Breathing the Rainbow: A guided meditation

When the energetic body isn’t balanced, we can experience a sense of irritation, anxiety or lack of balance. When you start to feel anxious or irritated, taking a few minutes to realign your chakras can help calm the body. Here’s a guided meditation you can practice…

The field of integrative treatment has rapidly expanded, and when speaking of this topic we focus not only on the physical/structural anatomy but also an invisible structure known as the energy body.

The energetic body has seven primary energy centers, called chakras, housed along the spine from the tip of the tail bone to the top of the head.

The seven chakras include:

  1. Root Chakra – Stability
    Represented by the color red, it is located at the bottom of the tailbone. Here we learn about establishing our foundation and the security of our family unit.
  2. Navel Chakra – Relationship and Creativity
    Represented by the color orange, this chakra is located in the abdomen. This is where we become more aware of lessons about relating to others. It’s here where we begin the process of individuating from the family.
  3. Solar Plexus Chakra – Self-Esteem
    Represented by the color yellow, this energy center is located above our waist and below our heart. It’s here where the student’s identity is cultivated and energy is exchanged between the student and the environment.
  4. Heart Chakra – Love and Compassion
    Represented by the color green, the heart chakra is located in the center of the chest close to the physical heart. It’s here where we learn lessons of love and compassion and how to heal past wounds.
  5. Throat Chakra – Communication
    Represented by the color blue, the fifth chakra is located in the throat. When stimulated with yoga, lessons of self-expression arise. When this chakra is balanced, we are better able to reach our goal of being clear in our communications.
  6. Brow Chakra – Divine Vision
    Represented by the color purple, it is located in the brow area and is often referred to as the third eye. It is here where imagination and intuition are stimulated and self-reflection is evoked.
  7. Crown Chakra – Spiritual Connection
    Represented by lavender, the chakra is located at the top of the skull. This energetic spot pertains to grace, soul and the Universe. It is here that we feel the energy of self-unification, or a coming together of our personality with our highest self.

When our energy body is balanced, it comfortably aligns with our physical body to create a feeling of wholeness and health. When the energetic body is not balanced, we can experience a sense of irritation, anxiety or lack of balance.

When you start to feel anxious or irritated, taking a few minutes to realign your chakras can help calm the body. Here’s a guided meditation you can practice:



This blog is based on the seminar Yoga for Self Regulation presented by PESI speaker Nancy Williams Cyr, M.SC, CCC-SLP, E-RYT-500.

YogaforSelfRegBanner


Palm the Present Moment: A practical mindfulness tool

One of the advantages of the Palm the Present Moment practice is that it’s portable and easy to use. It offers a multi-purpose means of centering to counter anxiety—especially when transitioning from one physical location or situation to another.

Anxious clients are often caught up in a myriad of thoughts spinning in their heads. For some, this rapid spinning of thoughts can even result in an overpowering sensation of nausea—almost like being on a boat that is bouncing up and down in choppy water. That makes sense when you consider that it has been estimated that the mind can generate up to 125 thoughts per second. Getting solidly rooted or grounded back in the body is one method for calming down, quieting the anxious or ruminating mind, and getting back onto more firm and peaceful ground.

In addition to anxiety, this practice is a good way of creating space from any negative emotions, anxious or ruminative thoughts, and feelings of being overwhelmed from stress or chaos. I also recommend this as a tool for when clients come into the counseling office and are not settled down due to the demands of time pressures, traffic congestion, getting a parking space, etc. Spending a minute or two getting grounded and centered at the start of a session can help the client enter a more receptive space.

One of the advantages of the Palm the Present Moment practice is that it’s portable and easy to use. It offers a multi-purpose means of centering to counter anxiety—especially when transitioning from one physical location or situation to another. (This is also a useful one-minute mindfulness technique for therapists to use between sessions for the same reasons.)

Watch as I demonstrate the Palm the Present Moment. I hope you find it as useful and practical as I do.


Want more mindfulness techniques for your toolbox? Get instant access when you sign up for our FREE CE: One Minute Mindfulness featuring Donald Altman, M.A., LPC.

OneMinuteMindfulnessCE


This blog is based on the writing of Donald Altman, M.A., LPC. You can read more in Donald’s book, The Mindfulness Toolbox.

Donald Altman is a psychotherapist, award-winning writer, former Buddhist monk, teacher and adjunct faculty at Portland State University. He is also a faculty member of the Interpersonal Neurobiology program at Portland State University and teaches various classes blending mindfulness and Interpersonal Neurobiology.


