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Today's article is about, “5 Reasons Why Families in ICU Have the Perception that ICU Teams Want to Stop Treatment Prematurely”
 

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5 Reasons Why Families in ICU Have the Perception that ICU Teams Want to Stop Treatment Prematurely

Hello and welcome to another intensivecarehotline.com and intensivecareathome.com livestream.

Today, our livestream is about, “5 reasons why families in intensive care have the perception that ICU teams want to stop treatment prematurely.”

Now, before we go into today’s topic, just some housekeeping issues. I also want to welcome anyone that’s watching this on replay, who doesn’t have the time to make it live here. We always get a lot of views on replay, but this is your opportunity to come on live on the show and ask questions to me directly, and I can answer them straight away. We will be going for approximately an hour.

I will talk about the 5 reasons why families in intensive care have the perception that ICU teams want to stop treatment prematurely, and then I will have other questions that we get during the week to go through. There’s plenty of things to talk about when it comes to pain points for families in intensive care, which is why I’m making these live streams and many other videos because we get so many questions and insights from families in intensive care, and we provide a safe place here to answer those questions.

So, before I go into the 5 reasons, what makes me qualified to talk about topics for families in intensive care? Once again, my name is Patrik Hutzel. I am a critical care nurse by background. I have been working in critical care nursing for 25 years in three different countries, where I worked as a nurse manager for over 5 years, and where I’ve been consulting and advocating for families in intensive care, all around the world, since 2013 here at intensivecarehotline.com.

I can very confidently say that we have saved many lives with our consulting and advocacy. You can verify that on our testimonial section at intensivecarehotline.com, and you can also verify it on our intensivecarehotline.com podcast section where we have done client interviews, once again, who verify the work that we’ve done for them saving their loved one’s lives.

So, I’m also the founder and managing director of Intensive Care at Home, and you can find more information at intensivecareathome.com.

With Intensive Care at Home, we are sending our critical care nurses into the home for predominantly long-term ventilated adults and children with tracheostomies, and we do that all around Australia.

At the moment, we are the only service in Australia that is actually third-party accredited when it comes to Intensive Care at Home nursing, which once again, includes ventilation, tracheostomy for adults and children, BIPAP, CPAP ventilation, tracheostomy care, Home TPN (Total Parenteral Nutrition), etc. We also provide Level 2 and Level 3 NDIS Support Coordination at Intensive Care at Home, and you can find out more information at intensivecareathome.com.

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Okay, without further ado, let’s talk about, “The 5 reasons why families in intensive care have the perception that intensive care teams want to stop treatment prematurely on their critically ill loved one.”

So, the video today comes out of talking to hundreds, probably, thousands of families in intensive care over the years in two and a half decades worth of intensive care nursing experience, and also Intensive Care at Home nursing experience. That’s the perception a lot of families have. I made a video the other day with the title, “What’s the urgency in killing someone in intensive care?” But that’s a title that came from one of the families that reached out to us and asked that very question, that was exactly their perception that they had.

Certainly, when I worked in intensive care still actively, I was certainly having the perception that there seems to be a rush to prematurely withdraw treatment whenever timelines of responsiveness to treatment wasn’t met.

So, what that means is if intensive care teams think that recovery is not happening in a timeframe that’s convenient for the intensive care team, then the clock is ticking. The clock is ticking down.

Then, families get told, “Well, we should be withdrawing treatment because if your loved one is going to survive, they won’t be having any “quality of life.” Well, what’s the quality of life? It’s a perception. No more than that. It’s a perception. No more than that. It’s not reality. It’s a perception. Intensive care teams are extremely bad at predicting the quality of life of a patient who survives intensive care. They’re extremely bad at that.

Next, let’s dive into the 5 reasons why families in intensive care think that intensive care teams want to stop treatment prematurely for their loved ones in intensive care. Now, these are the things that I’ve observed over the many years and decades that I’ve worked in this space.

Number one, and that is to me the most important point is that intensive care teams want to stay in control of the narrative, and they want to stay in control of a negative narrative. Why is that? They want to stay in control of a negative narrative to protect what they can do, to stay in control of the interaction.

So, picture this. You have a family member in intensive care for whatever reason, and the intensive care team tells you, “Oh yeah, we’ll be doing X, Y, and Z. Then, in three days or in three weeks, whatever the timeframe might be, your loved one will be discharged out of intensive care. Off they go to rehabilitation or recovery.” And then it doesn’t happen. The doctors and nurses could potentially be liable. So, it’s a liability issue. So, therefore they tend to underpromise. If anything, they tend to talk about the end of life early on.

