A great 18 minute summary of my experience from the Langone Critical Care Cardiology Symposium in 2024, NYC youtu.be/h_QFZjmdkNQ

SNAP-3: 7,128 UK patients aged 60 and over having surgery in 214 hospitals. Median hospital stay was 12.5 days with delirium and 1 day without. After adjusting for age, frailty, multimorbidity and type of surgery, delirium added 5.2 days (95% CI 3.8 to 6.5), and the odds of death within a year doubled. Observational, so some influences were not measured. doi.org/10.1016/j.bja.2026.0…

NICE says the diagnosis of delirium should be written in the person's notes and in their GP record. SIGN says the discharge letter should say the person had delirium, and that everyone who has had delirium should be reviewed by the primary care team. A letter that names the delirium, its cause, whether it has cleared and what the family were told gives the GP something to act on.

One of my biggest fears is the ~23 days in ICU I spent in delirium will result in accelerated dementia, alzheimer’s or other cognitive decline.

This All Day!!!

Phoenix roll call: Who’s going to EN2026? Emergency Nursing 2026 is coming to Phoenix, Arizona, September 28–October 1, and we want to hear who’s packing their bags! Somewhere in Phoenix, a restaurant is about to learn what emergency nurses consider appropriate dinner conversation. What’s the ONE thing you’re most looking forward to? Is there a session we should have on our radar, or are you counting down to seeing your nursing friends? Drop your state and your conference must-do in the comments. Tag someone you’re hoping to see there so they know to find you! #EN2026 #EmergencyNursing #ENA #ResusMed #TNCC #ENPC

ENPC 7th Edition is here! Pediatric emergencies can arrive on any shift. ENA’s updated Emergency Nursing Pediatric Course brings new content and learning activities to help nurses prepare for those moments. What’s new in the 7th Edition? • A dedicated “The Child in Shock” chapter. • The new PNP Primary Assessment Algorithm to guide assessment and interventions. • Expanded coverage of tuberculosis, brief resolved unexplained events (BRUEs), and emergencies involving heat or cold. • Practical strategies throughout the course to help strengthen pediatric readiness. • Fresh interactive activities for virtual and in-person learning. • Updated global child health content addressing cultural humility and health equity. The full provider course offers 19 CNE hours, with four-year ENPC provider verification earned upon successful completion. Whether you work in a pediatric ED or care for children in a community emergency department, this education applies to the patients who come through your doors. ENA says 7th Edition courses are coming soon. Follow ResusMed for updates on course availability. Ask use about our corporate programs and discounts. ResusMed.com/events #ENPC #PediatricEmergencyCare #EmergencyNursing #ResusMed #TNCC

"Hospitals are being cited for violating the federal emergency-care law more often than at any point in more than a decade, according to a Becker’s analysis of CMS inspection data. Deficiencies under the Emergency Medical Treatment and Labor Act — the law requiring hospitals to screen and stabilize anyone who arrives at the emergency department, regardless of ability to pay — appeared in 422 hospital inspections in 2024, the most in a public dataset spanning 2010 to 2026. " beckershospitalreview.com/le…

Saturday night shift with some good cardiac cases #WhiteBoardTeaching #foamed

410+ nurses registered so far. At this point, calling it a study group feels a little ambitious. We may need to start calling it an emergency nursing convention. HCA Healthcare and HealthTrust nurses are showing up in force for the ResusMed Live Virtual Certified Emergency Nurse (CEN) Review Course. October 28–29, 2026 14 CE contact hours Free for eligible HCA Healthcare and HealthTrust employees The CEN exam has a reputation for being tough. Fortunately, emergency nurses are not exactly known for backing away from a challenge. Contact your nurse educator for your facility or division registration coupon code. Sponsored and funded by HCA Healthcare East Florida Division. Powered by ResusMed. #CEN #CertifiedEmergencyNurse #EmergencyNursing #HCAHealthcare #HealthTrust #NursingEducation #ResusMed #TNCC #ENPC

WOW. More than 370 HCA Healthcare and HealthTrust nurses have already registered for the ResusMed Live Virtual CEN Review Course! Apparently, someone mentioned FREE continuing education and the nurse group chats took it from there. CEN stands for Certified Emergency Nurse, a national board certification focused on the knowledge and clinical judgment required in emergency nursing. The exam deserves serious preparation. BCEN’s 2025 exam statistics show that roughly half of candidates with reported pass-or-fail outcomes passed the CEN exam. In other words, “I work in the ED, so I’ll probably be fine” may need a study plan. Course details: October 28 and 29, 2026 Live virtual instruction 14 continuing education contact hours FREE for HCA Healthcare and HealthTrust employees Preparing to take the exam soon? Join more than 370 colleagues for two focused days covering the major CEN content areas. Nurses considering certification later will also gain a comprehensive review of emergency nursing practice. Contact your nurse educator for your facility or division coupon code and direct registration link. Sponsored and funded by HCA Healthcare East Florida Division. Presented by ResusMed ResusMed.com #CEN #CertifiedEmergencyNurse #EmergencyNursing #HCAHealthcare #HealthTrust #NursingEducation #ResusMed #TNCC #ENPC