 

Q and A: Venous ulcers with concurrent lymphedema

Have you ever treated that wound that you just can’t get to heal even with proper assessment and treatment? There are always those few wounds that challenge our skills, and without a solid understanding of the complexities of mixed etiology, we may actually cause harm. Here are the three most commonly asked wound care questions by clinicians…

Venous ulcers account for 70-90 percent of all lower extremity ulcers in the United States. In addition, upwards of one million of these venous patients have concurrent lymphedema. In spite of this staggering statistic, most will heal well with proper assessment and treatment.

There are, however, those few wounds that challenge our skills, and without a solid understanding of the complexities of mixed etiology, we may actually cause harm. Here are the three most commonly asked wound care questions by clinicians…

Q. I routinely use compression on my venous ulcer patients with good success. This week, however, when I removed a four layer compression wrap, my patient had blistered in multiple places. What could have caused this?

Barring any sensitivity to the cast padding layer, the most common reason for blistering under compression is an underlying diagnosis of lymphedema. While venous wounds respond exceptionally well to this type of compression (known as long stretch wraps), lymphedema will worsen.

Long stretch means the wrap is giving constant and continual compression. Fragile lymphedema channels will be cut off from normal flow causing a backup of lymph leading to blisters. Patients with lymphedema should only use short stretch wraps which give compression only when the patient is walking; at rest there is no compression allowing for proper lymphatic drainage.

Q. How can I tell if my patient has lymphedema?

A simple test called the Stemmer Sign is a quick assessment tool. An inability to pinch a fold of skin at the base of the second toe is indicative of lymphedema.

Q. I have tried multiple topical antimicrobials, even those able to kill MRSA and VRE, and still my patient’s wound looks dull with no bright, beefy granulation. It has a thin vail of yellow slough throughout the bed. My patient has had this wound for over 10 years. She has good arterial flow, yet compression for over 4 weeks has yielded no result. What could be wrong?

Chronic wounds often develop a biofilm. Biofilms are bacteria and fungi encapsulated in a thick, sticky barrier made of polysaccharides and proteins. These protect the bacteria from external threats and attach it to the wound surface rendering antimicrobials and wound cleansing ineffective. The only way to eliminate them is with low frequency ultrasound treatment or surgical debridement.


Have more questions about venous disease and lymphedema? Get the answers in this FREE 2 hour CE Seminar: Venous Disease & Lymphedema Assessment and Treatment Strategies. BONUS: Get up to 1.8 free CE Hours for watching.

VenousDiseaseFreeCE


This blog was brought to life by PESI speaker Cheryl Aaron, PT, DPT, CWS. Cheryl has over 36 years of hands-on experience in physical therapy and wound care. Her clinical practice, specializing in all aspects of wound care, has encompassed a variety of settings, including: acute care, subacute, long-term care, and private practice. In her current role, she is responsible for the educational and consultation needs for multidisciplinary professionals. She established an advanced wound management program and is responsible for clinical competency within the wound care team for nursing and physical therapy staff.

5 Questions to Ask Your Patient: Motivating change

Do you get frustrated with your patients not listening to your pleading to make seemingly simple lifestyle changes? When we realize that we cannot push, pull or drag our patients to change their behavior, we open the door to a new conversation: One that centers on relating to the fact that all people face struggles with change.

Tom has been your patient for five years. He suffers from hypertension, is 40 pounds overweight, maintains a diet of fatty foods, and incorporates little movement in his daily routine. You’ve prescribed medication to get his blood pressure under control, and you’ve talked at great lengths about the need to eat better, move more, and adhere to his medication. Yet year after year he returns to your office, prescription unfilled, and no change to his physical condition.

Nonadherence to medication schedules by patients with chronic illnesses has long been recognized as a problem. It is estimated that approximately 50% of patients follow treatment recommendations. As a healthcare professional, you know that nonadherence doesn’t end at medication regimens. It encompasses behaviors such as smoking cessation, diet adherence and exercise.

Do you get frustrated with your patients not listening to your pleading to make seemingly simple lifestyle changes?

This frustration is bound to happen if you see patients as collections of problems and pathologies. When we realize that we cannot push, pull or drag our patients to change their behavior, we open the door to a new conversation: One that centers on relating to the fact that all people face struggles with change.

One way to transform the conversation about change is to use Motivational Interviewing (MI).

