Hi, it's Patrik Hutzel from INTENSIVECAREHOTLINE.COM , where we INSTANTLY improve the lives of Families of critically ill Patients in Intensive Care, so that you can 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!
In last week’s PODCAST I’ve featured Dr Monica Williams- Murphy from www.oktodie.com “Podcast with Dr Monica Williams- Murphy from OKTODIE.COM”
You can check out last week’s PODCAST here!
In this week’s BLOG I want to share with you
It’s very easy to get bogged down and become negative if your loved one is critically ill
in Intensive Care!
After all you and your Family are facing one of the biggest challenges in your entire lifetime!
Having a loved one critically ill in Intensive Care is
nothing short of being a “ONCE IN A LIFETIME” experience and a “ONCE IN A
LIFETIME” challenge!
Surveys suggests that “The change in the health status of a Family member is in the top 10 of the most stressful events in one’s lifetime!”
Imagine that, “The change in the health status of a Family member is in the top 10 of the most stressful events in one’s lifetime!”
It doesn’t mention critical illness, it doesn’t mention Intensive Care and it doesn’t mention situations where your critically ill loved one is
- very unstable and in a very critical condition
- in a life threatening situation
- in Intensive Care for long-term treatments and long-term stays
- having a severe(traumatic) head or brain injury
- threatened with an “NFR”(Not for resuscitation) or “DNR”(Do not resuscitate)
order
- In a situation where the Intensive Care team suggests a “withdrawal of treatment” or a “limitation of treatment” as being “in the best interest” of your critically ill loved one
- approaching their end of life in Intensive Care
all it says is that “The change in the health status of a Family member is in the top 10 of the most stressful events in one’s lifetime!”
I bet that your and your Family’s stress levels are through the
roof!
And after more than 15 years Intensive Care nursing in three different countries and after I have literally worked with THOUSANDS of critically ill Patients and their Families I know first hand that the stress, the frustration, the anxiety, the overwhelm and the level of vulnerability you
are currently exposed to have skyrocketed.
And during this difficult, challenging and “ONCE IN A
LIFETIME” situation when your loved one is critically ill in Intensive Care it’s very easy to become negative.
It’s easy to become negative, especially if you look around and see all the other Families of critically ill Patients in Intensive Care who have no PEACE OF MIND, no power, no control and no
influence!
The Intensive Care team holds 99% of Families of critically ill Patients in Intensive Care hostage
It’s palpable that those Families of critically ill Patients in
Intensive Care are negative, you can see it by their poor body language and you can hear it in their tone of voice that the
Intensive Care team controls them.
Those 99% Families of critically ill Patients in Intensive Care who have no PEACE OF MIND, no power, no control and no influence are held hostage by the Intensive Care team’s positioning and they are held hostage by the Intensive Care
team painting a “doom and gloom” and a negative picture.
They are also held hostage by their own negative and pessimistic inner dialogue and their inability to take action and start being proactive!
And I am not talking about those situations where your loved one is in Intensive Care for a couple of days.
I am talking about those situations where your critically ill loved one is
- very unstable and in a very critical condition
- in a life threatening situation
- in Intensive Care for long-term treatments and long-term stays
- having a severe(traumatic) head or brain injury
- threatened with an “NFR”(Not for resuscitation) or “DNR”(Do not resuscitate) order
- In a situation where the Intensive
Care team suggests a “withdrawal of treatment” or a “limitation of treatment” as being “in the best interest” of your critically ill loved one
- approaching their end of life in Intensive Care
Because if your loved one is critically ill in Intensive Care and is facing one of the
aforementioned massive challenges, the Intensive Care team will put it in a negative light so that they can not only protect their professional reputation in case things go wrong.
They also put things in a negative light because of their competing interests, the dynamics, the
psychology, the intrigue, the power play and THE HIDDEN AGENDA “BEHIND THE SCENES” in Intensive Care!
It makes the Intensive Care team always position your critically ill loved one’s diagnosis and prognosis in a way that keeps all their options open.