HCA Healthcare and HealthTrust emergency nurses: Join ResusMed for a live virtual, two-day CEN Review Course. October 28 and 29, 2026 9:30 a.m. to 6:00 p.m. Eastern each day 14 continuing education contact hours FREE for HCA Healthcare and HealthTrust employees Strengthen your emergency nursing knowledge while preparing for the CEN exam. The course also provides a broad, practical review for nurses who are still deciding when to pursue certification. Contact your nurse educator for your facility or division coupon code and direct registration link. Sponsored and funded by HCA Healthcare East Florida Division. Presented by ResusMed ResusMed.com #CEN #EmergencyNursing #HCAHealthcare #HealthTrust #NursingEducation #ResusMed #TNCC #ENPC

Lexie Hull brought the heat for tonight's first pitch at the @indyindians game ⚾️

Never gets old watching Caitlin punk Dijonai 😂😤😂😤

Handing over the @nyulangone Division of Cardiology to @SVRaoMD in pretty good shape! Thankful for great colleagues who still believe in and support the tripartite mission of academic medicine - even in these most challenging of times.

Congrats @SVRaoMD 👏🏼👏🏼👏🏼 #Cardiotwitter @RadialFirstBot @mmamas1973 @SandeepNathanMD @fischman_david @Allison_Dupont @CircIntv @SCAI @Hragy @aymanka @mirvatalasnag

I Miss Delirium: The Strange Comfort of a Broken Reality I miss delirium. Even writing those words feels wrong. I know how that sounds. I know how it looks from the outside. Delirium is a medical emergency. It is a sign that something is wrong. The brain is struggling. The body is under stress. It is something healthcare providers work to recognize, treat, and resolve. And yet, from the inside, delirium was something different. For me, it was comfortable. Not comfortable because it was pleasant. Not comfortable because it was safe. Comfortable because it was simple. Reality is complicated. Reality requires decisions. It requires understanding. It requires accepting what is happening around you. It requires processing pain, fear, uncertainty, and everything you may not be ready to face. Delirium removed some of that. It created distance. It placed a barrier between me and the harsh reality of my situation. It was like a warm blanket pulled over my mind. The world became softer. The edges became less sharp. The things that were happening around me did not disappear, but they became farther away. In delirium, time stopped working the way it normally does. Minutes did not feel like minutes. Hours disappeared. The normal rules of existence became flexible. I floated between dreams and reality, between memories and imagined worlds. Sometimes I knew I was somewhere else. Sometimes I did not. Sometimes the world my mind created felt completely real. There were places I went, things I needed to accomplish, problems I needed to solve. I felt like I was trapped inside a story without knowing the ending. The strangest part was the feeling that there was something I needed to do. Something I needed to figure out. Something I needed to complete before I could move forward. It felt like there was a next level. A door. A way out. But I could never quite find it. I would circle back into the same thoughts, the same questions, the same confusion. A loop. A mental maze. Searching for an answer that may not have existed. Not all of it was comforting. There were dark moments. Moments of fear. Moments of confusion. Moments where I did not understand what was happening or what I was supposed to do. There were times when my thoughts became frightening. Times when I wished I could disappear. Times when death seemed like an escape from the confusion. But those thoughts existed inside a brain that was not functioning normally. A brain affected by illness, stress, medications, exhaustion, and an overwhelming medical experience. The person thinking those thoughts was me. But it was not the complete version of me. When delirium finally faded, reality returned. And reality was hard. The room was the same. The illness was still there. The questions were still there. The uncertainty was still there. The difference was that now I had to face it directly. The blanket was gone. The distance was gone. The escape was gone. And that is when I realized something uncomfortable: I missed it. I missed delirium. Not because I wanted to be sick. Not because I wanted to lose control. Not because I wanted to return to confusion. I missed the simplicity. In delirium, I did not have to solve the entire world. I only had to exist inside the moment my mind created. There was no overwhelming future. No endless questions. No complicated decisions. Just one strange reality at a time. Maybe that says something about me. Maybe it says something about the human mind. Maybe when people experience extreme situations, the brain creates places where we can temporarily survive. Delirium is not the same for everyone. For some people, it is terrifying. For others, it may be filled with memories, dreams, conversations, or experiences that feel meaningful. The brain takes whatever pieces it has available and builds something. Sometimes that something protects us. Sometimes it frightens us. Sometimes it does both. The difficult question is: What does it mean when you miss something that was harmful? Maybe it means we are more complicated than we realize. Maybe humans can feel nostalgia for experiences they never want to repeat. Maybe comfort does not always come from good places. Sometimes comfort comes from places that helped us survive. I do not want delirium back. I know what it was. I know what it meant. It was my brain struggling. It was my body telling me something was wrong. But I also understand why part of me misses it. For a short time, it took me somewhere else. It gave me distance when reality was too heavy. It wrapped my mind in a strange, imperfect blanket. And sometimes, even a broken reality can feel easier than a painful one. Delirium is not an escape I would choose. But I understand why, for a brief time, my mind created one.