Motivational Interviewing is a collaborative, goal-oriented style of communication with particular attention to the language of change. It is designed to strengthen personal motivation for and commitment to a specific goal by eliciting and exploring the person’s own reasons for change within an atmosphere of acceptance and compassion.

MI gains little momentum or effectiveness if you only think about problems. By way of illustration, consider the difference between these two accounts of the same person:

“She’s 46, female, 2 children, second marriage; chest infection; obese for many years; leads an inactive life.  She’s a moderate to heavy drinker, smokes, and has a diet that is high in fried food, with little fruit or vegetables.”

Or

“She’s 46, an account manager and mother of two; very determined person. Its her second marriage, and she keeps a keen eye on her children’s well-being. It’s a happy house. They work and play hard. She feels unwell with a chest infection. She has lots of friends, smokes and drinks, and gets little exercise. She likes to make sure everyone has a good filling meal, and this often means fried food.”

In one sense you have a choice about which of these two people you feel like working with. Motivational interviewing won’t get off the ground unless we allow the human spirit in the second account to grow and develop.

The questions you might ask will be less dependent on the person’s condition or problem, and will be focused more on harnessing internal motivation:

  • What kind of change makes sense to you?
  • Why does this change make sense?
  • How might you achieve this?
  • What help or advice might you need from me?
  • How might you find a way through that feels comfortable and manageable?

By asking these questions, you settle yourself and your patient down into a helpful conversation about change, and you guide them into why and how they might shift their behavior. In MI, you don’t present the arguments for change, they do.  And in doing this they harness their own internal motivation to change.

If you’re ready to change the conversation with your patients, I encourage you to learn more by watching my free CE seminar: Motivational Interviewing in Healthcare.

Sincerely,
Stephen Rollnick, PhD


FreeCERollnick

What’s in a Brand? Learning What Campbell’s Soup and Dr. Phil Already Know

For therapists, traditional ways of getting the word out—a discrete ad here, a few hints to colleagues there, even a fancy website—just won’t cut it anymore. In a sound-bite-saturated world of information overload, having a brand that stands out is the only way to attract potential clients.

The following was written by Joe Bavonese, PhD.

Some therapists might recoil in horror at the thought of “branding” their practices. We are, after all, healers and mental health professionals, not hawkers of cosmetics and cornflakes. Indeed, to many of us, the thought of promoting ourselves and our practice seems crass, undignified, and, perhaps, a tad narcissistic. But we can no longer deny: the traditional way of getting the word out—a discrete ad here, a few hints to colleagues there, some folders or business cards sprinkled around town, even a website with your impressive credentials listed in chronological order—won’t remotely cut it.

In a sound-bite-saturated world of massive information overload, frenetic tweeting, continual advertising, and endemic cultural attention deficit disorder, having a brand that stands out is probably the only way you’ll have a chance of capturing the attention of potential clients.

Before we throw our hands up, let’s take a breath and consider what branding really means.

A brand is a marker, often personal, of the specific identity and special attributes that propels something—a product, person, service, organization—out of the vague, undifferentiated backdrop of “somethings” and “somebodies.” Your brand individuates you, conveys a meaning, tells a story, and elicits strong feelings.

You may be surprised to learn that you probably already have a brand; as a therapist, your brand is your invisible identity, based on how people in your community see your business. Your brand may be neutral, positive, or negative.

While that may sound straightforward enough, it took a long time and an impressive number of mistakes for me to understand that I needed a brand, then to figure out what my brand was, and how to hone it, sharpen it, and promote it to the public.

The Naive Beginnings

In 1992, I was the clinical director of an outpatient mental health and substance abuse clinic, supervising 15 therapists, seeing about 25 clients a week myself, and already looking for an escape. While keeping my day job, I found two therapist friends to share a tiny office and start a small practice on the side.

Initially, I didn’t have to do anything to promote my practice: colleagues from my day job sent me referrals. Soon, I was seeing 10 to 12 people a week, in addition to spending my regular 50+ hours per week at the clinic. But that’s when I hit my first snag: I had no free time. I wasn’t sleeping enough. Conflicts with my wife increased. I got no exercise and, worse, began eating fast food regularly.

Realizing this pattern wasn’t sustainable, I dreamed of quitting my day job and doing private practice full time. How hard could it be? If I were in private practice, I thought, I’d have more hours for all those new clients I felt confident would flow my way.

I decided, quite arbitrarily, that getting to 15 clients a week would somehow prove beyond a shadow of a doubt that I could succeed in private practice. Assured of my future as a private practitioner, I’d then confidently quit my job. And it actually came to pass: I finally managed to squeeze in 15 clients two weeks in a row, and I gave my notice.

