How Not to Kill Your Patient

How do you create a drama-free shift? Start by recognizing patient deterioration before it becomes a code. In this episode, Kevin and Dr. Lisa Wolf discuss how patients often show signs of deterioration hours before cardiac arrest—and why those warning signs are too easily missed, minimized, or handed off to the next shift. From subtle changes in mental status and relative hypotension to rising re...

In this episode, Kevin and Dr. Wolf tackle a listener question about hourly rounding, and the conversation quickly evolves into a larger discussion about how healthcare systems often implement sweeping changes with little to no evidence behind them. From "check-the-box" tasks to reactionary policies created after adverse events, they explore how well-intentioned interventions can become burdensome...

We've all heard, "Pain is whatever the patient says it is." But do we actually practice that way? In this episode, Kevin and Lisa dive into a fascinating mixed-methods study exploring how nurses think about pain and how those beliefs change when real clinical decisions are made in triage. Dr. Wolf unpacks research examining nurses' attitudes, behaviors, and hidden biases surrounding pain assessmen...

Vaccines are one of public health's greatest success stories—but what happens when people start saying no? In this episode, Kevin and Dr. Lisa Wolf dig into the rising tide of vaccine refusal, what's fueling it, and how it's already impacting what we see in the emergency department.   If you've ever struggled to explain vaccine science to a skeptical patient, this episode is essential listening. R...

Fluid and electrolyte emergencies are the silent killers you might not notice until your patient crashes. In this episode, Kevin and Dr. Lisa Wolf break down the classic (and not-so-classic) presentations of hypo/hypernatremia, hypokalemia, hyperkalemia, and calcium derangements—and how they impact perfusion, mental status, and cardiac rhythm. Follow us on: Facebook:  https://www.facebook.com/Art-...

What happens when you're not the one about to make the mistake, but you're see someone about to make an error?   In this episode, Kevin and Dr. Lisa Wolf tackle one of the toughest ethical and professional dilemmas in healthcare: how to intervene when a colleague is on the verge of harming a patient. From quiet cues to full-on halts, theydive into the art of the interruption.   You'll also hear wh...

In this episode, Kevin and Dr. Lisa Wolf tackle the critical issue of intimate partner violence (IPV) and its implications for emergency nursing. They break down why IPV is often missed, how it can present in ED, and the subtle red flags that signal deeper concerns. From the limitations of triage screening to the importance of private conversations, they share strategies to identify and respond to...

In this episode, Kevin and Dr. Lisa Wolf dive into the ethical principles that shape nursing practice.   Nursing ethics are not just in crisis situations, but in the everyday decisions nurses make every single shift. From returning the bladder scanner to honoring patient autonomy, we explore how small actions reflect deep ethical commitments. Follow us on: Facebook:  https://www.facebook.com/Art-o...

In this episode, Kevin and Dr. Wolf dive deep into the under-discussed but critically important world of renal and urologic emergencies. From the agony of kidney stones to the subtleties of urinary retention.   They discuss the dangers of delayed diagnosis, unpack key presentations, triage considerations, and red flags that emergency nurses must recognize. Urine color chart Click here https://www....

Measles: It's Back, It's Contagious, and You Probably Haven't Seen It Before In this episode, Kevin and Dr. Lisa Wolf dig into the return of a disease we thought had been eradicated in 2000. In case you missed it—we're in the middle of a national measles outbreak, and chances are high you've never actually seen a real case. Measles is back, and we need to be on high alert, as it remains one of the...

In this episode, Kevin and Dr. Wolf delve into a critical but often underestimated condition: alcohol withdrawal syndrome (AWS). They challenge the assumptions and biases emergency nurses may bring to patient care, particularly in identifying withdrawal symptoms in individuals who don't fit the "typical" profile. The discussion emphasizes the importance of early recognition, exploring how biases c...

In this episode, Kevin and Dr. Wolf dive deep into the critical role that leadership plays in communicating change.   Dr. Wolf, shares insights from a soon to be published study on how emergency nurses are being left in the dark regarding changes in practice laws, particularly around pregnancy complications in states with restrictive abortion policies. We explore the consequences of silence, inclu...