Now, with all of that said, when a patient is in intensive care, they are very close to death compared to other situations, of course. They’re probably as close to death as they’ve ever been. There’s certainly some context to that.

By the same token, it is all about protecting the downside, and it’s part of that training. So, you have to read between the lines. Just because they’re putting a negative narrative out to you, doesn’t mean everything is doom and gloom. Not at all. That’s why you need to get a second opinion from Day 1.

Suggested Links: 

• “PEACE OF MIND, CONTROL, POWER AND INFLUENCE EVEN IN THE MOST CHALLENGING OF CIRCUMSTANCES THAT YOU, YOUR FAMILY AND YOUR CRITICALLY ILL LOVED ONE COULD POSSIBLY FACE IN INTENSIVE CARE!”
   
• Quality of life nursing services for Adults& Children requiring Non-Invasive mask ventilation such as CPAP or BIPAP and/or High-flow Oxygen therapy
   
• THE 7 THINGS FAMILIES DO WHO MAKE INFORMED DECISIONS HAVE PEACE OF MIND, ARE IN CONTROL, HAVE POWER AND HAVE INFLUENCE, WHILST THEIR LOVED ONE IS CRITICALLY ILL IN INTENSIVE CARE (PART 1)

That’s why you need to have someone hand holding you through this once in a lifetime situation. When you have a loved one critically ill in intensive care, and you simply can’t afford to get that wrong. If you do get it wrong, that’s when intensive care teams might withdraw life support prematurely without advocacy, without you getting a second opinion.

It’s much easier for them. Let’s just say things improve, your loved one is on their way to recovery, and everything is well. It’s much easier for them to say, “Oh, okay, we were wrong. Things have improved.” Great. But by creating a negative narrative right from the start, makes it very easy for them to tell you, “Well, I told you so. I told you so right from the start.” Makes it much easier for them to go down the track of, “Well, I told you right from the start we should be withdrawing treatment.” Makes it much easier for them to stay in control of the narrative.

Next, they are protecting their downside. Ties right in with the first case that health and intensive care, in particular, can be a very litigious arena. Many lawsuits might follow treatment in intensive care. Once again, by them saying, “Well, it’s not going to look great, we should be stopping treatment here very early on, so your loved one is not going to “suffer.”

Once again, protects their downside, protects them from telling you the opposite, which would be, once again, let me repeat that because I think it’s so important. They’re not telling you, “Oh yeah, we’ll do X, Y, and Z treatment here, and then your loved one will leave intensive care alive.” That would be one way to approach it. Then, if it doesn’t happen, you could sue them. By them telling you, “Oh, your loved one isn’t going to survive this, and your loved one isn’t going to survive this.” And then if they do, it’s much easier for them to say nothing. But if things go from bad to worse, they can easily tell you, “Well, we told you so.” You have to read between the lines. You absolutely have to read between the lines.

Number three, they want to manage beds and staff and equipment, and they want to stay in control of that. So, what do I mean by that? The most sought-after bed in a hospital is the intensive care bed, the critical care bed. That is the most sought-after bed and most in-demand bed in a hospital or in an ICU. 

So, with that said, if there’s pressure on beds and they need beds, one way to manage beds is simply by saying, “Look, we should be stopping treatment here. Your loved one won’t survive. They won’t have any quality of life if they do survive, and let’s stop treatment.” That, I have seen hundreds of times in intensive care, and I didn’t realize it at the time when I was working there but this is what’s actually happening because especially with services like now with Intensive Care at Home, for example, you can take patients home and continue treatment at home, improve quality of life at home, improve quality of end of life at home. So, they want to manage the resources, and that’s another reason.

I’ll give you a tangible example here. I remember many years ago, when I was still full-time employed in an ICU as a critical care nurse, I was coming onto a night shift, and I remember it was a 60-something-year-old man after he fell off his roof. He was doing some work on his house, he fell off his roof, and he banged his head on the ground, and he ended up with a traumatic brain injury. His brain was severely, severely damaged and he was declared brain-dead. Gone through all the testing, and he was declared brain-dead.

Now, in most jurisdictions, when someone is declared brain-dead, they’re also legally dead. That’s just the law. Well, explain that to a family who’s in shock, who is going through bereavement, who has no idea what’s happening, what does it even mean when someone is brain-dead, that they’re legally dead?

 Explain that to a family emotionally, who’s in emotional distress. You can’t really explain that to them.