Within three weeks, however, I’d gone from triumph to terror. I had hours and hours of open time slots to fill, but was unable to get more than 20 clients a week consistently. Without the daily contact with therapists at my old clinic, referrals slowed down substantially, and I had absolutely no idea how to promote my practice.

Eventually, my wife, an MSW, joined my practice. We both loved working to help people find more intimacy in their lives, and we’d always gotten great feedback on our work. To make sure we were concentrating on what potential clients needed in this area, we organized a series of focus groups. We contacted the directors of four local singles’ groups and found two couples’ meetings through a church and a synagogue near our office. We provided dinner for these groups, and asked them what types of services they and their friends might want. We asked questions, took copious notes, and got feedback on different workshop ideas and business names.

Without realizing it, we were taking the steps necessary to create a distinctive and viable brand.

Based on the focus group feedback, we started a drop-in support group for singles, an eight-week psychoeducational workshop for singles called Creating Lifelong Loving Relationships, and two workshops for couples. Also, we offered individual, couples, and group therapy. We chose the name Relationship Institute, with the tagline “Teaching the world to love.” This name emphasized the learning aspect of our approach, and conveyed the idea that singles who were alone and couples who were unhappy were not that way because of intrapsychic deficits, but because they’d never been taught the essential skills for healthy relationships.

We hired a graphic designer to create a logo and a professional brochure that told our story about how we’d spent a great deal of time in individual and couples therapy ourselves, learning how to have a more fulfilling relationship. It stated that we could now help others learn to do the same, but much more rapidly and inexpensively.

As therapists, we had all the elements of a successful brand: a unique visual image, a unique business name, and an emotionally engaging personal story to tie it all together. I was soon seeing about 22 clients a week in addition to running two groups and leading bimonthly workshops. Hey, I thought, maybe this isn’t so hard after all.

Necessity Is the Mother of Invention

We had our first child in 1995, and our second pregnancy the following year resulted in the birth of twins. I panicked as the carefully constructed financial spreadsheet I’d created unraveled before my eyes. My only thought was that I needed more clients – a lot more clients. At this point, I learned that having a good brand was necessary but not sufficient on its own for a successful practice.

In desperation, I searched nationwide for help and discovered a small business-marketing guru named Jay Abraham in Los Angeles. I reluctantly signed up; too embarrassed to tell anyone but my wife that I was paying for something 10 times more expensive than any clinical workshop I’d ever taken.

Soon I was sitting in a large, noisy conference room with 425 people at a hotel. The workshop, a sort of crash course in Small Business Marketing 101, created a sea change in my attitude and mindset. I discovered that I was a small business owner, not just a psychologist, and that I had to work on my business, not just be in it. The workshop led to a powerful call to action when Jay took the branding concept deeper by introducing the idea of a unique service proposition (USP), which encapsulates what problem in the world your product or service addresses and what its specific benefits are.

Jay also taught us the concept of the Lifetime Value of a Referral – every new client, on average, brings in a specific amount of money (your fee times your average number of sessions before termination, which for most therapists is more than $1,200). If you spend half of this amount to get a new client, you’ll get a 100 percent return on your investment. Really? I thought. Spend $600 to get one new client? That’s insane. But the numbers didn’t lie.

Difficult as it was to grasp at first, I found myself increasingly guided by the Lifetime Value of a Referral concept, and began placing expensive display ads – $300 to $500 – in various print publications. The ads used my USP-enhanced brand, along with the four-part advertising formula Jay outlined:

  • Start with specific problem statements in the language of potential clients
  • Follow with the benefits they’ll receive after a successful experience working with you
  • Add unique features of your training or how you work
  • End with a way to contact you.

I wrote articles for local publications, started a public-relations campaign targeting local media, and began tracking my referrals, income, and expenses with extreme precision. Within six months, my caseload was consistently averaging 35 clients a week, and we had plenty of money to support our growing family.

I thought I was doing great. Then my accountant mentioned two things: college education for the kids, and retirement for me and my wife.

Expanding the Brand

I began thinking of ways to generate multiple units of income per unit of time. One of my business coaches repeatedly said to me, “Therapy doesn’t scale,” meaning you always have to provide one office, one therapist, and one client to make one chunk of money. But scalable services can multiply the results of your work. You do the work once and your income multiplies from that point on, as with books, large group workshops, or DVDs.

