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 BLOG you’ve discovered

“The 5 compelling reasons why you need to have PEACE OF MIND, control, power and influence whilst your loved one is critically ill in Intensive Care”!

You can check out last week’s BLOG by clicking on the link here.

In this week’s BLOG I want to give you 

The 5 ways how RESILIENT FAMILIES in

Intensive Care STAND BACK UP when life knocks

them down!

Most Families of critically ill Patients in Intensive Care have no PEACE OF MIND, no control, no power and no influence!

I even go as far to say that 99% of Families of critically ill Patients in Intensive Care have no PEACE OF MIND, no control, no power and no influence!

Why do I say this?

I say this because after more than 15 years Intensive Care nursing experience in three different countries and after I have literally worked and looked after THOUSANDS of critically ill Patients and their Family members in Intensive Care, I know firsthand the pain, the frustrations, the fear, the sacrifice, the emotional drama and the level of vulnerability those Families of critically ill Patients in Intensive Care go through and experience!

 You and your family are way outside of your comfort zone!

I also know how much they throw their hands up in the air and I know that Families of critically ill Patients in Intensive Care say, feel and think how much this situation of having a loved one critically ill in Intensive Care is immediately throwing them outside of their comfort zone!

I also know firsthand and from my experience that Families of critically ill Patients in Intensive Care feel like they are helpless and overwhelmed with the situation and they don’t really know what to do.

I also know firsthand and from my experience that Families who’s critically ill loved one in Intensive Care is either

• 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

that they are feeling even worse off and they feel like they are so far outside of their comfort zone that they feel like they are literally “losing the plot!”   

And rightly so, if your critically ill loved one is in one the aforementioned difficult, challenging and often heartbreaking situations your and your Family’s job is to get resilient quickly!

Your and your Family’s job is to literally “get your act together” so to speak!

And I’m not suggesting that in normal and everyday life you don’t have your act together. However, in this unique and “ONCE IN A LIFETIME” situation and challenge you can’t afford of to not having your act together and become more resilient!

And once again, after more than 15 years Intensive Care nursing in three different countries and after having worked with literally THOUSANDS of critically ill Patients and their Families I have seen it all and I know how the few Families who became more resilient have done it!

In the process they have gained tremendous levels of PEACE OF MIND, control, power and influence, something 99% of Families of critically ill Patients in Intensive Care will never achieve!

Therefore I want to share with you

 “The 5 ways how RESILIENT FAMILIES in Intensive Care STAND BACK UP when life knocks them down!”

Let's dive right into it

1. Families who are RESILIENT are not or stop being intimidated by the Intensive Care team

Look, if you are like 99% of Families of critically ill Patients in Intensive Care you play the game the Intensive Care team wants you to play. You buy into the “perceived power” and the “perceived authority” of the Intensive Care team and you are quite frankly intimidated by it!

After all that’s how society conditioned you and you should certainly “play by society’s rules”!

And if you are like 99% of Families of critically ill Patients in Intensive Care you are nice, you “suck up” to the Intensive Care team, you don’t question, you abide by their rules and you are generally speaking kept at “arm’s length” by the Intensive Care team because you don’t want to be a “trouble maker”!

In the meantime, the Intensive Care team is driving their mainly hidden agenda and in the meantime you, your Family and your critically ill loved one are even losing more ground!

What’s also quietly happening “BEHIND THE SCENES” in the meantime is that the Intensive Care team’s politics, the dynamics, their competing interests, the power play, the intrigue and the psychology in an Intensive Care Unit is what’s driving the positioning of the Intensive Care team!

Those forces are often also what’s driving the positioning of your critically ill loved one’s diagnosis and prognosis by the Intensive Care team!

The fact of the matter is that if you and your Family continue to be intimidated by the Intensive Care team, your critically ill loved one may bear the brunt and you will literally have no PEACE OF MIND, no power, no control and no influence!

Related article:

How to stop being intimidated by the Intensive Care team and how you will be seen as equals!

