EP 212: A Patient’s Perspective of Delirium With Amelie Susanne
What is a patient’s perspective of delirium? An induced coma is also known as MIC or medically induced coma, barbiturate-induced coma, or drug-induced coma.
It is also called as temporary coma or a deep state of consciousness controlled by an anesthetic drug.
Often, barbiturates like pentobarbital or thiopental are used to help patients. It can also be intravenous anesthetic drugs like midazolam or propofol, but what happens when a patient goes through an induced coma and wakes up from it?
Can a patient recall any memory while they are in a coma? This episode will talk about a patient’s perspective of delirium and many more.
In this episode, we would like to introduce you to Amelie Susanne Roth. Susanne is a coma survivor. After an initial bacteria infection, Susanne had to be placed into an induced coma that lasted 16 days.
We talk about her time in the ICU and her experience of being in a coma and suffering from it. In this episode, we flip the script and learn firsthand about the patient’s experience.
Questions for Our Guest
The questions below are some we’d like to tackle. We often go off-topic, so we don’t expect to hit them all. If you have any ideas, please let us know.
Looking forward to our conversation!
These are the questions you had in Calendly. We’ll go off our questions, and wherever else our conversation goes.
Please give us a little background about yourself.
How did you end up in the hospital? And can you go a little in-depth into what happened?
Do you know what kind of infection it was? Where it came from?
3. Can you put us through the course of your hospital experience? Before this, coming from the day you came in?
What you heard, what were you told, and how did you feel?
4. You going into a coma and being intubated; was this something you expected?
5. When you were intubated and unresponsive, what was happening?
Do you remember any of it?
How did it feel?
Were you able to hear anything?
Was it just like a dream state?
6. When you came out of the coma, were you mentally back to normal?
Were you aware of the whole extubation process? For example, when nurses say, can you open your eyes, squeeze my hand, weaning process?
Did you suffer from any delirium or confusion?
How did you feel during everything that was going on?
7. Where do you think healthcare providers can improve?
Do you want to learn more about a patient’s perspective of delirium? Watch the full episode here 👇👇
TIMESTAMPS:
00:00 Introduction 01:32 About Amelie Susane Roth 02:38 How it all started 07:25 Experiences of Being Under Sedation and in a Coma 13:40 How does it feel to be in delirium or a coma? 15:57 A better understanding of why a patient gets agitated 18:14 The post-coma experience 25:03 Medicine Failing Patients and the Need for a Different Approach 27:50 Coping with Traumatic Experiences After a Coma 35:00 Life’s outlook after coma 40:48 Amelie’s life prior to becoming a patient 44:27 The Life Lessons While Traveling The World 47:18 Wrapping up the show
EP 210: ER Nurse to Viral Content Creator With Stephanee Beggs
Can one become a viral content creator? The short answer is yes. Our profession gives us the freedom to become an inspiration to others. Whether it be through bedside nursing or content creators, we have the means to help others.
It is unsurprising to see many healthcare professionals rise to the ranks of online personalities as they help educate others about health and well-being. If you’re a nurse interested in making digital content, this episode is for you.
In this episode, we would like to introduce you to Stephanee Beggs. Stephanee is a content creator, Forbes 30 under 30, and Emergency Room nurse.
She unintentionally became viral on social media for her quick, concise educational tools that led to the creation of RNExplained, Inc.
The questions below are some we’d like to tackle. We often go off-topic, so we don’t expect to hit them all. If you have any ideas, please let us know.
Looking forward to our conversation!
These are the questions you had in Calendly. We’ll go off your questions, and wherever else our conversation goes.
Please give us a brief background about yourself and your nursing experience.
What made you decide to get into emergency nursing?
Let’s address the elephant in the room, do you have any beef with ICU nurses?
What is the day in the life like of an emergency nurse?
Has your life changed significantly being a social media influencer?
Did you get any backlash from your employer?
How did you create RNExplained? What inspired you?
You became the 30 under 30 on Forbes for the education category.
How do you juggle multiple roles as a nurse?
How do you prioritize self-care as a nurse?
Ending Questions
Before we end the show, we have one last question we like to ask all our guests. If you had the opportunity to have a Cup of coffee with anybody one last time, who would it be & why?
