Walking Home From The ICU

Kali Dayton introduces the Walking Home From the ICU podcast’s focus on creating awake, mobile, humanized ICUs through high reliability systems, then interviews high reliability expert Alan Bennett, who shares how his work in patient and workforce safety became personal. Alan describes seeing prior safety and mobility initiatives he helped implement—like CorTrac feeding tube guidance, pressure injury prevention devices, and cardiac chair use—directly support Nate’s care, and emphasizes that clinicians’ work leaves a legacy that may one day affect their own loved ones. He highlights empowering interdisciplinary rounds, family inclusion and overnight presence, delirium challenges, communication tools, early psychiatric evaluation leading to a bipolar I diagnosis and treatment, and end-of-life moments made meaningful through compassionate, reliable teamwork Check out how Alan used Cartridge.com to share Nate's journey with his community during his time in the ICU: https://www.caringbridge.org/site/f42c9509-ffa7-11ef-84b9-27fb4887a222 www.DaytonICUConsulting.com 00:00 Welcome to the ICU Revolution 01:01 Why High Reliability Matters 03:14 Meet Alan Bennett 05:20 Nate’s ICU Journey 07:27 Legacy of Safety Work 10:08 Being a Family Teammate 19:58 Delirium and Sedation Tradeoffs 25:11 Communication and Connection 29:59 Faith Psychiatry and Meaning 38:16 Humanizing End of Life Care 43:25 High Reliability Explained 45:13 Culture Burnout and Retention 48:44 Tech Can’t Replace Nurses 52:09 Legacy Message and Closing

Revolution in sedation, delirium, and mobility culture in the ICU requires more than a memo, grand rounds, or a weekend symposium. Leaders who provide minimal support without teaching teams the how and why but expect a drastic change in care and outcomes risk a mutiny. Leadership and implementation strategy can inspire innovation, humanity, and transformation OR can leave clinicians bitter, burned out, and shut down. Listen to the insights from revolutionist’s concerns about their leaders' current implementation attempts. ⁠www.DaytonICUConsulting.com ⁠

Posting a video about the role of communication for sedation management to help prevent post-ICU syndrome sparked important discussion and the sharing of valid concerns. @pulmtoilet comes back to the podcast to address the cultural and educational roots of the the current state of affairs to dissect why communication prior to sedation is a hot topic in the ICU community. Follow @pulmtoilet and check out Dr. Ghionni's YouTube channel with incredible content on ventilator management! Find the agitation algorithm here! www.DaytonICUConsulting.com

From 180 lbs at peak athleticism, intelligence, and financial prosperity — to 120 lbs, isolated and locked in his penthouse. Anjan Chatterjee tells the harrowing reality of life during and after prolonged sedation in the ICU. Most people think surviving the ICU is the hard part. For Anjan, it was only the beginning. On August 14th, 2022, a routine run ended with a slip, a fall, and a traumatic brain injury that left him clinically dead — resuscitated only because his dog, Kingston, wouldn't stop barking. What followed was two weeks in a medically induced coma, seizures, facial fractures, and a mind that couldn't tell dreams from reality. He woke up convinced he'd been arrested, shot at by police, and sentenced to death. He burst through hand restraints. It took 14 nurses to hold him down. Then he was discharged — to a psychiatric ward — still hallucinating, still terrified, and completely alone. "I sat in this lavish penthouse, and I was a prisoner. I didn't talk to a single soul for six months." In this episode, Anjan opens up about the psychological and physical toll of post-ICU syndrome — the delirium, the 60-lb muscle loss, the cardiac deconditioning, the brain fog, and the crushing isolation that followed. No referrals. No support. No one who believed him. Just a man, his trauma, his dog, and four walls at the top of a building. This is a story about what it really means to survive — and what it takes to actually come back. Stay tuned for upcoming online courses! www.DaytonICUConsulting.com

Walking Home from the ICU Translating the ICU with Stephen Ramsey Part 2: ICU Case Study Guest: Stephen Ramsey, PT In Part 2 with Stephen Ramsey, physical therapist and ICU mobility expert, the discussion dives into a complex cardiothoracic ICU case Stephen presented at APTA's CSM conference. Using the MENTOR framework, Stephen walks through how rehab clinicians should approach critically ill patients — from chart review to interdisciplinary communication to real-time clinical decision-making. A structured approach for PT/OT clinical reasoning in the ICU: M – Map the Story: Thorough chart review and understanding the patient's full history E – Expose the Unknowns: Identify gaps and questions before entering the room N – Narrate Your Reasoning: Verbalize your clinical thinking to colleagues and the medical team T – Test the Theory: Treat PT/OT as an assessment, not just an intervention — mobilize to observe physiologic response O – Observe for Signals: Monitor real-time hemodynamic and respiratory responses R – Review with the Team: Debrief after every session, whether it went well or not Stephen walks Kali and the audience through a real case study using the MENTOR framework.