The Intensive Care team wants to keep their options open to
keep the upper hand at all times
Keeping their options open means that at any given point during your critically ill loved one’s stay in Intensive Care, the Intensive Care team wants to be in a position to
- STOP OR LIMIT TREATMENT if they think that it’s taking up too much of their financial($$$) or emotional resources
- “sell” you and your family on the idea that “withdrawing” or “limiting” treatment is “IN
THE BEST INTEREST” of your critically ill loved one
- Manage their beds and Patient flow effectively. I.e. Intensive Care beds are scarce, expensive and in high demand and if at any given point during your critically ill loved one’s stay in Intensive Care the pressure on beds gets too high- again- the Intensive Care team
wants to be in a position to admit other Patients that they may deem more financially viable($$$), more interesting and more “sexy” to look after
- Conduct medical research on their critically ill Patients. After
all, medical research is a multi Billion $$$ Dollar per year Industry and often care, treatment and the positioning of your critically ill loved one’s diagnosis and prognosis is dependent on whether the Intensive Care team can enrol your critically ill loved one in a medical research study
This is only a snapshot of the moving parts in Intensive Care “BEHIND THE SCENES”.
This is only a snapshot of what you and your Family have to consider if your loved one is critically ill in Intensive Care! And it’s only a snapshot of why you and your Family have the negative talk in your head that things are pretty dicey!
Staying positive is essential and not optional
The alternative is to stay positive anyway no matter the challenges you and your Family are currently facing.
Related article:
How to stay positive if your loved one is critically ill in Intensive Care
The alternative is also to be proactive, the alternative is to start managing the
situation from your end and the alternative is to have PEACE OF MIND, control, power and influence whilst your loved one is critically ill in Intensive Care!
The alternative is to start doing your own research, to not take anything for “FACE VALUE” the Intensive Care team is
telling you, the alternative is to have a plan and a strategy to turn things around in your favour, no matter how difficult the situation is!
Related articles:
The 3 ways on HOW TO TURN THE TABLES IN YOUR FAVOUR and have control, power and influence whilst your loved one is critically ill in Intensive Care
The 4 ways you can overcome INSURMOUNTABLE OBSTACLES whilst your loved one is critically ill in Intensive Care!
The
alternative is to also not take “NO” for an answer no matter how challenging the situation is and the alternative is to get a handle on things and get an unfair advantage compared to 99% of Families of critically ill Patients in Intensive Care who remain at the mercy of the Intensive Care team and who are left behind without PEACE OF MIND, without power, without control and without influence!
Arming yourself with the right tools and strategies is key
By now you know that PEACE OF MIND, control, power and influence are within your reach, you know it’s possible and you know that
if you keep arming yourself with the right tools and the right strategies, I promise you the Intensive Care team will notice and they will treat you and your Family differently compared to the 99% of Families of critically ill Patients in Intensive Care who have no PEACE OF MIND, no control, no power and no influence!
You know by now that if you keep going against the grain, the Intensive Care team can’t keep playing their games with you and they will literally have a hard time to keep playing their games with you and keep you at “arm’s length”!
Every Family that I have counselled and supported so
far has always confirmed that my strategies work and that all of a sudden, they have gotten results and the Intensive Care team changed their positioning. All of a sudden those Families had negotiation and bargaining power!
Because if you keep asking the right questions, if you are not
intimidated by the Intensive Care team’s perceived power and perceived authority you will find yourself in a position where you will have PEACE OF MIND, control, power and influence!
Also, check out our "YOUR QUESTIONS ANSWERED" section
where I answer all of YOUR questions
http://intensivecarehotline.com/category/questions/
Hi, it's Patrik Hutzel from INTENSIVECAREHOTLINE.COM , where we INSTANTLY improve the
lives of Families of critically ill Patients in Intensive Care, so that you can 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” and in last week’s episode I answered another question that our readers ask quite frequently and the question last week was
“How long can a critically ill Patient stay on ECMO?”
You can check out the answer to last week’s question by clicking on the link here.
