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How Not to Kill Your Patient
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How Not to Kill Your Patient

Author: Kevin McFarlane RN & Dr. Lisa Wolf

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HNTKYP is a series that address symptomatic presentation and how to move to a working diagnosis and plan for patient care. Kevin McFarlane and Lisa Wolf cover red flags, cognitive pitfalls, and ways to make sure your patients survive their encounter with the health system.
43 Episodes
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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 why modeling behavior matters, how burnout can blind providers, and why letting a mistake slide is more than just dangerous, it’s bullying. If you’ve ever asked yourself, “How do I say something without causing a scene?” this one’s for you. Key Takeaways: Your first loyalty is to the patient There's an art to interrupting mistakes Focus fatigue and burnout cause errors If you don't stop it, you're complicit Modeling matters Letting someone fail is a form of bullying Follow us on: Facebook: https://www.facebook.com/Art-of-Emergency-Nursing-276898616569046/  YouTube: https://www.youtube.com/channel/UCJTnz4phtCTjojTIDJo2afA?view_as=subscriber  Twitter: @AoenPodcast Instagram: https://www.instagram.com/artofemergencynursing/  To support the show: Leave an honest review on iTunes. Your ratings and reviews greatly contribute to the success of the podcast, and I appreciate each and every one of them. Subscribe on Apple Podcasts, Google Podcasts, or your preferred podcast platform to never miss an episode. Thank you for being a part of our AOEN community!
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 intimate partner violence Links to articles Warning Signs of Partner Abuse in Intimate Relationships Intimate Partner Violence and Human Trafficking Investigating the prevalence of intimate partner violence victimisation in women presenting to the emergency department in suicidal crisis Follow us on: Facebook: https://www.facebook.com/Art-of-Emergency-Nursing-276898616569046/  YouTube: https://www.youtube.com/channel/UCJTnz4phtCTjojTIDJo2afA?view_as=subscriber  Twitter: @AoenPodcast Instagram: https://www.instagram.com/artofemergencynursing/  To support the show: Leave an honest review on iTunes. Your ratings and reviews greatly contribute to the success of the podcast, and I appreciate each and every one of them. Subscribe on Apple Podcasts, Google Podcasts, or your preferred podcast platform to never miss an episode. Thank you for being a part of our AOEN community!
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-of-Emergency-Nursing-276898616569046/  YouTube: https://www.youtube.com/channel/UCJTnz4phtCTjojTIDJo2afA?view_as=subscriber  Twitter: @AoenPodcast Instagram: https://www.instagram.com/artofemergencynursing/  To support the show: Leave an honest review on iTunes. Your ratings and reviews greatly contribute to the success of the podcast, and I appreciate each and every one of them. Subscribe on Apple Podcasts, Google Podcasts, or your preferred podcast platform to never miss an episode. Thank you for being a part of our AOEN community!
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.medicalnewstoday.com/articles/urine-color-chart  Follow us on: Facebook: https://www.facebook.com/Art-of-Emergency-Nursing-276898616569046/  YouTube: https://www.youtube.com/channel/UCJTnz4phtCTjojTIDJo2afA?view_as=subscriber  Twitter: @AoenPodcast Instagram: https://www.instagram.com/artofemergencynursing/  To support the show: Leave an honest review on iTunes. Your ratings and reviews greatly contribute to the success of the podcast, and I appreciate each and every one of them. Subscribe on Apple Podcasts, Google Podcasts, or your preferred podcast platform to never miss an episode. Thank you for being a part of our AOEN community!
HNTKYP: Measles

