Michael A. F rakes, APRN, MS, CCNS, CFRN, CCRN, EMTP: LIFE STAR Hartford Hospital, Hartford, Conn.While Michael is a leader caring for patients during critical care transport, CNS See Continuous net settlement.
See continuous net settlement (CNS). practice differs from expert clinical practice away from the bedside.On a recent afternoon, two of our new staff cared for patients with an aortic dissection Aortic Dissection Definition
Aortic dissection is a rare, but potentially fatal, condition in which blood passes through the inner lining and between the layers of the aorta. , an expanding subdural hematoma Subdural Hematoma Definition
A subdural hematoma is a collection of blood in the space between the outer layer (dura) and middle layers of the covering of the brain (the meninges). , a pediatric pediatric /pe·di·at·ric/ (pe?de-at´rik) pertaining to the health of children.
Of or relating to pediatrics. seizure and cardiogenic shock cardiogenic shock
Shock resulting from a decline in cardiac output that occurs as a result of serious heart disease, especially myocardial infarction. . This high-intensity, high-acuity experience was completely safe, as the encounters took place in a very realistic, high-fidelity human patient simulator program that Michael has helped to develop and operate. More important than the scenarios are the debriefings, which always begin with the team "talk(ing) about three things that went really well" before discussing improvement opportunities. Experienced staff benefit from an equally thorough program of "high-risk, low-frequency" cases for recurrent education.
Clinical education and consultation are not limited to the sophistication so·phis·ti·cate
v. so·phis·ti·cat·ed, so·phis·ti·cat·ing, so·phis·ti·cates
1. To cause to become less natural, especially to make less naive and more worldly.
2. of the simulation center. We often turn to Michael for answers to clinical questions, to which he invariably in·var·i·a·ble
Not changing or subject to change; constant.
in·vari·a·bil answers either "a recent paper says ..." or "great question, let me look around," followed soon by an e-mail summarizing the current literature. This evidence-based approach extends to ensuring that our practice standards consistently reflect best practices and to nonclinical features of team performance, such as patient safety, documentation and transport operations.
Michael is also a contributor to the medical literature. In the past year, he has edited a book, written three chapters, published seven clinical articles and four abstracts, and made seven national presentations. More importantly, he has helped us to develop skills in clinical inquiry. Michael either helps us to develop an idea into a workable project ("any idea can be a great project:") or asks for "a little help with something" to get us involved in research. Currently, 14 members of our multidisciplinary team are involved in projects, along with a college student seeking research experience.