, 2020
Episode 51: Post-ICU PTSD: Fact vs. Fallacy
What does research reveal about the most common contributing factors of post-ICU PTSD? Does sedation prevent or inflict trauma? Dr. Jackson shares with us his decades of research and experience with post-ICU PTSD. What do you want to know about the Awake and Walking ICU? Join our Facebook group for more discussion! @HomeICU
September 19, 2020
Episode 50: The Reality of Post-ICU PTSD
What causes Post-ICU PTSD? What is it like to live with this trauma? How does it impact life after the ICU? Spencer Freeman shares with us intimate insight into living with Post-ICU PTSD. @HomeICU
August 31, 2020
Episode 49: The Cost of Rot
How do Hospital Acquired Pressure Injuries (HAPI) impact patient outcomes and quality of life? How can they be better prevented? Cami, our wound care specialist, shares with us penetrating insight into the reality of rotting in the ICU. @HomeICU
July 12, 2020
Episode 48: Q&A
What do you want to know about the Awake and Walking ICU? Join our facebook group for more discussion! @HomeICU
July 10, 2020
Episode 47: Change Practices to Change Lives
What does an awake and walking ICU patient look like walking back into the pulmonology clinic? Dr. Shilling shares what this process has meant for his practice in the clinic. @HomeICU
June 28, 2020
Episode 46: Waking Up After Decades of Sedation
What is like for a seasoned ICU nurse with decades of valuable experience to completely change their sedation practices? What is like to then re-enter a “normal” environment and strive to continue the best practice? Paula shares with us her personal shock and conversion. @HomeICU
June 19, 2020
Episode 45: Physical Therapy In the ICU During COVID19
What roles do physical and occupational play in helping COVID19 patients survive and thrive? How have they changed their approaches during the challenges of COVID19? Why should we never remove their therapies from ICU care? @HomeICU
June 11, 2020
Episode 44: Walking Home From the ICU after COVID19
When 69-year-old Dr. Ken Hurwitz was intubated for COVID19, how was his life saved and even preserved? After 3 weeks on the ventilator, why was he able to walk away and go straight home?  See photos at citations at: @HomeICU
June 6, 2020
Episode 43: Trapped In My Body As An ARDS Survivor
Now that we know what happens to patients after sedation and immobility, do we know what it is really like? Do we understand what happens to patient dignity, autonomy, and identity when they lose control of their bodies? Eileen Rubin shares with us what it was like as a 33-year-old trial attorney to wake up and not be able to lift a finger. @HomeICU
June 5, 2020
Episode 42: The Power of Nursing Care Against COVID19
When good nursing care is not possible during a pandemic, what happens to patient outcomes? Makenzie tells her tales as an ICU nurse in NY as we explore the role nursing care plays in saving and restoring lives. @HomeICU
June 3, 2020
Trailer @HomeICU
May 19, 2020
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. @HomeICU
May 17, 2020
Episode 40: Cultural Revolution
What was it like in the early phases of the “Awake and Walking ICU?” How was the new practice introduced? How was the culture revolutionized in spite of opposition? Who rejected the change? How did nurse Patty go from incredulous to emphatic? @HomeICU
May 16, 2020
Episode 39: Ethical Turmoil
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. @HomeICU
May 13, 2020
Episode 38: “THEY’RE AWAKE?!?”
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. She teaches us the changes and wisdom her practice has gained. @HomeICU
May 11, 2020
Episode 37: Culture Shock
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?” @HomeICU
May 11, 2020
Episode 36: We Need To Talk
What 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? @HomeICU
May 9, 2020
Episode 35: Mobility is EVERYONE’S job
What happens after patients are sedated and immobilized for weeks? What will the rehabilitation process for COVID19 survivors be like? How long will it take for them to be able to sit, stand, and walk again? Christiane Perme, the post-ICU rehabilitation specialist, shares with us how to prevent such outcomes and help patients thrive in their lives again. @HomeICU
May 5, 2020
Episode 34:Recommendations From a 4-Time Ventilator Survivor
Ann Bannon was intubated four times and awake on the endotracheal tube and ventilator for months. She gives us valuable insight into how to help the new flood of ventilated patients.
April 2, 2020
Episode 33: COVID19- The Domino Effect
What can we do to improve mortality in the midst of a pandemic? As times have changed, our practices must change as well.