HNTKYP: Measles

2025-04-1846:37

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 most contagious diseases in the world. What happens when a patient with a suspicious rash sits in your waiting room for hours? How long does measles hang in the air? (Spoiler: it’s longer than you think.) From triage missteps to public health policies, this episode walks through how to identify, isolate, and respond to highly contagious diseases—especially when you've never seen them in real life. We also bust the autism myth (again), talk about vaccine hesitancy, and explore what your ED should be doing to prepare right now. Measles Resources Centers for Disease Control and Prevention. (2023, September 6). Measles signs and symptoms. U.S. Department of Health & Human Services. https://www.cdc.gov/measles/signs-symptoms/index.html Centers for Disease Control and Prevention. (2023, September 6). Photos of measles. U.S. Department of Health & Human Services. https://www.cdc.gov/measles/signs-symptoms/photos.html Child Vaccination Schedule https://www.cdc.gov/vaccines/hcp/imz-schedules/child-adolescent-age.html Vaccinations and Autism Eggertson, L. (2010). Lancet retracts 12-year-old article linking autism to MMR vaccines. CMAJ: Canadian Medical Association Journal, 182(4), E199–E200. https://doi.org/10.1503/cmaj.109-3179 Hviid, A., Hansen, J. V., Frisch, M., & Melbye, M. (2019). Measles, mumps, rubella vaccination and autism: A nationwide cohort study. Annals of Internal Medicine, 170(8), 513–520. https://doi.org/10.7326/M18-2101 Tanne, J. H. (2002). MMR vaccine is not linked with autism, says Danish study. BMJ: British Medical Journal, 325(7373), 1134. Immune Memory Loss & Measles Cohen, J. (2019, May 1). How measles causes the body to ‘forget’ past infections by other microbes. Science. https://www.science.org/content/article/how-measles-causes-body-forget-past-infections-other-microbes
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 can cloud clinical judgment and hinder effective decision-making. Kevin and Dr. Wolf also provide essential insights into screening, scoring, and treating AWS, equipping emergency nurses with the knowledge needed to improve patient outcomes for this potentially life-threatening condition. MD Calc CIWA -AR https://www.mdcalc.com/calc/1736/ciwa-ar-alcohol-withdrawal Prediction of Alcohol Withdrawal Severity Scale https://www.mdcalc.com/calc/10102/prediction-alcohol-withdrawal-severity-scale#pearls-pitfalls  Follow us on: Facebook: https://www.facebook.com/Art-of-Emergency-Nursing-276898616569046/ YouTube: https://www.youtube.com/channel/UCJTnz4phtCTjojTIDJo2afA?view_as=subscriber Twitter: @AoenPodcast Instagram: https://www.instagram.com/artofemergencynursing/ To support the show: Leave an honest review on iTunes. Your ratings and reviews greatly contribute to the success of the podcast, and I appreciate each and every one of them. Subscribe on Apple Podcasts, Google Podcasts, or your preferred podcast platform to never miss an episode. Thank you for being a part of our AOEN community!
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, including fear, uncertainty, and potential patient harm.  The full article will be out in the April Journal of Nursing Administration JONA Follow us on: Facebook: https://www.facebook.com/Art-of-Emergency-Nursing-276898616569046/ YouTube: https://www.youtube.com/channel/UCJTnz4phtCTjojTIDJo2afA?view_as=subscriber Twitter: @AoenPodcast Instagram: https://www.instagram.com/artofemergencynursing/ To support the show: Leave an honest review on iTunes. Your ratings and reviews greatly contribute to the success of the podcast, and I appreciate each and every one of them. Subscribe on Apple Podcasts, Google Podcasts, or your preferred podcast platform to never miss an episode. Thank you for being a part of our AOEN community!
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 ever found yourself mid-code wondering, “Are we doing the right thing here?”—this is the conversation you won’t want to miss. Follow us on: Facebook: https://www.facebook.com/Art-of-Emergency-Nursing-276898616569046/ YouTube: https://www.youtube.com/channel/UCJTnz4phtCTjojTIDJo2afA?view_as=subscriber Twitter: @AoenPodcast Instagram: https://www.instagram.com/artofemergencynursing/ To support the show: Leave an honest review on iTunes. Your ratings and reviews greatly contribute to the success of the podcast, and I appreciate each and every one of them. Subscribe on Apple Podcasts, Google Podcasts, or your preferred podcast platform to never miss an episode. Thank you for being a part of our AOEN community!
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 behavioral health needs. Some links to the documents referenced during the episode: Ethnoracial disparities in care on a consultation-liaison service at an academic hospital Racial and ethnic disparities in emergency department restraint use: A multi center retrospective analysis Refining the model for an emergency department-based mental health nurse practitioner outpatient service Psychiatric Emergencies and the Potential Role of Psychiatric–Mental Health Nurse Practitioners Follow us on: Facebook: https://www.facebook.com/Art-of-Emergency-Nursing-276898616569046/ YouTube: https://www.youtube.com/channel/UCJTnz4phtCTjojTIDJo2afA?view_as=subscriber Twitter: @AoenPodcast Instagram: https://www.instagram.com/artofemergencynursing/ To support the show: Leave an honest review on iTunes. Your ratings and reviews greatly contribute to the success of the podcast, and I appreciate each and every one of them. Subscribe on Apple Podcasts, Google Podcasts, or your preferred podcast platform to never miss an episode. Thank you for being a part of our AOEN community!
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, stressing the "rights" of medication administration and the need for vigilance in following them. This episode is a must-listen for new and seasoned nurses alike.   
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 barriers nurses face in acting with moral courage, and the systemic challenges that impact their ability to provide ethical care. Find the article here: https://journals.sagepub.com/doi/abs/10.1177/09697330241265415  View the nursing Code of Ethics here https://www.nursingworld.org/practice-policy/nursing-excellence/ethics/code-of-ethics-for-nurses/    Follow us on: Facebook: https://www.facebook.com/Art-of-Emergency-Nursing-276898616569046/ YouTube: https://www.youtube.com/channel/UCJTnz4phtCTjojTIDJo2afA?view_as=subscriber Twitter: @AoenPodcast Instagram: https://www.instagram.com/artofemergencynursing/ To support the show: Leave an honest review on iTunes. Your ratings and reviews greatly contribute to the success of the podcast, and I appreciate each and every one of them. Subscribe on Apple Podcasts, Google Podcasts, or your preferred podcast platform to never miss an episode. Thank you for being a part of our AOEN community!
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 disconnect between business-driven metrics and the clinical reality of patient care.
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.   
HNTKYP: Anxiety

