The ICU Team Should Help My Mom Get Better, But They Stopped Caring and Want Her Out of ICU. Help!
Published: Thu, 08/10/23
Hi, it’s Patrik Hutzel from INTENSIVECAREHOTLINE.COM where we instantly improve the lives for Families of critically ill Patients in Intensive Care, so that you can make informed decisions, have PEACE OF MIND, real power, real control and so that you can influence decision making fast, even if you’re not a doctor or a nurse in Intensive Care!
This is another episode of “YOUR QUESTIONS ANSWERED” in last week’s episode I answered another question from our readers and the question was
You can check out last week’s question by clicking on the link here.
In this week’s episode of “YOUR QUESTIONS ANSWERED” I want to answer questions from one of my clients, Angie, as part of my 1:1 consulting and advocacy service! Angie’s mom is in ICU and she is asking why the ICU team stopped caring for her mom and wants her out of ICU.
Patrik: Well, you’ve got to get it at least by Monday. In the mean… Look, the
worst thing that can happen is you get me on a call, and they turn me down. That’s the worst thing that can happen.
Angie: Sure.
Patrik: But not trying, I think that’s probably the worst, also.
Angie: Sure. That’s right.
Patrik: So that’s all I can say to that. But you’ve got more insights now in terms of what could work. What could work I believe is just simply trying the trach collar. That could work. One obstacle might be the hemoglobin. Right?
Angie: Okay.
Patrik: But if you’re saying that otherwise she’s stable, there’s nothing that should stop them from trying.
Angie: What about the radiology details I read to
you? Is that… Because this attending was saying her FEV1 (forced expiratory volume in 1 second) is probably low.
Patrik: Mm-hmm.
Angie: So that’s why she has not cleared these fluids, and these remnants of the infection.
Patrik: Mm-hmm.
Angie: Is that right? I just listened but I know the guy was hostile, so he was going to tell me the most negative thing. So, we gave up. But does that make sense that she doesn’t have a good chance of clearing all these fluids out?
Patrik: Is she on diuretics? Do
you know what I mean by diuretics?
Angie: Oh, yeah. Yeah. I requested it yesterday. They were trying that so that her electrolytes remain stable, so they can discharge her. But yesterday I asked for Lasix, so they gave her a little bit of Lasix. I don’t know how much it helped. But it’s not every day, but that’s all I
can say. It’s not every day.
Patrik: Okay. So, correct me if I misunderstood this, so basically what you’re saying, until you requested Lasix, she didn’t have it?
Angie: No.
Patrik: Because they were worried that her electrolytes would derange, and that would stop her from going? Do I understand this correctly?
Angie: Correct. Exactly. Exactly.
Patrik: Oh, my goodness.
Angie: To me, it sounded very
unethical because you want to make sure a patient is progressing.
Patrik: That is very unethical.
Angie: But they want to free the bed.
Patrik: That is very unethical.
Angie: They just want to free the bed. Yeah.
Patrik: Oh, my goodness. Well, I hope you’ve got records of that, because that in and of itself is negligence.
Angie: Yes.
Patrik: I mean the aim of any patient is to progress them forward. You know?
Angie: Correct.
Patrik: And they don’t want to deal with it by the sounds of things.
Angie: No. No. They just want us to leave. That’s the bottom line, so that they can… Actually, we got into this trouble because she had the fall, even if just one night of observation, but they kept
her for three nights for financial purposes. But this accident happened on the third night. So, greed gets this old patient into trouble and then greed kicks her out. That’s how I would summarize this whole hospitalization.
Patrik: I’m so sorry to hear that.
Angie: Yeah.
Patrik: Coming back to your question, does the chest X-ray result potentially stop her from getting off the ventilator? Look, a lot of chest X-rays, from the findings that you read out, a lot
of those chest X-rays for patients in ICU would look very similar.
Angie: Okay.
Patrik: Especially if they had pneumonia, would look fairly similar. So, when you read out the X-ray report, I’m just thinking to myself, “Oh, yeah. Sure. A, ‘Normal,’ X-ray
result for a patient in ICU, that’s been there for a while.” Okay?
Angie: Okay.
Patrik: So that should not stop from mom getting off the ventilator. It
just means they need to do all the right things; they need to try her on trach collar. They need to give her some diuretics and see how she goes.
Angie: She’s just been in bed for close to 30 days, she’s only been sitting, maybe three or four times, and standing a couple of times. So, some of that might be related to more mobility, maybe. But I’m not sure.
Patrik: Yep. Sure. I wouldn’t… Yeah. Look, your mom is 95, it’s fantastic that she stood a couple of times. You know what I mean? They need to do more of that. You see, the trouble is this, in LTAC (long-term acute care), she may get a little bit more of that. She may. She may not. But what she’s not getting more of generally speaking, is the clinical expertise that is needed to wean someone off the ventilator.
