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Dialysis Nursing with Alayna Laranjo, ADN, RN

In this episode, I join Alayna Laranjo who is a Dialysis Nurse and in Dialysis clinical care for 9 years. We talk about her upbringing as a fire fighter and upbringing in healthcare as an EMT, Medic and 911 Dispatcher. We talk all things from preparing for a mass casualty, teaching classes, and even receiving a call that lead to the birth of twins! We then move into how she became a Certified Clinical Hemodialysis Technician, as well as the importance of a longer orientation and continual learning environment. Moving into her career as a nurse became a passion for wanting to do more for the patients she was taking care of. We also detail the daily life of a dialysis nurse, what her 5am-2pm shift is like, and how important wellness is for nurses. Alayna  started out her career in the emergency medical services as an EMT for 6  years, a medic for 10 years and 911 dispatcher for 7 years. She even  taught EMT classes for 2 years. Alayna decided to change careers and  started out in a dialysis clinic that lead her to become a Certified Clinical Hemodialysis Technician. She eventually decided to attend nursing school and graduated with her Associates Degree in Nursing in 2012. She has been with the same dialysis company for 9 years and has a thorough passion for dialysis patients and dialysis nursing. Alayna is about to graduate with her BSN and will eventually pursue her Master’s in Nursing Leadership in the fall. In her personal time, she is a  softball umpire, triathlete, and raises her children in the town of Troy, NY.---Support this podcast: https://anchor.fm/virtualclinical/support
August 3, 2020
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Doctors shouldn’t feel ashamed for wanting to protect themselves or their family

"Although I personally hope to continue to be at or near the frontlines, I understand those that are in a compromised position, and they shouldn’t feel ashamed for wanting to protect themselves or their family. There is no portion of the Hippocratic Oath that implicitly or explicitly states that physicians have a duty to patients above their own safety. Even though we’re in the midst of the pandemic, I’ve found it to be a beneficial practice to reflect and think about the way we can improve the safety and efficacy of those delivering care. While it may be commendable to rush to be directly involved in patient care, we need to take a step back and review the role that residents play: who is being put on the frontlines, how is that being decided, and how is this impacting resident burnout? This is one of the many questions I hope can be thoughtfully revisited after the emergency of the pandemic is over." Jon Zaid is an internal medicine physician who blogs at 34justice. He shares his story and discusses his KevinMD article, "Doctors shouldn’t feel ashamed for wanting to protect themselves or their family." (https://www.kevinmd.com/blog/2020/04/doctors-shouldnt-feel-ashamed-for-wanting-to-protect-themselves-or-their-family.html)
August 3, 2020
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174 – Update 6.2 – Changing Sh*t up

Time for a new update!!! This is Update 6.2! Have I been keeping track of the updates so far? Hell no, but just know that I’m moving forward with my updates. Dr. Renee jumps on and helps me explain the new changes for the show. Here’s what to expect on this episode: Focus on the 3 M’s for the show Money Mindset Mission Shout out to my successful podcast coaching alumni and current student: 3 Friends Talk Podcast The Mindset Experience Understand your voice is intellectual property
August 3, 2020
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Patient no-shows often have complicated reasons behind them

"I typed up a brief response to the no show memo, hit reply, and then deleted the original message. It’s not that I am a fan of wasting time and resources, but for now, I have a general personal policy to never dismiss pregnant patients. I’d have to try to address her barriers to care.  Again.  Our clinic tended to be a safety net for health care in the city, if I dismissed her, where would she go?  I do believe people can be changed.  Also, help me when I really don’t believe it." Erin Hoffman is a family physician. She shares her story and discusses her KevinMD article, "The patient who no-shows." (https://www.kevinmd.com/blog/2020/05/the-patient-who-no-shows.html)
August 2, 2020
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Practice empathy and compassion for the critically ill and dying

"It seems as though the looming reality for many of us is that we will have patients who need ventilators, and none will be available. It seems like we might benefit from remembering that we can still succeed in practicing medicine by being present with those suffering before us, even when we know we cannot cure them of disease. In a more pragmatic sense, maybe in addition to logistical discussions and articles about how ERs and ICUs are going to decide who should get a ventilator, we should also discuss how we are going to communicate with empathy and compassion to the families of the critically ill and dying; there are ways to learn to do this well that alleviates heartache for families and for physicians." Elaine M. Colby is a family physician. She shares her story and discusses her KevinMD article, "When should we start having a discussion about palliative and end of life care?" (https://www.kevinmd.com/blog/2020/03/when-should-we-start-having-a-discussion-about-palliative-and-end-of-life-care.html)
August 1, 2020
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If you want to be a physician-inventor, here’s what you should know