HNTKYP: Anxiety

2024-06-1033:22

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 potential causes. Remember that even patients with anxiety can still have medical problems. Tune in to learn more about how to effectively triage potential anxiety in the ED and ensure that no patient's symptoms are overlooked. Anxiety is the Last Diagnosis on the ListLisa Wolf, MS, RN, CEN Published:February 01, 2010https://www.jenonline.org/article/S0099-1767(10)00002-4/fulltext (subscription required)  
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: @icuscenarios @theqwordpodcast @straightanurse @nursedosepodcast @therapidresponsern @upmynursinggame   #distributiveshock #cardiogenicshock #hypovolemicshock #obstructiveshock Obstructive Shock; Critical Care Scenarios and Rapid Response RN https://podcasts.apple.com/us/podcast/104-obstructive-shock-with-guests-bryan-boling-and/id1535997752?i=1000655162568  Distributive shock with Straight A Nursing https://podcasts.apple.com/us/podcast/346-distributive-shock-simplified/id1210975738?i=1000655023378 Cardiogenic Shock: With Up My Nursing Game and Nurse Dose Podcast https://podcasts.apple.com/us/podcast/cardiogenic-shock-with-annie-from-up-my-nursing-game/id1486427611?i=1000654832483 
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, signs, and appropriate treatments.
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 importance of critical thinking and the application of knowledge in nursing to prevent errors, enhance patient care, and, fundamentally, avoid causing harm. Follow us on: Facebook: https://www.facebook.com/Art-of-Emergency-Nursing-276898616569046/ YouTube: https://www.youtube.com/channel/UCJTnz4phtCTjojTIDJo2afA?view_as=subscriber Twitter: @AoenPodcast Instagram: https://www.instagram.com/artofemergencynursing/ To support the show: Leave an honest review on iTunes. Your ratings and reviews greatly contribute to the success of the podcast, and I appreciate each and every one of them. Subscribe on Apple Podcasts, Google Podcasts, or your preferred podcast platform to never miss an episode. Thank you for being a part of our AOEN community!
HNTKYP: Burnout

HNTKYP: Burnout

2024-02-0845:44

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 nursing, where stress isn't just a part of the job—it's the job. But it's not all doom and gloom; we're also tackling how to fight back, recognize the warning signs, and protect both our patients and our sanity. Follow us on: Facebook: https://www.facebook.com/Art-of-Emergency-Nursing-276898616569046/ YouTube: https://www.youtube.com/channel/UCJTnz4phtCTjojTIDJo2afA?view_as=subscriber Twitter: @AoenPodcast Instagram: https://www.instagram.com/artofemergencynursing/ To support the show: Leave an honest review on iTunes. Your ratings and reviews greatly contribute to the success of the podcast, and I appreciate each and every one of them. Subscribe on Apple Podcasts, Google Podcasts, or your preferred podcast platform to never miss an episode. Thank you for being a part of our AOEN community!
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 patient behind door number two.  Follow us on: Facebook: https://www.facebook.com/Art-of-Emergency-Nursing-276898616569046/ YouTube: https://www.youtube.com/channel/UCJTnz4phtCTjojTIDJo2afA?view_as=subscriber Twitter: @AoenPodcast Instagram: https://www.instagram.com/artofemergencynursing/ To support the show: Leave an honest review on iTunes. Your ratings and reviews greatly contribute to the success of the podcast, and I appreciate each and every one of them. Subscribe on Apple Podcasts, Google Podcasts, or your preferred podcast platform to never miss an episode. Thank you for being a part of our AOEN community!
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 responsibility we hold during what is no longer just a flu season but a battlefield against a plethora of respiratory viruses, including RSV and COVID-19. Get ready for this critical and timely update.
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