Connect and catch up with Stephanee through her socials at:
Want to become a viral content creator too? Watch the full episode here 👇👇👇
TIMESTAMPS:
00:00 Introduction 01:39 About Stephanee Beggs 05:08 What causes the conflict between ER and ICU nursing? 07:24 What does an ER nurse’s shift look like 11:19 Traumatic experiences as a nurse 16:03 The love of helping and nursing patient 18:05 How RNExplained started 18:47 What is it like to be an entrepreneur and a social media influencer? 19:46 Secrets on how Stephanee balances her life 21:29 Nurse Influencers are being misunderstood by hospital administration. 27:51 Tips on how to avoid trouble with what you post on social media 29:13 Setting Boundaries with Employers and Social Media Influence 30:47 How Stephanee grew RNExplained 33:11 Stephanee’s future business plans 34:30 The importance of self-care? 35:52 Wrapping up the show
Patient falls are one of the many incidents that could happen to patients in hospitals, and as much as nurses do their best to prevent this from happening, it cannot be avoided. It does happen. But can you avoid this incident?
And what are the usual or common causes of patient falls? Knowing these can help save your patient’s life and your license. It’s best to be prepared at all times.
In today’s episode, we will discuss our experiences when a patient fell. We’ll also discuss how it happened, how we felt, and what we had to do. In addition to that, we will also discuss what to do when a patient falls and the most common causes of it.
What to Do When a Patient Falls
Call for help and stay with the patient
Assess the patient for any injuries
Ask what happened and if they have any pain or hit their head
If the patient is unable to respond appropriately, assume they hit their head
Are there any visible injuries?
Notify MD, Charge, house supervisor
Take the patient to CT
Notify family if needed
Make the patient a forever high fall risk
Chart what happened
File an incident report
Reports on Patients Falling in Hospitals
Each year, somewhere between 700,000 and 1,000,000 people in the United States fall into the hospital. A fall may result in fractures, lacerations, or internal bleeding, increasing health care utilization.
Falls occur at a rate of 3–5 per 1000 bed-days
Resulting in around 250,000 injuries and up to 11,000 deaths
Approximately one in four falls result in injury, with about 10% resulting in serious injury.
Most Common Causes of Patient Falls
We looked at several websites to see the most common causes of falls. According to some law firms, the most common causes of falls are:
To avoid this situation, watch the full episode here 👇👇👇
TIMESTAMPS:
00:00 Introduction 03:02 Matt’s Patient Fall Experience 10:20 Peter’s Patient Fall Experience 16:46 Who is liable for patient falls 20:26 What to do when a Patient Falls 24:55 LAW FIRM: Most commons reasons why patients fall 28:44 Healthcare Joint Commission: Most commons reasons why patients fall 37:52 Wrapping up the show
The renal system produces, stores, and eliminates urine. Kidneys make urine by filtering wastes and extra water from the blood. Urine travels from the kidneys through two thin tubes called ureters and fills the bladder.
When the bladder is full of urine, a person urinates through the urethra to eliminate the waste.
Functions of the Kidneys
The kidneys are located on either side of the spine at the lowest level of the rib cage, consisting of the functional unit called a nephron.
There are about one million nephrons in each kidney; these nephrons consist of tiny blood vessels called glomerulus attached to a tubule.
When blood enters the glomerulus, it is filtered, and the remaining fluid passes to the tubule. In the tubule, minerals, elements, chemicals, and water are absorbed or filtered according to the body’s needs to create the final product, urine.
Our kidneys maintain a delicate balance of water and electrolytes in the body and remove excessive waste:
Remove wastes, urea, and ammonia, from the blood.
Maintain fluid status balance in the body by holding or retaining water and releasing and removing water from the bloodstream
It maintains the electrolyte balance of the blood.
Maintain acid-base/pH balance of the blood
Assist with endocrine functions such as the production of erythropoietin and calcitriol.
It is needed to produce red blood cells and calcium reabsorption, respectively.
Produce the enzyme renin
Help regulate blood pressure.
Convert vitamin D into its active form
Fun Fact:
Every 24 hours, your kidney filters 200 quarts of fluid. About two quarts are removed from the body, and 198 quarts are returned to the bloodstream.
The right kidney sits lower than the left kidney.
It helps accommodate the large size of the liver, right above the right kidney.