Here is another strategy. And I’m not sure whether that will work in your situation. But if you have real concerns with the care she’s getting at the moment, and the way you’re treated with disrespect, you could leave an online review for them on their website, or on Google.
Angie:
Right.
Patrik: Or even on Facebook. You know?
Angie: Yes.
Patrik: I have seen this strategy work. They do not want people to comment publicly about their experience.
Angie: Sure.
Patrik: I don’t know whether that’s… I was working with a client recently, and they did exactly that. They went on the hospital’s… They left a public Google review, and they left a public Facebook review, and all of a sudden, they started talking.
Angie: Got it. Oh, man. I should have… That’s… I should have talked to you a month ago.
Patrik: Right.
Angie: Oh, man. Yeah.
Patrik: Right. Right.
Angie: Yeah. Yeah.
Patrik: It’s those type of things that sometimes move the needle as well.
Angie: Yeah.
Patrik: Hospitals are very good at trying to shut people down because that’s what they’ve been doing forever. You know?
Angie: Correct.
Patrik: But in this day and age, you have more leverage than ever before.
Angie: Right. I agree. They’re very, if you listen to local airwaves, TV and radio, they’re always
advertising.
Patrik: Mm-hmm.
Angie: So, they don’t need any negative publicity. I’m sure there’s an office with multiple people monitoring their
internet reputation.
Patrik: Mm-hmm.
Angie: And they respond to these things.
Patrik: Mm-hmm. I would think so.
Angie: Sure.
Patrik: I would think so. But-
Angie: Yes.
Patrik: So, strategies are,
ask for the hospital policy about discharge. Right?
Angie: Okay.
Patrik: And see what that policy says.
Angie: Okay.
Patrik: The other thing you can do, is as I said, I do believe it’s worth me talking to them, if we can. And the reason… Whilst you’ve given me a lot of
information-
Angie: Sure.
Patrik: … if I talk to them, they might say things where I might hone in and say, “Oh, hang on a second.” There’re
just more questions that I can ask. It’s a very, what’s the word, specialized area.
Angie: Sure.
Patrik: And if I start talking to them, I might
think, “Okay, why are they not doing this? Why are they not doing that?” I believe there will be more things coming to light where we might be able to build an argument. You know?
Angie: And ask for a hematology consult, also. That’s another takeaway.
Patrik: I would not send her anywhere without a hematology review first.
Angie: Okay. Okay.
Patrik: Look, are you saying that yesterday you were able to ask for diuretics, and they did that?
Angie: Yes.
Patrik: What-
Angie: Yes. I asked one of the fellows, I said, “Well, her Chest X-rays have been like this for the past few days. What can be done? Is it just Lasix? Is it exercise?” So, then it showed up, just for one day.
Patrik: So, without you asking, she may not have received the Lasix, you think?
Angie: No, absolutely not.
Patrik: Okay. Okay, that’s good.
Angie: No. No.
Patrik: That’s good to
know.
Angie: Yeah.
Patrik: Because if you can ask for Lasix, you can ask for a hematologist. You know?
Angie: Yes. Yes. Yes.
Patrik: I’m constantly surprised sometimes what moves the needle.
Angie: Hello?
Patrik: Hi Angie, it’s Patrik here again. I don’t know what happened.
Angie: Oh, okay. Yeah. I was just… No problem. I was talking. All right. So, I don’t know what I was saying, but it came from one of the fellows, I believe.
Patrik: Right.
Angie: Not the attending.
Patrik: Okay.
Angie:
And that I’ve known him for the whole 30 days.
Patrik: Right.
Angie: So, we were on a first name basis, but he doesn’t work every
day.
Patrik: Sure. But the good news is you were able to ask for some therapy, and you got through.
Angie: Yes.
Patrik: The bottom line is this Angie-
Angie: Yes.
Patrik: … if you don’t ask, you don’t get. That’s for sure.
Angie: Sure. Sure.
Patrik: You know their agenda. You know their agenda.
Angie: Sure.
Patrik: And that low hemoglobin could knock
her back into ICU if it’s not being sorted now. If it’s not being looked at now.
Angie: Got it. Sure.
Patrik: And-
Angie: Very fair, I understand. That’s very high risk.
Patrik: Absolutely. Absolutely. So, Angie, I need to move on for now, I’m sorry, we’re up to the
hour.
Angie: Sure.
Patrik: I’m-
Angie: No problem.
Patrik: Yep.
Angie: Sure. Sure. No
problem. Very helpful. I’ll be in charge.
Patrik: Okay.
Angie: See what I can do.
Patrik: Yep.
Angie: Based on your strategies. And I’m sure I’ll need more help.
Patrik: Yep. Please-
Angie: I just need to define in what shape and form.
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