2. Families who are RESILIENT understand what’s happening “BEHIND THE SCENES” in Intensive Care

Look, if you don’t understand that what’s happening “BEHIND THE SCENES” in Intensive Care you are doomed!

The fact of the matter is that Families of critically ill Patients in Intensive Care who are RESILIENT, understand that the moving parts, the interests and what’s happening “BEHIND THE SCENES” in Intensive Care go way beyond their critically ill loved one’s prognosis and diagnosis!

So does decision making!

If your critically ill loved one is either

• 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

the Intensive Care team is weighing up their options WITHOUT TALKING TO YOU and/or your critically ill loved one!

You, your family and your critically ill loved one are the last ones to find out that if the Intensive Care team thinks that

• continuing to treat your critically ill loved one is costing too much money $$$ or that they will lose money that they will sit you down and try and “sell” you on a “withdrawal of treatment” or a “limitation of life support” as being “IN THE BEST INTEREST” of your critically ill loved one

• This could also be the case if the Intensive Care team has other critically ill Patients waiting for ICU beds, because generally speaking the demand on precious, scarce and expensive ICU beds is usually high!

• You also need to be on high alert about medical research in Intensive Care! Medical research is a Billion Dollar $$$ per year industry and often critically ill Patients are enrolled in medical research studies in Intensive Care without them or their Families knowing about it, let alone them having given written or verbal consent! Often, critically ill Patients who can be or who are enrolled in medical research may get preferred treatment or get prolonged treatment, because there is funding($$$) attached to it. This can sometimes also mean that in end of life situations treatment and unnecessary suffering is prolonged because the Intensive Care team wants to conduct medical research! It could also mean that if your critically ill loved one doesn’t fit a medical research category that the Intensive Care team has less interest in treating them!

 Related Articles:

Why decision making in Intensive Care GOES WAY BEYOND your critically ill loved one’s DIAGNOSIS AND PROGNOSIS!

How MEDICAL RESEARCH DOMINATES your critically ill loved one’s diagnosis and prognosis, as well as the CARE and TREATMENT your loved one IS RECEIVING or NOT RECEIVING!

3. Families who are RESILIENT are “difficult and demanding”

If you are like 99% of Families of critically ill Patients in Intensive Care who have no PEACE OF MIND, no power, no control and no influence, you are nice, you “suck up” to the Intensive care team and you generally speaking don’t want to “rock the boat”!

That’s the mindset of 99% of Families of critically ill Patients in Intensive Care who have no PEACE OF MIND, no power, no control and no influence! Therefore it’s easy for the Intensive Care team to drive home their agenda!

Families in Intensive Care who are RESILIENT, who have PEACE OF MIND, control, power and influence tend to be “difficult and demanding”, they don’t buy into the “perceived power” and the “perceived authority” of the Intensive Care team!

Families in Intensive Care who are RESILIENT have also realized that they are in a “ONCE IN A LIFETIME” situation that they can’t really afford to get wrong!

Families in Intensive Care who are RESILIENT have also realized that they are in control of their own destiny and that they need to take full responsibility for the outcomes and results that they get!

Related Articles:

The 5 reasons why you need to be difficult and demanding if your loved one is critically ill in Intensive Care!

Why having a loved one critically ill in Intensive Care is “A ONCE IN A LIFETIME” situation and why YOU can’t AFFORD GETTING IT WRONG!

4. Families in Intensive Care who are RESILIENT have good body language and posture!

99% of Families of critically ill Patients in Intensive Care who have no PEACE OF MIND, no control, no power and no influence share this implicitly or explicitly with the outside world by displaying poor body language and poor posture!

Their back is slumped, their shoulders are moved inwards, they avoid strong eye contact, they have a weak handshake, their arms are crossed and their tone of voice is weak!

Everybody can see that they have no PEACE OF MIND, no control, no power and no influence!

Families in Intensive Care who are RESILIENT realize this and they change it!

And I can promise you that the minute that you change your body language and the minute that you realize that this situation is challenging but that you will also do whatever it takes to have PEACE OF MIND, to have power, to have control and to have influence, that’s the minute when things will change!

