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Experienced practice · Across roles and settings

Keep sharpening
the next decision.

Bring the patterns you recognize and the cases that still make you pause. Start with the free handoff case, then see what we’re working on next.

For ICU and acute-care nurses, critical care nurse practitioners, NP students, paramedics, and transport clinicians. Explore reasoning for bedside care, emergency care, rapid response, acute-care practice, and transport. Each planned lesson will make its setting, age group, assumed knowledge, and professional scope explicit.

Open the free clinical caseExplore the lesson roadmap
Free preview available

“Stable for transport.”
What would you ask next?

In this fully fictional handoff, the pressure barely changes while support increases. Decide what the next team needs to know before you open the explanation.

Experienced clinicians can compare competing priorities. Students can follow the same case step by step and explain what would change their thinking.

Work through the caseDiscuss the reasoning
  1. ICU bedsideDescribe the baseline, the change, and the response to support.
  2. TransportIdentify what gets harder away from the unit and what the crew must prepare.
  3. Receiving teamName the clinical question that could change the next plan.

Six sections · 24 planned lessons

Build depth where your practice needs it.

This is the curriculum roadmap. Every lesson listed below is coming soon; the titles describe planned learning objectives, not completed courses. Launch dates have not been set. The free handoff case above is available now.

01 · Coming soon

Hemodynamics & shock

Work toward a clearer explanation of the circulation problem, the evidence behind it, and the trend that would change your working assessment.

Intended starting point: adult ICU or critical care transport experience; advanced students can use the foundation links below.

  1. 01

    The pressure is holding. What changed to hold it?

    Compare blood-pressure trends with changing support and the rest of the perfusion assessment.

    Coming soon
  2. 02

    Four shock patterns and mixed shock

    Organize findings into competing explanations and identify what does not fit the first hypothesis.

    Coming soon
  3. 03

    A fluid question needs a clinical question

    Explore the distinctions among volume status, fluid responsiveness, and fluid tolerance in fictional cases.

    Coming soon
  4. 04

    When the arterial waveform and the bedside disagree

    Examine measurement quality, the patient assessment, and how to communicate conflicting information.

    Coming soon
02 · Coming soon

Ventilation & gas exchange

Connect the patient, the ventilator, and the trend. Practice explaining the problem before jumping to a setting change.

Intended starting point: adult ventilator exposure and basic blood-gas knowledge; activities will distinguish nursing, respiratory therapy, and prescriber roles.

  1. 05

    Oxygenation and ventilation: name the problem

    Connect respiratory observations, oxygen support, and blood-gas trends into a concise explanation.

    Coming soon
  2. 06

    The ventilator alarm as a question

    Walk through a structured assessment of the patient, airway, circuit, and available monitoring.

    Coming soon
  3. 07

    Read the waveform, then check the patient

    Explore pressure, flow, and volume examples with the assumptions and limitations made visible.

    Coming soon
  4. 08

    The liberation conversation

    Organize the questions teams ask about readiness, barriers, goals, and reassessment.

    Coming soon
03 · Coming soon

Neuro, sedation & delirium

Make a change in mental status easier to describe, investigate, and hand over without collapsing every finding into “agitated” or “sleepy.”

Intended starting point: adult acute or critical care assessment; fictional scenarios will state the available examination and medication history.

  1. 09

    A new neuro change: establish the last useful baseline

    Build a time line of findings, confounders, and missing details for the next clinical conversation.

    Coming soon
  2. 10

    Pain, sedation, and the goal of the assessment

    Separate observations, stated goals, medication effects, and the response the team needs to reassess.

    Coming soon
  3. 11

    Delirium: describe the pattern and the uncertainty

    Explore screening, contributing factors, and how findings become a focused team discussion.

    Coming soon
  4. 12

    Neuro monitoring through a handoff

    Practice reporting the examination, devices, prescribed goals, and agreed escalation triggers.

    Coming soon
04 · Coming soon

Renal, metabolic & nutrition

Bring labs, intake and output, medications, and nutrition into the same clinical story instead of reporting them as separate lists.

Intended starting point: adult acute or critical care practice; calculations and units will be shown explicitly.