In this week’s episode of “YOUR QUESTIONS ANSWERED” I want to answer another question from one of our readers and this week, Chris from Denver asks.
Hi Patrik,
My 75 year old father has been on a ventilator with tracheostomy for about four weeks after he
developed a severe Pneumonia after he had open heart surgery for a bypass.
Thankfully, after a long and arduous process, he managed to stay off the ventilator, but he still has his Tracheostomy in. He has been off the ventilator for 5 days now and only requires some humidification through the Tracheostomy.
He is coughing up a fair amount of sputum and he does require regular suctioning from the nurses.
As you can imagine, we as a family and my father as well are quite keen to have the Tracheostomy removed as quickly as possible as well.
The doctors are saying that as long as he still has many secretions coming up that they don’t want to remove the Tracheostomy as yet.
My father is desperate to talk and he’s desperate to eat and drink.
We are worried that this is dragging on for much longer than necessary and we want
to find out what the options are and how long after somebody has been weaned off the ventilator the Tracheostomy can be removed?
Your advice is much appreciated.
Chris
Hi Chris,
thank you for making contact and thank you for
sending your question through!
It sounds like your father and your family have been through a lot, as generally speaking open heart surgery in most cases tends to be fairly straight forward these days, as long as it’s elective or planned.
That didn’t appear to be the case with your father and I’m very sorry to hear that he ended up in Intensive Care for more than four weeks on a ventilator and the Tracheostomy.
Thankfully, he managed to stay off the ventilator and the next natural step is to
obviously have the Tracheostomy removed as well.
As a rule of thumb, the current guidelines for Tracheostomy removal should be considered before removing the Tracheostomy (decannulation)
- Your father should be off the ventilator for at least 3-4 days, which it sounds like he has been
- He should be able to cough and swallow and therefore not at any risk of aspiration(aspiration is the entry of stomach content or sputum into the lungs after swallowing or vomiting)
- The frequency of suctioning, therefore suctioning should be at a minimum and less than once or twice a day
- Your father should be able to clear and maintain his own airway and he should
therefore be able to cough up his secretions
- Generally speaking the Tracheostomy protects from aspiration because of the blocking of the trachea(wind pipe) with a cuff
- A normal
and satisfactory ABG(Arterial blood gas) test, which checks the level of oxygen(O2) and carbon dioxide(CO2) in the blood
- Oxygen saturation in the blood above 93-94%
- A normal and
clear chest x-ray that doesn’t suggest anything malicious like an infection, collapse or Pneumonia
- A swallowing test that is normal, because again after Tracheostomy removal you want to make sure that there is no aspiration and that your father can actually enjoy some food and drinks. A swallowing test should be carried out by the
speech pathology team
After your Dad fulfils all of those requests, his tracheostomy may be plugged(closed) for twenty four hours and they are monitored for breathing/respiratory difficulty or suction requirement before the tube can be removed.
So please Chris, if you are unsure you now have the guidelines for Tracheostomy removal to give back to the Intensive Care team and you can prompt them towards the steps of those guidelines.
What you can also do in the meantime is to ask the Physiotherapy to do more
breathing and coughing exercises with your Dad, as often the respiratory or breathing muscles get tired and exhausted after prolonged mechanical ventilation.
Therefore, your father might have to build up some of that strength first before they can remove the Tracheostomy.
I hope that helps Chris.
Please let me know if you have any other questions.
Sincerely,
YOUR FRIEND
Patrik
Hutzel
If you want your questions answered just hit reply to this email or email me at support@intensivecarehotline.com and I'll answer your questions!
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- long-term stays in Intensive Care
- end- of- life situations
- Family meetings with the Intensive Care team
- withdrawal of treatment situations and/or perceived medical futility
- what to do if your critically ill loved one is THREATENED with an "NFR"(Not for resuscitation) or "DNR"(Do not resuscitate) order
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Your Friend
Patrik Hutzel
Critical Care Nurse
Founder& Editor
WWW.INTENSIVECAREHOTLINE.COM