"If you have an employment agreement with a provision on intellectual property, have it reviewed by an attorney before you begin applying for patents. A good attorney should be able to give you some clarity. Suppose, however, that your employment agreement has muddied the waters a bit. In that case, you have a few different options, and all of them will come with some risk. First, you may speak with your employer vaguely about your plans and attempt to get a release, or work out some other agreement so that you can pursue your project alone. In some cases, collaboration may provide you with the resources to proceed, and ease a bit of the financial burden. Of course, this may bring undesired attention to you, and may require some diplomacy and care. Second, you may sit on your invention or change your employment. Here, time is working against you and may affect the patentability of your invention. Additionally, it’s possible that even after the termination of your employment, that your old employer will still claim a right to an invention that was conceived during your employment with them. Third, you can forge ahead without telling your employer. There are no easy answers, but this is the requisite analysis, and it is quite easy to make a mess. If you do intend to pursue an invention while employed, a good rule of thumb is to work on your invention on your own time, in your own house, using your own resources and your own money. You don’t want to blur the lines. You want to clearly differentiate between your property and your employer’s." Peter D. Sleman is an attorney.  He is the author of The Physician Inventor: The Doctor’s Handbook to Patenting Medical Devices and Methods. (https://amzn.to/3htbjgk) He shares his story and discusses his KevinMD articles, "Intellectual property provisions in physician employment agreements" (https://www.kevinmd.com/blog/2020/03/intellectual-property-provisions-in-physician-employment-agreements.html) and "The COVID-19 breakthroughs are coming." (https://www.kevinmd.com/blog/2020/03/the-covid-19-breakthroughs-are-coming.html)
July 31, 2020
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A Savvy Nurse Scribe Graces the Airwaves | The Nurse Keith Show, EPS 281

On episode 281 of The Nurse Keith Show nursing career and healthcare podcast, Keith interviews Janine Kelbach, BSN, RNC-OB, an accomplished nurse writer, educator, entrepreneur, and host of The Savvy Scribe podcast. Keith and Janine discuss networking, writing, starting a business, podcasting, and why Janine hasn't left the bedside. Nurse Keith is a holistic career coach for nurses, as well as a professional podcaster, published author, inspiring speaker, and successful nurse entrepreneur. 
July 31, 2020
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The Virtual Waiting Room with Shelby Sanderford, CEO & Founder of DOCPACE

Waiting for your appointment in a doctor's lobby can be frustrating. And in this time of COVID, we want to minimize being in public places as much as possible. Today's guest in the podcast has a great solution to the waiting room problem. Shelby is the founder and CEO of DOCPACE, a virtual waiting room. In this interview, Shelby discusses how her company identifies bottlenecks within the appointment process and helps providers eliminate operational inefficiencies to make a seamless and easy journey for both patients and providers. Tune in and find out how DOCPACE can help your practice!
July 30, 2020
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Pain management’s painfully fine line

"I find that managing chronic pain can be a bit of a dance between myself and the patient. Sometimes a little bit of a compromise. I always tell my patients that pain is subjective but many things can contribute to pain — certainly stress, lack of sleep, any emotional issues can make pain worse. Your pain is different than my pain. I don’t like to use the word “tolerance” when it comes to opioids, but certainly, some people are able to tolerate pain more than others. But it does go back to the emotional component related to pain. One of my attendings in fellowship — known to be a bit of a hard ass — used to tell our patients, you can’t die from pain. Your blood pressure that’s 210/110? That can kill you. The 100 percent blockage of your artery in your heart? That can most certainly kill you. Your smoking four packs a day? That may kill you. Your pain is a by-product of your experience. Snowing yourself with opioids only tricks your body into believing there’s nothing more serious going on. And it’s a temporary solution for a more permanent problem." Michelle Dang is an anesthesiologist and hosts the podcast, WISH Well. She shares her story and discusses her KevinMD article, "The painfully fine line of pain management." (https://www.kevinmd.com/blog/2018/06/the-painfully-fine-line-of-pain-management.html)
July 30, 2020
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Healthcare Spatial Analytics: Addressing the First Mile with Hillit Meidar-Alfi, Founder & CEO at Spatially Health

This episode features Hillit Meidar-Alfi, founder and CEO at Spatially Health. Hillit discusses how Spatially helps health organizations make data-driven decisions that align with both the interests of the company and the population they serve. She also talks about real-world analysis, testing, location data, spatial data, and social determinants of health. Learn how Hillit and her team are optimizing patterns that can accelerate real-world insights into health care! Tune in to this podcast for more information.
July 29, 2020
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A physician embraces the power of the word, “and”

"I struggle for words to describe life in the season of COVID-19. Depending on the day, I need at least a few adjectives: 'peculiar,' 'fine, all things considered,' 'terrifying.' 'Joyous' and 'anxious' certainly make odd bedfellows in my brain. As a mother and physician living this new reality, I’ve been extra thankful for Irene, who taught me the power of “and.” Irene is a clinical psychologist who was tasked with helping my family medicine residency classmates and me build skills for self-care and counseling.  She taught me to replace 'but with 'and' in conversation.  This subtle verbal acknowledgement can reconcile what would typically be perceived as conflicting emotions or realities–like mental yoga.  The shift has served me well in my medical career and in personal relationships.  Imagine how different it feels to hear someone say, 'You’re doing the best you can, but you can do better' versus 'You’re doing the best you can, and you can do better.'" Rachel E. Hines is a family physician. She shares her story and discusses her KevinMD article, "A physician mother embraces the power of 'and' during the pandemic." (https://www.kevinmd.com/blog/2020/04/a-physician-mother-embraces-the-power-of-and-during-the-pandemic.html)
July 29, 2020
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Leveraging Low Cost Technology to Improve Access and Delivery of Care: Voice First Healthcare with Mika Eddy, Clinical Product Innovation at UnitedHealthcare