After reviewing various options, I decided that hiring therapists to work under our brand was the smartest choice. The idea was that I’d generate referrals for the therapists and get a percentage of the fees collected. My income would rise as more clients were seen by more of my contracted therapists.

I’d embarked on a path I’d never have imagined traveling, but everything seemed in place. Thanks to my successful brand and Jay Abraham’s ideas, there were plenty of referrals for everyone. The problem was that since I had no idea how to run a business with staff, at first, I kept messing up.

I hired the wrong people—too young, too inexperienced, too controlling—or I paid them too much. I also wanted them to like me too much, which led me to overlook clinical shortcomings or unresolved personality issues. I didn’t know how to fire people who weren’t performing, and I wanted to do everything myself, which resulted in even more hours at the job and less profit than before.

After several years, however, I began to see the light. I kept studying business and management principles, hired office staff, delegated tasks, learned how to create systems to run the practice more efficiently. Soon my monthly passive income began to grow steadily.

As technology evolved, I took several advanced trainings in Internet marketing and discovered the profound opportunity that the Internet presented to savvy marketers. Instead of me reaching out to potential clients, they were now searching for people like me. It was a startling 180-degree shift. All I had to do was create an online presence optimized for local search, making sure that when someone Googled “marriage counselor” in any of the three cities we had offices in, our website would show up on the first page.

Using this online strategy, I doubled our practice in five years. Currently, at least 70 percent of our monthly referrals come from online sources. Our brand is firmly established in both the local and online worlds.

Creating Your Brand

While branding is central to business success, the best brands are an authentic expression of who you are as a human being. Don’t choose a brand simply because you think there’s a large pool of potential clients out there with a specific issue.

Ask yourself: What do you want people to feel and think about when they hear your practice name or think of working with you? What are you doing to create that in your clients’ minds?

In today’s world, technology makes it to share your brand with thousands of people are a negligible cost. Unfortunately, too many therapists still tend to be uncomfortable around technology – which limits their ability to connect with a vast Internet-based audience of potential clients. But there’s a simple solution: if you aren’t comfortable using technology yourself, hire someone who is.

A website costs less to maintain than the phone in your office, and high-definition video can be created, edited, and uploaded to the web for free using just a smartphone. You can tell your story in your own voice while looking directly at potential clients who are seeking the exact help that you provide.

As therapists, many of us still carry around the idea that our profile in the world is supposed to be discreet and modest. But that old attitude has become a crippling handicap. These days, our brand needs to be highly visible and energizing, offering an authentic picture of who we are and what we can do for people who need our services. It’s an essential form of communication that helps us attract the people whose lives will benefit from contact with us. And the more people we connect with, the greater the good we can do in the world.


Joe Bavonese, PhD, is the director of the Relationship Institute in Michigan and the codirector of Uncommon Practices, a service that helps psychotherapists create their ideal practice.

PrivatePractice


This post is based on an article originally brought to life by our partner, Psychotherapy Networker.

The full article, “What’s in a Brand?” written by Joe Bavonese, appeared in the Sep/Oct 2013 issue of Psychotherapy Networker magazine.

Bessel van der Kolk’s Trauma Treatment Discovery

For 40 years, as both a researcher and a clinician, Bessel van der Kolk, M.D., has studied those living with trauma. Among them were soldiers, torture victims, child abuse survivors, and many others. What has he determined after years of research?

Trauma is a fact of life.

  • One in five Americans has been molested.
  • One in four grew up with alcoholics.
  • One in three couples have engaged in physical violence.
  • Millions of Veterans and their families deal with the painful aftermath of combat.

Such experiences inevitably leave traces on minds, emotions, and even on biology. Trauma disturbs people’s relationships with themselves, with others, and with their environment.

But trauma isn’t something we’ve always talked about. When leading trauma expert Bessel van der Kolk, M.D., entered the field, PTSD didn’t exist, and trauma wasn’t even whispered about in the halls.

For 40 years, as both a researcher and a clinician, Dr. van der Kolk has studied those living with trauma. Among them were soldiers, torture victims, and child abuse survivors, and many others. What has he determined after years of research?

There is not a one size fits all approach to trauma.

As clinicians, we can no longer be just a psychoanalyst, an EMDR expert, or a CBT practitioner. Instead, we must be exposed to a large number of different treatments and know when to use the tools of each method to best help our patients overcome the challenge of trauma—reestablishing ownership of their body, mind and self.

