Before the Crisis
For sixteen years I have worked in critical care. I have stood in rooms where a family honored what their person had already told them, and in rooms where a family had to guess. The difference between those two rooms is the work of my life.
I am Luke Adams. I speak, write, and build programs so fewer families end up in the second room.
“Most patients do not fail to plan because they do not care. They fail to plan because no one ever showed them how.” Luke Adams, Before the Crisis
1 Yadav et al., Health Affairs, 2017 — approximately one-third of US adults have any advance directive on file. 2 Aldridge & Kelley, American Journal of Public Health, 2015 — using CMS data on end-of-life spending.
About
Luke Adams is a critical care nurse with sixteen years at the bedside, currently a clinical coordinator on a 36-bed high-acuity intermediate care unit in South Carolina.
He is a Respecting Choices® Certified Facilitator, an ELNEC Trained Educator, and a member of the Strategic Advisory Board at Steadywell. He was honored at the White House in the Oval Office for frontline nursing service during the COVID-19 pandemic, and has been featured on Good Morning America, Nightline, and Pandemic.
Before the Crisis is a platform dedicated to starting conversations that help patients live and die better.
It has three parts:
The aim is bigger than any one talk or training. It is to carve out room in modern healthcare for what gets crowded out: time to connect, permission to be human, and the work of aligning a patient’s care with what that patient actually values.
Views expressed on this site are Luke’s own and do not reflect the positions of any current or past employer.
Speaking
If you have a topic adjacent to these that you would like built out for your audience, ask.
Keynote
The case for having the conversation early, on a calm day, before anyone is in crisis. Drawn from sixteen years at the bedside and tailored to the audience in the room, whether that is clinicians, executives, students, or the public.
Clinician workshop
A working session for nurses, residents, hospitalists, and social workers on how to actually start the conversation at the bedside. Role play, language practice, how to hold the silence. In-service formats available.
Executive session
For outpatient network directors, service-line executives, CMOs, and COOs. The case for a structured, outpatient, CPT-billable Advance Care Planning service line embedded in primary care. Covers the economic model (CPT 99497 and 99498, incident-to billing, revenue per FTE), workflow design, and pilot metrics.
Family & community
For senior centers, community groups, faith communities, caregiver networks, and civic audiences. What a family actually needs to talk about before the crisis, in plain language, with worksheets. Accessible to people with no medical background.
Media & writing
White House, Oval Office honor for frontline nursing service during the COVID-19 pandemic response.
Long-form essays in progress: Two ICU Rooms, Death Has the Worst PR Team in History, and the executive case for a dedicated Advance Care Planning service line. Posting here as they go live.
Full archive on LinkedIn: linkedin.com/in/leadership2025
YouTube channel launching in 2026. Subscribe when it goes live.
Voices from the bedside
For the patients and families I have been part of caring for: if this work meant something to you, I would love for you to say so in your own words. Nothing here is required. This page exists as a reminder that the work we do is impactful, meaningful, and, above all else, human.
This is where patient and family voices will appear, in their own words, once they have shared and I have reviewed each one personally.
Luke
Book Luke
For speaking, workshops, executive sessions on the ACP service line concept, or press inquiries.