March 24, 2020
Episode 32: Delirium Day
In commemoration of Delirium Day, it is most appropriate to hear from one of the leading delirium experts, Dr. Sharon Inouye! She shares with us her professional and personal experiences with delirium in all aspects of hospitalization. @HomeICU
March 11, 2020
Episode 31: Nurse Manager
Nancy tells us about her transition to the awake and walking ICU as a nurse manager. She explains the nurse manager’s role in preserving a culture of humanity in the ICU. She shares with us how sedation cessation saved her own mother’s life. @HomeICU
March 11, 2020
Episode 30: Speech Language Pathologists
Lydia, CCC-SLP, shares with us the vital role speech therapy plays in helping patients get back to their lives. She explains how awake and walking enables patients to resume eating sooner and preserves cognition. The utilization of speech therapy is explained and applied in ways that the ICU world has never understood before. @HomeICU
March 11, 2020
Episode 29: Occupational Therapists
How does occupational therapy get to be utilized when patients are awake and walking on the ventilator? What role does occupational therapy play in preserving physical and cognitive function during critical illness? How has this enhanced role impacted the fulfillment Merrill, MOT, finds in his career? @HomeICU
March 11, 2020
Episode 28: Pharmacists
Kathryn, BCCCP, tell us of her culture shock coming to the awake and walking ICU after years in units around the country. She tells about the role pharmacists play in delirium prevention and preservation of function in the ICU. She shares how this shift in focus has enhanced her job satisfaction. @HomeICU
March 10, 2020
Episode 27: Physicians
Dr. Badke, MD, shares what it was like to shift perspective and culture as a new intensivist in the awake and walking ICU. He explains what role the physician plays in helping patients walking home after the ICU. @HomeICU
March 10, 2020
Episode 26: Nurse Practitioners
What does it mean to be the steward of patient outcomes? Louise, ACNP, explains how nurse practitioners are guardians of delirium prevention and preservation of function for her patients in the ICU. @HomeICU
March 10, 2020
Episode 25: Respiratory Therapists
Respiratory therapists are key to helping patients walk on the ventilator. Cash, RRT, shares his tips and secrets to walking and even showering patients on the ventilator. He reveals how having patients awake and walking has impacted his ICU career. @HomeICU
March 10, 2020
Episode 24: Physical Therapists
What is it like for physical therapists that get to do more than a passive range of motion with patients on ventilators? Physical therapists in the awake and walking ICU save lives and enable patients to have their lives back after discharge. Angela, DPT tells us how they do it. @HomeICU
March 10, 2020
Episode 23: Registered Nurses
What is it like as an RN to care for intubated patients on the ventilator that are AWAKE and WALKING? Brandy, RN shares with us why she is passionate about keeping brains and bodies strong during critical illness. She reveals how humanizing the ICU has impacted her career. @HomeICU
March 8, 2020
Episode 22: Multidisciplinary Teamwork
Patients cannot walk out of the ICU without the efforts and expertise of each discipline. What role does each discipline play in returning patients to their lives? @HomeICU
March 8, 2020
Episode 21: What We've "Always Done" Isn't Always Right
How did this ICU get so off the grid? Decades before the research and in a generation of paralytics and benzodiazepines, a nurse saw a problem and had a vision. Polly Bailey, ACNP, shares with us her journey to building an awake and walking ICU. @HomeICU
March 8, 2020
Episode 20: A Chance To Say Goodbye
Though avoiding sedation and mobility decreases mortality, death is not always avoidable. How does being awake and mobile during critical illness impact your last mortal moments? What does it look like to have a chance to say goodbye? @HomeICU
March 8, 2020
Episode 19: Walking On ECMO Part 2
Tyler Lintz was admitted for severe septic shock, pneumonia, and ARDS. He eventually needed ECMO but was still allowed to keep walking. Tyler and Amber tell us how he returned to being a firefighter 3 months after ECMO. @HomeICU
March 8, 2020
Episode 18: Walking On ECMO Part 1
Tyler Lintz was admitted for severe septic shock, pneumonia, and ARDS. He eventually needed ECMO but was still allowed to keep walking. Tyler and Amber tell us how he returned to being a firefighter 3 months after ECMO. @HomeICU