We call it REabsorption rather the just absorption because the substances filtered from the glomerulus were already absorbed through the GI tract and taken into the bloodstream.
Then the substances travel through the body via the heart and are sent to the kidneys through the renal artery to be filtered out. Therefore, our body reabsorbs these nutrients based on their needs, and the leftovers are excreted in the urine.
Anatomy of the Kidney
As a nurse and a nursing student, you’ll need to know these most critical parts of the kidney to understand how the renal system works.
Renal Capsule
The outer layer of the kidney protects the kidney from outside organ infections.
Renal cortex:
A layer outside contains the renal corpuscles, which house the glomerulus and Bowman’s capsule, whose primary functions are to FILTER the urine and renal tubules.
Renal medulla:
The inside layer is located within the renal pyramids. It is hypertonic and very salty. Along with the nephron, these conditions help maintain water and salt balance in our body, specifically the Loop of Henle.
Renal artery:
The renal artery takes oxygenated blood from the heart and moves it to the kidney to be filtered. It branches off around the renal columns into the renal cortex, into arterioles, and finally to the peritubular capillaries.
Renal vein:
The renal veins take filtered blood to heart for re-oxygenation and are pumped throughout the body. It comes from the efferent arterioles.
Renal pyramids:
Lie Within the renal medulla contains the loop of Henle and parts of the collecting tubule.
Renal papilla, minor and significant calyx:
Pointed projections of the renal pyramid play a role in draining urine along with the renal pelvis, ureters, bladder, and urethra.
Nephrons:
The functional part of the kidneys.
Filters the blood via the renal corpuscle
Reabsorbs minerals/water and secretes waste via the renal tubule
Produces urine which drains down into the ureters, is stored in the bladder, and voided out via the urethra.
Each nephron is composed of
Renal corpuscle (glomerulus within Bowman’s capsule)
Proximal tubule
An intermediate tubule (loop of Henle)
A distal convoluted tubule, a connecting tubule, and cortical, outer medullary, and inner medullary collecting ducts.
Glomerulus:
Lies within the nephron
Circular capillaries that have incredibly high pressure helps perform ULTRAFILTRATION.
Bowman’s capsule
Forms a cup-like sack around the glomerulus
It helps the glomerulus filter blood
The Nephron and blood supply
Blood enters the afferent arteriole and sends blood to the first part of the nephron, called the glomerulus.
In the glomerulus, blood will be filtered, and filtrate will be created, a liquid consisting of the collection of fluid and particles from the blood.
The filtrate will “drip” down into a capsule surrounding the glomerulus called Bowman’s capsule.
Bowman’s capsule collects the filtrate.
Water, NA, CL, CA, K, Mg, Phos, Bicarb, amino acids, glucose, creatinine, and urea.
Then the filtered blood exits via the efferent arterioles to the peritubular capillaries surrounding the nephrons.
Peritubular capillaries carry the reabsorbed nutrients from the filtrate back into the body’s system to the renal vein. They secrete urea, ions, and drugs in the blood into the tubules.
The created filtrate then flows through the proximal convoluted tubule (PCT); here, the tubule reabsorbs most of the parts of the filtrate that we need to function that just came from the Bowman’s capsule.
Then the filtrate enters the Loop of Henle; we are now in the renal medulla. The loop of Henle has a descending limb and ascending limb. Its goal is to concentrate the urine via the renal medulla.
The renal medulla’s interstitial fluid is hypertonic, helping reabsorb water from the filtrate to maintain the body’s water and salt balance.
Descending limb is only permeable to water.
Ascending limb is only permeable to ions.
The filtrate then enters the distal convoluted tubule, where more substances are reabsorbed and secreted.
Then it travels to the collecting tubule, where parts of the filtrate are reabsorbed.
Finally, the filtrate leaves the collecting tubule as urine which flow through the renal papilla, minor/major calyx, renal pelvis, ureters, bladder, and urethra.
Kidney and Blood Pressure Management
The renin-angiotensin-aldosterone system (RAAS) is the system of hormones, proteins, enzymes, and reactions that regulate your blood pressure and blood volume long-term.
It regulates your blood pressure by increasing sodium (salt) reabsorption, water reabsorption (retention), and vascular tone (the degree to which your blood vessels constrict or narrow). The RAAS consists of three major substances including:
Renin (an enzyme).
