Art of Critical Care with Ricardo Dukes

What happens when a lifelong nurse, educator, and grant writer pulls back the curtain on how healthcare really works? Ricardo Dukes joins Siobhan to talk critical thinking, epigenetics, holistic care, and why he still believes in the next generation of nurses, most days.

Summary

Ricardo Dukes thought his love of basketball might lead him into sports medicine. Instead, a mentor, a growing interest in patient care, and the people he met along the way led him into nursing and teaching. In this conversation, he and Siobhan trace that path—and ask what happens when healthcare gets so focused on protocols that it forgets the person in front of it.

Ricardo talks about teaching nursing students to think beyond the textbook, apply what they know in a clinical setting, and listen closely to patients. Siobhan brings her own experience of growing up sick and living with chronic pain to the conversation, including the frustration of being told her symptoms don’t fit the expected answers. Together, they explore the links between mind, body, environment, stress, and health, while making room for curiosity about approaches to care beyond a single prescription.

The conversation also takes an unexpected turn into Ricardo’s grant writing work with community organizations, then lands on self-care: what it means for caregivers to pay attention to their own well-being, too. It’s a wide-ranging pond chat about critical thinking, advocacy, and the simple power of treating people like people.

Ricardo Dukes

Ricardo Dukes is a Sacramento-born nurse, educator, and sports medicine specialist who has spent over 26 years in nursing and nursing education. After starting in sports medicine and later transitioning into nursing, he’s built a career at the intersection of patient care, critical thinking, and holistic wellness, teaching at institutions like Saint Mary’s University and working with UCSF and Stanford-connected communities.

Beyond the classroom, Ricardo is a grant writer and founder of Newer Paths, helping nonprofits and community organizations secure funding to expand their impact. His work is grounded in mentorship, equity, and a deep belief that health must be understood through biological, psychological, social, and cultural lenses.

Resources & Mentions

Places & People

• Vinyl Wine Bar & Shop — the Alameda listening bar where Siobhan and Ricardo connected.

• Chef Lamont and Todd on Ducking Realitea — their Proof & Pairing episode.

• Chamaine Wofford on Ducking Realitea — the episode about opening Vinyl. Name correction: the published episode spells her name Chamaine, rather than Charmaine.

• UCSF Health and Stanford Medicine Research — institutions discussed in the conversation.

• Sonoma State University, Department of Kinesiology — the university Ricardo says he attended.

• Samuel Merritt University, College of Nursing — name correction: this appears to be the school Ricardo means in the transcript, rather than “Saint Mary’s.” I’d confirm his current title with him before publishing it.

• Life Chiropractic College West, Hayward Health Center — the Hayward school and clinic.

• Highland Hospital / Alameda Health System and John Muir Health — healthcare systems mentioned in clinical stories.

Concepts & Approaches

• Epigenetics — how chemical markers help regulate whether genes are turned on or off.

• Complementary and alternative health approaches — an NIH guide to the terminology and approaches discussed.

• Ethnomedicine / traditional medicine — the National Library of Medicine’s entry for healing practices grounded in cultural traditions.

• Precision medicine — care that considers individual differences in genes, environment, and lifestyle.

• Breathing and relaxation techniques — a useful evidence-based companion to the discussion of vagus nerve exercises and nervous system regulation.

• Network Spinal Analysis — a description of the gentle-touch chiropractic approach mentioned in the conversation.

• Alarm fatigue in hospitals — an AHRQ patient-safety resource on the risks of excessive monitor alerts.

Books & Organizations

• The Body Keeps the Score by Bessel van der Kolk — the book Siobhan mentions.

• 100K Trees for Humanity — name correction: Amos White’s organization uses 100K Trees for Humanity, rather than 10,000 Trees for Humanity.

💡 Key Takeaways

• Nurses as the true front line of care
  Nurses spend the most time with patients, gather key context from families and lived experience, and often see what doctors miss in their five-minute visits.

• Critical thinking beats checklists
  Ricardo stresses that nursing isn’t about blindly following algorithms or EHR prompts, it’s about pausing, reassessing, and treating the whole patient, not just the numbers.

• Epigenetics and environment matter
  Our genes don’t change, but their expression does. Stress, trauma, environment, and even zip code can trigger biological responses that show up as illness, and can also be shifted through awareness and lifestyle.

• Holistic and complementary care are not “woo”
  Meditation, vagus nerve exercises, spinal network chiropractic care, herbs, and ethnomedicine can work alongside traditional medicine to address root causes, not just mask symptoms.

"Our patients are not their injury or their illness; they are a full, whole person.”

~ Ricardo