In his book, The Body Keeps the Score, Bessel van der Kolk outlines 8 paths to recovery. They include: owning your self, language,  EMDR, yoga, self-leadership, creating structures, neurofeedback, and communal rhythms and theater.

Do any of these paths to recovery surprise you? We think it’s important for clinicians like yourself to understand how these paths to recovery came to be. That’s why we’re providing a free video from Bessel van der Kolk discussing The Body Keeps the Score.

As a bonus, we’re providing a free hour of CE just for watching. Get started instantly (seriously, it’s free—don’t wait).

FreeBesselCE

3 Common Cardiac Assessment Questions

Although each area of physical assessment has its own art and mystery, many report struggling the most with cardiac assessment. Here are three common questions about cardiac assessment and their answers.

A thorough assessment of your patient is like an adventure in hunting, and it enables you to make sense of the clues to your patient’s current health status. But in order to find and understand those clues, one must have a strong foundation in their assessment skills. Although each area of assessment has its own art and mystery, many report struggling the most with cardiac assessment. When teaching assessment programs, I repeatedly hear some common questions. Here are three of those questions and their answers.

Q. What does it mean when I hear an S3 heart sound, and where can it be heard the clearest?

An S3 is the most commonly heard extra heart sound in adults and is heard with fluid volume overload, such as that related to heart failure. Left-sided heart failure is heard best at the mitral valve location. Remember, S3 heart sounds are soft and subtle, so a quiet environment is necessary when listening for one. Frequently, S3 sounds are heard best in the left lying position, shifting the heart towards that part of the chest wall. This extra heart sound is heard right after lub (S1) and dub (S2), leading to pneumonic Kentucky—a short extra sound tagged on to the end of S1 and S2. One last reminder – after the fluid volume overload is resolved, an S3 heart sound will no longer be heard, and we go back to just hearing S1 and S2.

Q. Are there clues on auscultation to whether a heart murmur is systolic or diastolic?

In reality, the distinction between systolic and diastolic is not hard to tell. First, identify the swooshing sound of a murmur being present. Then listen again to identify where in the cycle you hear it. Is it between S1 and S2? If so, that is a systolic murmur. If you hear it between S2 and S1, then that is a diastolic murmur. Ironically, even though systolic murmurs are often benign or functional (medically managed unless severely symptomatic), they are often the louder of the two.

Q. How do I tell the difference in my cardiac assessment findings between  right- or left-sided failure?

Visualizing blood’s journey through the body may help us see clues to right- or left-sided failure. Before the blood hits the right side of the heart, it comes from the body. Blood makes its journey to the tissues dropping off oxygen and picking up carbon dioxide (CO2), and then journeys up the superior vena cava to the right side of the pump. If the patient is having right-sided heart dysfunction, blood backs up to the body causing systemic symptoms, such as lower extremity edema, jugular vein distention, and engorgement of the liver. If the liver engorges enough, the patient may start to develop ascites.

From the right side, blood goes to the lungs and then to the left side of the pump. If a patient is having left-sided pump dysfunction, blood backs up the lungs and the patient experiences pulmonary symptoms. These may include dyspnea, hypoxia, the development of rales (crackles in the bases), and orthopnea (when patient lies flat, they feel they can’t breathe).

Now that being said, I need to remind you: The most common cause of right-sided failure is severe left-sided failure, where blood finally backs up to the right side of the heart. Those patients have both pulmonary and systemic symptoms. Many of the patients you work with may have this mixed failure.

Were you able to answer these questions? Has it lead you to pondering more cardiac questions? Or perhaps you have questions about other aspects of the physical assessment. To give the best care to our patients we need to understand how to find the clues and decipher what they are telling us.


Are you hungry to learn more about physical assessments? Get a free hour of CE when you watch Mastering the Neurological Assessment with Cyndi Zarbano.

FreeCE_Zarbano


PUB074500
Get quick access to essential reference information. This full color pocket guide is filled with descriptive images for effective physical assessments. Available now!

This post was brought to life by PESI speaker Cyndi Zarbano, MSN, BSN, CCRN, CMSRN, CLNC, NLCP. Cyndi is an intensive care nurse with over 20 years of nursing experience who is currently practicing in the Twin Cities area of Minnesota. She is a nationally-recognized seminar speaker who has opened multiple national symposiums and speaks on several topics for PESI, as well as a variety of other companies in the US and Canada. Her national acclaim is well deserved for her ability to make knowledge practical, as well as encouraging knowledge retention by her frequent use of stories, humor and case studies.