Then, when I came on the shift, I was told, “Well, you need to extubate this patient by 10:00 tonight. We’re just going to stop everything.” And I said, “No, I’m not because the family’s not ready.” I knew that instinctively. I was told, “Well, are you going to not follow orders?” And I said, “That’s exactly what I’m doing. I’m not going to follow orders.” I said to the doctor at the time, “If you want to extubate this patient at 10:00 PM, go for your life. I’m not going to do it because I’d rather go home.” And those were my words.

I had the family on my side. There was no way I was going to do that. Felt very wrong. After much back and forth, they agreed with me. Also, knowing that I meant that I would go home and not continue my shift. I bought the family time. That’s all they wanted. It’s not that families don’t understand when their loved ones are dying because it was inevitable in this situation. It was a real end-of-life situation versus perceived end of life situation. That was a real end of life situation but it’s about how we go about it.

Many ICUs these days have completely sold out and lost their morals and ethics. Not all of them. There’s a lot of good things happening in ICU, but there’s also many ICUs who are simply desensitized. They’re desensitized by the work they’re doing. They’re desensitized to patients’ and families’ emotions, and feelings, how we need to approach those very sensitive topics with families and give them the time they need to grieve and go through the bereavement. There’s probably never enough time. But the more time, the better.

I know at the time what happened, I think it was on a Sunday night, actually. I remember there were lots of cases coming in the next day. So, the ICU was under a lot of pressure, freeing up the beds but we can’t just free up beds by killing people. That’s just not on.

Also, there’s a shortage of ICU staff, doctors, nurses, physios, whatever the case may be. That inevitably beckons the question, “How do we treat those people when they’re working in ICU? Are we treating them well enough, so they actually stick around for a long time to come?” That’s a whole separate discussion, but you understand what I’m saying here.

Suggested Links: 

• THE 7 THINGS FAMILIES DO WHO MAKE INFORMED DECISIONS HAVE PEACE OF MIND, ARE IN CONTROL, HAVE POWER AND HAVE INFLUENCE, WHILST THEIR LOVED ONE IS CRITICALLY ILL IN INTENSIVE CARE (PART 2)
   
• FOLLOW THIS PROVEN 6 STEP PROCESS, ON HOW TO BE POWERFUL, IN CONTROL, INFLUENTIAL AND HAVE PEACE OF MIND, IF YOUR LOVED ONE IS A LONG-TERM PATIENT IN INTENSIVE CARE OR IS FACING TREATMENT LIMITATIONS IN INTENSIVE CARE!

Then, what are 5 reasons why families in ICU have the perception that ICU teams want to stop treatment prematurely?  Well, another reason that I believe is happening, it’s clearly undermining patient rights and it’s also undermining family rights and it’s undermining human rights. I think we are in an era now where human rights and basic human rights are trying to be undermined, especially with this woke narrative going on everywhere that, in my mind and from my perspective, is clearly trying to undermine human rights, trying to limit free speech, and so forth.

Case in point. Last week, I was in a family meeting with one of our clients in an ICU in the U.S. I was there through a video call, and the ICU is trying to withhold nutrition from a patient. Now, nutrition in critical care is incredibly important. There’s enough research out there to warrant that nutrition is absolutely inevitable to be given for a critical care patient. It helps with healing, it helps with recovery, and so forth. There’s enough research out there.

This man has not had any nutrition for 5 days. That is negligence. That is starvation. I go as far as it’s an attempt of euthanasia, potentially an attempt of murder, could be perceived as that, and I was calling them out. I said, “By you not giving nutrition, you’re denying a basic human right and you are attempting to kill this person. We can’t live without nutrition.”

It was about the argument around whether the patient should have TPN (Total Parenteral Nutrition) or a jejunostomy tube, and the reason for that is the patient is BIPAP (Bi-Level Positive Airway Pressure)-dependent. If you feed them through a nasogastric tube or a PEG tube, they’re at high risk of aspiration. So, the other alternative here is TPN. TPN needs a central line insertion or a PICC (Peripherally inserted central catheter) line insertion.

Then, the intensive care team told the family that it’s too high infection risk to do a PICC line, central line, Hickman’s line for TPN. Now, my response to that is that’s like saying, “We should stop eating and drinking in case food is contaminated,” So, ICU says, “We can’t do TPN because of infection risk.”

Yes, there’s a higher infection risk for TPN than there is, for example, for feed through a nasogastric tube or a PEG tube. No doubt, no doubt about that.  However, once again, that is like saying, “We stop feeding, we stop eating and drinking because food and drinks might be contaminated.” That’s ludicrous. That is absolutely ludicrous.

