All posts by Cassandra's BSN Student Blog

ICU Delirium

Did you know that having an illness that requires a prolonged ICU stay, can lead to months of disability after discharge? As patients are grateful for overcoming a critical time in their lives, there is a high probability of having another difficult challenge ahead of them: not being able to function as they had been able to prior to their ICU stay. This may result from ICU delirium which affects 60% to 80% of patients that were on ventilators and 20% to 40% of patients that were not on ventilators (Brummel et al., 2014). In Nashville, Tennessee at St. Thomas Hospital, 126 ICU patients were studied between October 2003 and March 2006 and researchers found an association between the duration of ICU delirium and patients’ post ICU disability (Brummel et al., 2014). During the following year after discharge from the ICU, functional ability to perform activities of daily living (ADLs) were tested and the correlation of a longer period of ICU delirium and decreased ability to perform ADLs was found. After watching three videos on ICU delirium and reading the article on this study, I agree with Dr. Brummel et al., that treatment of delirium is essential in attempt to prevent months of diminished motor function since performing one’s ADLs is of high importance to most individuals. This article also pointed out another interesting study that showed reduced delirium in ICU patients at risk of atrophy and weakness who received physical and occupational therapy (PT/OT) within the first couple of days while on a ventilator. It appears steps that need to be taken are assessment of ICU delirium, attempt to reduce the duration of ICU delirium, have PT/OT work with patients at risk in the ICU sooner rather than later, and continue to research ways to reduce disability post ICU discharge.

  References Brummel N E Jackson J C Pandharipande P P Thompson J L Shintani A K Dittus R SGirard T D 2014 Delirium in the Intensive Care Unit subsequent long-term disability among survivors of mechanical ventilation.Brummel, N. E., Jackson, J. C., Pandharipande, P. P., Thompson, J. L., Shintani, A. K., Dittus, R. S.,…Girard, T. D. (2014). Delirium in the Intensive Care Unit subsequent long-term disability among survivors of mechanical ventilation. Crit Care Med, 42(2), 369-377. doi:10.1097/ccm.0b013e3182a645bd 201509211616561221419573    

Technology and Patient Care

EKG monitoring through a person’s iphone to prevent stroke sound like a great invention that I may personally use one day since Afib runs in my family. Raney Linck is right in his blog about nurses needing to step up to the challenge…the changing technology in healthcare challenge (2014). I agree that we are going to have to increase our knowledge of the upcoming tools and resources that will impact our patient’s lives. I believe society will continue to increase their spending on quick and easy access to apps, devices, and biometric measuring tools, like the now common Fitbit, to improve their health. As nurses are educators and advocates, we must be prepared by expanding our own knowledge of technological health tools.

Mental health issues continue to affect society and finally people are starting to open up about specific mental health concerns that they are experiencing. People are looking for ways to overcome their personal problems by watching television shows like Dr. Oz, surfing the internet, and asking healthcare providers. New interventions like mobile health sensors along with therapy may be the answer to help those that are struggling with diagnoses of depression, anxiety, or PTSD.

Along with verbal, demonstration, and multiple printed educational handouts that we use in the NICU at St. John’s Regional Medical Center to educate our babies caregivers, we also use educational videos on a tablet. Caregivers can choose to watch multiple videos about NICU baby care on our unit’s tablet at their baby’s bedside or they can access the website from anywhere by logging on to and using our hospital’s password 02557. This free website contains a video library in English and Spanish and also contains many helpful articles in the parent resource section. The education provided by leading Neonatologists and neonatal nurses on this website, in my opinion, is a great informative and helpful tool for caregivers of NICU babies (The Wellness Network, 2015).

Linck, R. (2014, August 1). MHealth: What do we do with all the data? [Web blog post]. Retrieved from

The Wellness Network (2015). Your nicu baby. Retrieved from



IMG_1870 My name is Cassandra Elston. I received my ADN from Ventura College in May 2000. I worked in med-surg during my first 3 1/2 years as a registered nurse. I made my way to where I am now by working in a pediatric unit for 1 year and then postpartum for 6 years. Finally I have been working at my dream job in the NICU at St. John’s Regional Medical Center for the past 4 years. That is where I would like to continuing working with my BSN. I have found the CSUCI RN to BSN program challenging, however I feel the degree that I will be receiving in May 2016 is of great worth. Since I started this current journey to obtain a higher degree, I have not had much time to do what I really love, which is spend time with my family and paddleboard. I have been married for 25 years. We have been blessed with 3 kids and 2 grandchildren. Our 25 year old son is married, has a 6 year old daughter, is in the Army, and lives in Alaska. Our 24 year old daughter is married, has a 18 month old son, and attends Ventura College.  Our 16 year old son is a Junior at Rio Mesa High School, and is on their water polo and swim team. My dog is a 6 year old Shitzu named Jaylee. sliding with Jaylee 3