March 8, 2020
Episode 17: Walking On The Ventilator For 17 Days
Joan Johnston was admitted for ARDS and remained on the ventilator for 17 days. She shares with us what it was like to be awake, walking, and even showering while intubated. @HomeICU
March 6, 2020
Episode 16: Defending the Defenseless
James was admitted for severe mycoplasma pneumonia that turned into mild ARDS. His downs syndrome and autism inspired the ICU team to get creative to keep him awake and walking on the ventilator. His journey straight home moves us to reconsider our standard practices. @HomeICU
March 5, 2020
Episode 15: Walking Through Severe ARDS
Bryan Carter was admitted for severe pneumonia that became severe ARDS. He was allowed to be awake and walking on the ventilator until he was proned. When he was able to be supine he was right back on his feet. He shares with his story and how his treatment impacted his outcomes. @HomeICU
March 5, 2020
Episode 14: Different Treatment Different Outcomes
If we treated patients differently, would their outcomes be different? What if patients never stopped walking during critical illness? One ICU dared to ask. @HomeICU
March 4, 2020
Episode 13: Loved Ones Are Survivors Too Part II
Caregivers also leave ICU with high rates of PTSD and long-term life impacts. Mike Maranhas shares his side of his wife's ICU stay and recovery.
March 3, 2020
Episode 12: Loved Ones Are Survivors Too Part I
Caregivers also leave ICU with high rates of PTSD and long-term life impacts. Mike Maranhas shares his side of his wife's ICU stay and recovery. @HomeICU
March 3, 2020
Episode 11: Rehabilitate Rehabilitation
When we send patients to LTAC or SNF to relearn how to walk, what is that like? Susi Rimkus, DNP, shares with us her experience with rehabilitating rehabilitation. @HomeICU
March 1, 2020
Episode 10: I Can't Move
What is it like to wake up with less physical capacity than a newborn? What is it like to be sent to LTAC with no expectations of returning home? When patients have not moved for weeks+, what is the journey to recovery like? How long does it take? What are the psychological effects on survivors and loved ones? Jim and Cheryl Rettinger gives us an inside look. @HomeICU
February 29, 2020
Episode 9: The Big Picture of Immobility
What happens down the road to patients that are on bedrest during their time on the ventilator? Is there another way? Let's put it into the big picture. @HomeICU
February 29, 2020
Episode 8: Living With Post-ICU Syndrome Part II
ICU Survivor, David Burrows, shares his experience of weeks of sedation and the delirium and ICU acquired weakness that followed. He gives us insight into the reality of his new life with the post-ICU syndrome. @HomeICU
February 28, 2020
Episode 7: Living With Post-ICU Syndrome Part I
ICU Survivor, David Burrows, shares his experience of weeks of sedation and the delirium and ICU acquired weakness that followed. He gives us insight into the reality of his new life with the post-ICU syndrome. @HomeICU
February 28, 2020
Episode 6: Broken Brains
Survivors tell us what "cognitive deficits" really look like and the impact they have on their function and lives. @HomeICU
February 27, 2020
Episode 5: The Big Picture of ICU Delirium with Dr. Wes Ely
Dr. Wes Ely, the creator of the CAM scoring tool and the ACDEF Bundle, shares with us the realities and consequences of ICU delirium. @HomeICU
February 25, 2020
Episode 4: Sedation is NOT Sleep
68% of nurses believe sedation is for patient comfort. Survivors of prolonged tell us the reality of how sweet their sedation dreams really were. @HomeICU
February 23, 2020
Episode 3: DNS= Do NOT Sedate Me
Susan East is a three times survivor of ARDS. She tells us why she sought legal protection against sedation after her first experience with ARDS. @HomeICU
February 19, 2020
Episode 2: How Did We Get Here??
Is sedation always a necessity or a habit with history? Dr. Terry Clemmer, one of the founders of critical care, shares the evolution of mechanical ventilation and sedation culture he witnessed during his 50 years of critical care medicine. @HomeICU
February 16, 2020
Episode 1 Start Here.
Kali shares the variation in sedation and mobility practices she witness in critical care throughout the USA. ICU survivors changed her perspective and belief in what is right and best for patients. Twitter: @HomeICU Instagram: @walkinghomefromtheicu
February 1, 2020