So, it’s an undermining of patient and human rights, clearly and ICUs want to stay in control of that. They want to tell you that it’s humane to kill someone because they’re suffering, and they won’t have any quality of life in the future. Well, as far as I’m concerned, life is sacred.

When I worked in ICU still, in the end, it sort of opened my eyes eventually that there’s actual euthanasia happening in ICU but nobody wants to call it that way. If you start morphine and midazolam to help someone in the process of dying, that is euthanasia, as far as I’m concerned. We need to open our eyes to practices. We need to open our eyes. Now, it’s undermining patient and human rights, and we need to open our eyes.

Now, what they also did this week, when I was in the family meeting as an advocate, they told me that we should have a civil conversation around what’s happening. I said, “Well, let’s not use euphemisms here. You are trying to kill a patient by starving them.” And that’s what I mean. People want to restrict what people can say in this arena. Well, it’s time to call people out for when they’re doing the wrong things. We need to call people out for when they’re doing the wrong things.

What I also mean by that is they’ve lost all morals and ethics. They’re desensitized. For them, Mr. Smith in Bed 5, he’s on BIPAP, he’s got a critical illness, and that’s it. They’re not looking at that. It’s someone’s dad, someone’s husband, someone’s grandfather, whatever the case may be. For them, it’s just, “Yep, Mr. Smith in Bed 5, he’s on BIPAP. He’s dying” perceptionally because you can keep people alive for a long time if you want to, with the right mindset, with the right resources.

Once again, that’s why we have a business called Intensive Care at Home, where we send patients, adults and children, home from ICU predominantly for long-term ventilation, tracheostomy. But ask our clients, ask their families, do they think they’re suffering? No, they’re not. They want to live.

Suggested Links: 

• QUALITY OF LIFE NURSING SERVICES FOR VENTILATED ADULTS WITH TRACHEOSTOMY AND THEIR FAMILIES AS A GENUINE ALTERNATIVE TO INTENSIVE CARE
   
• 5 POWERFUL THINGS YOU NEED TO DO IF THE INTENSIVE CARE TEAM IS NEGATIVE WHEN YOUR LOVED ONE IS CRITICALLY ILL IN INTENSIVE CARE

So, this whole notion of, “Well, we don’t think that this person will have any quality of life if they do survive,” is complete and utter nonsense. Ask the patients and families what they want. Why did Stephen Hawking live into his ’70s on MND (Motor Neuron Disease), on a ventilator with a tracheostomy if he didn’t have any so-called quality of life? You got to look at what’s happening in the real world, and you got to open your eyes to it.

Lastly, the 5th reason why I believe that families think in intensive care that intensive care team are withdrawing treatment or stopping treatment prematurely. I do believe we have this population control. I do believe we have moved into an era where governments, health services, try to control the population. By deciding who can live and who can die, and when, we have an element of population control.

That, in my eyes, is particularly visible in the U.K. If you look at what’s happening in the U.K., but it’s also happening in the U.S., Australia, but in the U.K. in particular, where the courts are giving free rein to the NHS to kill children in ICU. The latest cases were Alfie Evans, Charlie Gard, Archie Battersbee, and there were others as well. Alma Hicks, I think. There were others too. Look at those cases.

They want to decide who can live and die, even though those kids could have ongoing treatment in other countries, the U.K. courts wouldn’t even let them fly out to other countries. That, in my mind, is population control. They didn’t want that kids can live because their parents are advocating for them. It’s wrong. It’s wrong on all ends.

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Okay, next. So, those are the 5 reasons. What do you think are the reasons? Leave your comments. Leave your comments, or join me live now on the StreamYard link, if you like, and share your opinion. You can join me live here on the StreamYard link by clicking on that link here. You can talk to me directly. Don’t need to go on camera, but you can go on camera or type your questions into the ChatPad and I will respond to them.

Also, there was a documentary from NBC News in the U.S. last year (https://rumble.com/v2wtd84-how-to-avoid-the-trap-of-the-medical-industrial-complex.html). It’s an interesting documentary and you must watch it. You must absolutely watch this documentary because journalists have done some research that some hospitals in the U.S. get incentivized by moving people into palliative care and into hospice and letting them die. They get incentivized by health insurances.

Let me repeat that. Hospitals are getting incentivized by health insurances to let patients die in either hospice or palliative care. It’s getting better than that, and then those numbers of palliative care patients don’t even show up in the mortality rate of hospitals. It is bizarre. Bizarre beyond words.

So, I could probably list another 5 reasons, but I think you get the gist here.

 You are getting the gist here of what’s really happening in this world, and you got to keep your eyes open. You absolutely have to keep your eyes open.

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