  1. 13

    The kidney story beyond one creatinine

    Build a time line of renal markers, urine output, baseline function, and relevant exposures.

    Coming soon
  2. 14

    Acid–base reasoning with a competing explanation

    Use worked examples to practice a primary interpretation, check its assumptions, and consider a mixed picture.

    Coming soon
  3. 15

    Electrolytes, glucose, and the monitoring plan

    Connect a trend to the treatment already prescribed and the information needed for the next reassessment.

    Coming soon
  4. 16

    Nutrition belongs in the handoff

    Compare intended and delivered nutrition, interruptions, tolerance, and questions for the multidisciplinary team.

    Coming soon
05 · Coming soon

Transport & flight

Think through what changes when the care environment changes: equipment, access, communication, staffing, and the ability to respond.

Intended audience: transport nurses, flight nurses, EMS clinicians, and paramedics working within their team’s scope and service protocols.

  1. 17

    Before the wheels move

    Practice reconciling the patient’s trajectory with the crew, equipment, destination, and agreed transfer plan.

    Coming soon
  2. 18

    Oxygen, power, infusions, and the backup plan

    Use clearly stated fictional transport assumptions to examine resource planning and contingencies.

    Coming soon
  3. 19

    What changes in the flight environment?

    Explore the questions raised by cabin conditions, noise, restricted access, communication, and mission planning.

    Coming soon
  4. 20

    Across ages: what must be reconsidered?

    Compare adult, pediatric, and neonatal transport planning while keeping age-specific equipment, assessment, and team expertise distinct.

    Coming soon

Pediatric and neonatal topics will be labeled separately. Adult assumptions will not be reused as pediatric protocols, and this roadmap does not establish specialty transport competency.

06 · Coming soon

Acute-care reasoning & teams

Make your reasoning visible: a focused problem representation, competing diagnoses, priorities, response to care, and the plan if the picture changes.

Intended audience: practicing critical care NPs, AG-ACNP and other acute-care NP students, and ICU or transport clinicians building shared team reasoning.

  1. 21

    The one-sentence problem representation

    Practice combining baseline, trajectory, severity, and current supports without reciting the entire chart.

    Coming soon
  2. 22

    Likely, cannot miss, and what would change your mind

    Rank a differential, name evidence for and against it, and identify a discriminating finding or test.

    Coming soon
  3. 23

    Priorities, response, and the next decision

    Explain the purpose of a plan, the response to look for, and how deterioration changes the team’s priorities.

    Coming soon
  4. 24

    Disposition, escalation, and a useful debrief

    Discuss level-of-care questions, transfer readiness, team roles, and what to carry forward from a fictional case.

    Coming soon

NPs and NP students are intended readers. The author is a critical care RN and educator with acute-care NP training; this is not a claim of NP licensure or practice.

The planned lesson experience

Show the thinking behind the decision.

These are the elements we intend to build into the deeper lessons. The roadmap will grow as content is developed and reviewed.

Start with a fictional handoff

A stated setting, baseline, timeline, and current supports. No real patient stories or internal workplace materials.

Pause at a decision

Explain what you think is happening, what you need next, and which alternative deserves attention.

Switch clinical perspectives

Compare bedside, transport, and receiving-team questions while keeping each clinician’s role clear.

Reassess and check the sources

Review the response, identify remaining uncertainty, and follow public references behind the teaching points.

The roadmap is educational planning, not a treatment protocol. Future clinical lessons require source review and clear scope before release. No contact hours, certification eligibility, or course completion are conferred by these previews.

Choose the next useful step.

Keep the foundations close

Revisit a concept when you need it.

Experienced clinicians still need clear explanations. Return to the circulation model or the beginner feedback lesson, then bring that concept into a more complex discussion.

Follow the bloodA&P refresher

Help shape the next lesson

What deserves a closer look?

Tell us which topic you want next, which assumption is often missed, or where an explanation could be clearer. Share the learning question without identifying patients, coworkers, or workplaces.

Suggest a lessonJoin the discussion

Looking for exam preparation? The learning pathways page keeps planned certification prep separate from this practice-focused roadmap. Check current requirements directly with the certifying organization.

Adult CCRN · AACNCTRN · Ground transportCFRN · Flight nursing