When "Do Everything" Isn't the Answer.  In this episode we discuss one of the most complex and emotionally charged aspects of emergency care: navigating code status and advance directives. We unpack the nuances of "Do Not Resuscitate" (DNR) orders, the dynamics of family presence during resuscitations, and the moral dilemmas that arise when patient wishes conflict with family demands. If you've ev...

In this episode, Kevin and Dr. Wolf dive deep into the complex world of behavioral health in the emergency department. Too often, psychiatric patients are treated as though their visit is a carceral event—stripped of autonomy, dignity, and decision-making capacity. We explore the ethical dilemmas, systemic barriers, and practical challenges that emergency nurses face when caring for patients with...

Kevin and Dr. Wolf dive into the critical skill of the medication assessment. They explore how understanding a patient's medication list can provide invaluable insights into their overall health and guide essential clinical decisions, especially in high-stakes environments like the emergency department. The pair discusses the ethical and legal responsibilities tied to medication administration, st...

In this crossover episode of "How Not to Kill Your Patient" and "Art of Emergency Nursing," we dive into the critical topic of moral courage within the nursing profession. Kevin and Lisa discuss Lisa's recent study on how emergency nurses handle ethical dilemmas, particularly in states with restrictive abortion laws. We explore the complexities of balancing professional and personal ethics, the ba...

In this episode, Lisa and Kevin discuss the importance of accurate triage in emergency departments and its impact on patient outcomes. They critique current triage models that prioritize metrics such as length of stay and door-to-physician time over patient outcomes. They remind us that a thorough nursing assessment is essential for patient safety and effective care. The episode highlights the dis...

I found this episode from 2022 never posted so I updated the episode, but it didnt show up as a new episode so this is the repost. In this episode, Kevin and Dr. Wolf talk about emergency nurses floating out to the department into other areas.  Hopefully, this doesn't happen often but we talk about what to expect when it happens and how not to kill your floor patients.   

This episode of HNTKYP features Kevin and Dr. Lisa Wolf discussing anxiety. They explore the complexities of diagnosing anxiety, emphasizing the importance of ruling out serious underlying conditions before attributing symptoms solely to anxiety. They stress the importance of not dismissing physical symptoms like tachycardia, tachypnea, and numbness as mere anxiety until ruling out all other poten...

In this special collaborative episode, part of the "Nurses Podcrawl," Dr. Wolf and Kevin delve into the fascinating world of distributive shock. As part of a unique project featuring seven different podcasters, each covering a specific type of shock, our hosts take on distributive shock, exploring its nuances and critical aspects and this super cool type of shock Listen to all the episodes here: @...

This episode of HNTKYP Kevin and Dr. Lisa Wolf take a deep dive into the high-stakes world of shock management.   Why does it matter you ask?   If you miss the early signs of septic shock, and 30% of those patients won't make it home. This episode provides a comprehensive overview of the different types of shock – hypovolemic, distributive, cardiogenic, and obstructive – detailing their causes, si...

This episode of HNTKYP delves into the crucial distinction between merely knowing nursing protocols and truly understanding them. Kevin and Dr. Wolf discuss the importance of nurses not merely performing tasks or following protocols blindly but grasping the underlying pathophysiology and the reasoning behind the actions they take and the medications they give. This episode highlights the importanc...

This episode of HNTKYP takes a no-holds-barred look at burnout among emergency nurses, and it's not for the faint of heart. We're getting real about the brutal reality of the emergency department, where the relentless pressure cooks even the toughest among us. We talk about how burnout not only affects the nurse, but the team and most importantly the patient. It's a deep dive into the dark side of...

Understanding how to prioritize patient care is essential, particularly for new ER nurses. This HNTKYP episode offers a systematic approach to assessing and managing a typical patient assignment ranging from four to six individuals. We delve into the critical nature of effective report-giving and receiving, the significance of delegation and teamwork, and the risks associated with the forgotten pa...

In this episode, Kevin makes it back from the brink of death from the deadly "man flu." Just kidding, but he really was sick, and it inspired this week's topic on the respiratory season. We cover some of the most prevalent viral respiratory diseases and how to prevent them.   We discuss red flags that may signify that your patient is in trouble.   Our conversation delves into the collective respon...