Angiotensin II (a hormone).
Aldosterone (a hormone).
RAAS System
Increases blood pressure when it drops too low by activating Angiotensin II
Angiotensin II increases vasoconstriction, causing an increase in blood pressure. Conserves sodium and water to increase volume. Aldosterone and ADH are released.
The sympathetic nervous system sends nerve impulses to Juxtaglomerular Cells in the kidneys to release RENIN.
RENIN present in the blood will activate ANGIOTENSINOGEN in the liver.
ANGIOTENSINOGEN then turns into ANGIOTENSIN I causing a release of ACE
ACE is Angiotensin-Converting Enzyme. ACE converts Angiotensin I into ANGIOTENSIN II
ANGIOTENSIN II activation will cause
Vasoconstriction
Increases systemic vascular resistance (SVR) and blood pressure.
Increase Blood Volume
Kidneys will keep water and sodium.
The adrenal cortex gland will be triggered by angiotensin II to release aldosterone. Aldosterone will also cause the kidneys to keep sodium and water and excrete potassium.
Angiotensin II triggers the pituitary gland to release ADH. It causes the kidneys to keep water.
2. Increased blood pressure
To learn more about the renal system, click here for the full episode 👇👇👇
TIMESTAMPS:
00:00 Introduction 02:10 The functional parts of the kidney 03:18 What does a kidney do 04:40 Kidney fun facts 05:40 Anatomy of the kidney 10:00 The nephron and blood supply 15:48 Kidney and blood pressure management 17:39 How the Renin-Angiotensin-Aldosterone System (RAAS) works 21:50 Further views on the episode 24:02 Wrapping up the show
Sports psychology is a practical skill that helps address athletes’ optimal performance and well-being. How can this be used? And what do you know about sports psychology?
Traumas and repressed emotions can affect us in the long run. Some of us can handle these emotions well, while others displace them, creating more trauma, stress, fear, anger, resentment, depression, and anxiety.
How can people heal from this? Is there a way to work through these feelings?
In this episode, we would like to introduce you to Sean O’Connor. Sean is a licensed mental health counselor (LMHC) at Peaceful Living Mental Health Counseling in Scarsdale, NY.
He specializes in sports psychology and trauma-informed counseling to help adults and athletes overcome anger, depression, anxiety, PTSD, and stress.
To treat his patients, he uses a combination of EMDR therapy, mindfulness, meditative science, polyvagal theory for nervous system regulation, and neurofeedback when working with clients.
Sean loves working with athletes and survivors of past trauma to help them heal from the past, love the present, and have hope for the future.
Questions for Our Guest
The questions below are some we’d like to tackle. We often go off-topic, so we don’t expect to hit them all. If you have any ideas, please let us know.
Looking forward to our conversation!
These are the questions you had in Calendly. We’ll go off your questions and wherever else our conversation goes.
Can you give us a little background about yourself?
2. How did you get into Sports Psychology & what is sports psychology?
3. How do Athletes cultivate their identity?
4. What does it take to improve your mental health?
What is the simplicity of happy living?
What are some common stigmas in mental health?
5. How does holistic health play a role in mental health?
6. What is the Polyvagal theory?
7. What is the problem with the age of information?
8. Martial arts
ENDING QUESTIONS
Before we end the show, we have one last question we like to ask all our guests. If you had the opportunity to have a Cup of coffee with anybody one last time, who would it be & why?
Do you want to know more about sports psychology? Click here for more 👇👇👇
TIMESTAMPS:
00:00 Introduction 02:11 About Sean O’Connor 08:41 What is the language of an Athlete 12:13 The most frequent problems that athletes face 15:35 What transpires when an athlete leaves their sport 17:37 How to guide struggling athletes 22:34 What are the traits of an athlete 25:27 How to overcome extreme pressure and performance anxiety 30:38 How to communicate to a person who is tense and fearful 36:02 How important is physical health to mental health 40:16 How to recognize danger and when it exists 43:25 How our emotions make our consciousness 48:18 The negative impacts of the modern age of information 52:31 What makes EMDR more efficient 58:43 How martial arts enhance both mental and physical health 01:08:03 How martial arts foster self-control 01:11:45 The significance of a warm community 01:19:48 What separates an elite athlete from the rest 01:22:13 Wrapping up the show
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