In this podcast, Mika Eddy, Director of Clinical Product Innovation at UnitedHealth Group, discusses how United is focused on driving preventative care to help lower cost and improve the quality of the care delivered in and across our system. She shares her thoughts on solutions to improve patient experience, changes in the healthcare system brought by the COVID-19 pandemic, and possible integrations that will go a long way to helping people be healthy. Tune in to hear our interview with the exceptional Mika Eddy!
July 28, 2020
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How physicians can share health information and manage dissent online

"In the time of the COVID-19 pandemic, I am both hopeful and inspired as well as disappointed. I see those angry that their ideas or opinions conflict with science. Instead of the steady path and hard work of building bridges, they create division. I see many capitalizing on fear and uncertainty, weaving a compelling story and drawing in the desperate ones who need a scapegoat, an explanation, or some form of certainty. It’s OK to be a dissenter. It’s OK to challenge what seems to be the status quo. It’s OK to ask questions about why we do things the way we do them. But if you really want to see a meaningful conversation, you must go about it in the right way. The right way is usually slow and painful but full of the promise of refinement that only comes through allowing our work and our perspectives to pass through the filters of those who see the world differently. Only then can the purest form of our questions be answered, and our message be heard." Jaclyn Lewis Albin is an internal medicine-pediatrics physician. She shares her story and discusses her KevinMD article, "Dissent in the time of COVID-19." (https://www.kevinmd.com/blog/2020/05/dissent-in-the-time-of-covid-19.html)
July 28, 2020
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Mid-Career Nurses Take it to the Next Level | The Nurse Keith Show, EPS 280

On episode 280 of The Nurse Keith Show nursing career and healthcare podcast, Keith interviews certified executive performance and life coach Nicole Coustier regarding mid-career positioning, owning your expertise, networking, resumes, and much more that can help you take your nursing career to the next level of authenticity and accomplishment.  Nurse Keith is a holistic career coach for nurses, as well as a professional podcaster, published author, inspiring speaker, and successful nurse entrepreneur.  The Nurse Keith Show is a proud member of Ars Longa Media, a collaborative network of podcasts and media entities adding a humanistic touch to professional education, educate the public from a scientifically informed perspective, and improve lives by addressing social ills. The Nurse Keith Show is also a proud member of The Health Podcast Network, one of the largest and fastest-growing collections of authoritative, high-quality podcasts taking on the tough topics in health and care with empathy, expertise, and a commitment to excellence. Show notes NurseKeith.com Facebook.com/NurseKeithCoaching Twitter.com/nursekeith Instagram.com/nursekeithcoaching LinkedIn.com/in/keithallancarlson
July 28, 2020
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An Effective Approach to Fluid Management with John Erb, Chairman and CEO, CHF Solutions, Inc.

In today's episode of Outcomes Rocket, we are excited to share with you our interview with John Erb, CEO and Chairman of the board at CHF Solutions. John talks about how Aquadex makes fluid management smarter and easier. He went to the details of Aquadex works to showcase how it supports patients, He also shares some of the help his company has extended to facilities treating COVID-19 patients.If you're thinking of expanding your portfolio for a company with a billion-dollar potential or you're looking for an ultrafiltration device to advance the quality of care in your hospitals, this is a podcast you must not miss.
July 27, 2020
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What physicians today can learn from the history of surgery

"Billroth spent long hours dissecting cadavers and planning on surgical interventions. He was able to pioneer abdominal surgery with careful preparation and strict adherence to meticulous antiseptic technique. Animal experimentation and cadaveric-rehearsed surgery emboldened the Viennese professor; perhaps the abdomen could be entered. Nothing short of a 'godlike creative spirit,' as Mukherjee calls it, would suffice when it came to intestinal surgery. Vienna has a centuries’ old reputation for virtuoso performances; with Imperial spirit, maestro Billroth would take his place for master class performances in the greatest theater in the City of Music: the Allgemeines Krankenhaus operative theater. In 1872 Billroth resected a portion of the esophagus and joined the ends together. In 1873, he performed the first complete excision of a larynx. Even more amazing, he became the first surgeon to excise a rectal cancer, and by 1876, he had performed thirty-three such operations. What seems commonplace today (abdominal surgery) is nothing short of a stupendous magic act, in reality." David J. Schneider is an orthopedic surgeon and author of The Invention of Surgery: A History of Modern Medicine: From the Renaissance to the Implant Revolution. (https://amzn.to/2CtzDQb) He shares his story and discusses his KevinMD article, "Surgery is nothing short of a stupendous magic act." (https://www.kevinmd.com/blog/2020/03/surgery-is-nothing-short-of-a-stupendous-magic-act.html)
July 27, 2020
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Is our biggest strength our greatest weakness? Dr. Danielle Ofri joins Dr. Nii to discuss whether our professionalism is being taken advantage of by hospitals.