The minute you take control of your body language and your town of voice, that’s the minute when the Intensive Care team will know that they are dealing with a RESILIENT and POWERFUL Family!

Try it at your own risk but I promise you that the world will notice!

Related article:

Why YOUR BODY LANGUAGE may be your BIGGEST OBSTACLE to PEACE OF MIND, control, power and influence whilst your loved one is critically ill in Intensive Care!

5. Families in Intensive Care who are RESILIENT do their own research, they are driving their own agenda and they won’t take “NO” for an answer

If you have come this far, you already know what you need to do! You already know that doing your own research, that driving your own agenda, irrespective of what the Intensive Care team keeps throwing at you and not taking “NO” for an answer is what’s getting you results!

You already know that “doing whatever it takes” on your path to PEACE OF MIND, control, power and influence is what you need to do!

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 from one of our readers and the question last week was PART 3 of

“My Mother is in ICU after her heart stopped! We believe that the Intensive Care team is keeping her sedated & paralysed for longer than necessary, what should we do?”(PART 3)

 You can check out the answer to last week’s question by clicking on the link here.

Trudie and her Dad have also been featured in our PODCAST and you can check out Trudie's and her Dad's interview here. Trudie and her Dad share their story when their mother was in Intensive Care, while they were dealing with a difficult Intensive Care team! Check it out here!

 In this week’s episode of “YOUR QUESTIONS ANSWERED”   I want to answer the next question that Trudie from the UK has, as her mother continued to be in Intensive Care after the cardiac arrest!

So, therefore in today’s episode of “YOUR QUESTIONS ANSWERED”  I want to answer PART 4 of

“My Mother is in ICU after her heart stopped! We believe that the Intensive Care team is keeping her sedated & paralysed for longer than necessary, what should we do?”(PART 4)

Hi Patrik,

Thank you again. You have given us immense support and confidence. You are clearly a busy man yourself, but your advice and guidance has been invaluable. I'm pleased to report my Mum was moved out of ICU this morning. I expect we'll have different battles with different medical teams now and so to all intents and purposes our correspondence is probably at an end (notwithstanding the interview we'll do with you in a few weeks).

I honestly don't think we could have been so brave without your back-up and I really believe that our persistence helped my mother - we are the only family (from the ones I met during the course of last week), that wasn't taken into a side room to be given bad news - seeds were planted, e.g. "she's making good progress, but she may take backwards steps", but we weren't officially 'groomed' for the worst.

And I think that's because we didn't let up with the pressure and intelligent questioning. It was hard to stay calm and cordial, and although we were clearly difficult, we were never rude or abusive, never raised our voices and often smiled.

Not easy when I wanted to cry and shout quite a lot, but again, that's where you came in. I could almost hear you in my head. However, as you point out even if we had been rude that shouldn't prejudice care. My father pointed out that the fear that people have that being difficult will impact upon their loved one indicates that there is something very wrong going on. Yet, we were still told by some family members last week, 'be quiet, let them do their job, you'll make things bad'.

I think it's really interesting that no-one has researched the role of families in supporting those in critical care, but not surprised as the research plays into the power lines you describe. However, I am heartened that nurses like you, and our friendly and supportive nurse on the team here, exist.

The nurse we were impressed by here kept saying how useful our presence was  - he was interested in going on to do research, perhaps even into the role of families - I told him about your site and he was genuinely interested - maybe he'll find you. I expect he'll be told off for being so open with us, so he may need your support too.  There must be lots of others like you both and perhaps you'll all be able to join up through INTENSIVECAREHOTLINE - you are really agents of change.

I do think it's really important that we see this all through now, even though my Mum has left ICU. We have emailed the hospital trust governance board, pointing out why transparency is in the 'best interests' of the patient and I have constructed a legal argument based on the Mental Capacity Act 2005 to demonstrate this. In doing this I have shown how they failed to adequately implement certain sections of the law and that including us more fully would have remedied this. I have no doubt their lawyers will disagree, but perhaps it will make them think about things a bit.

I am happy to share this correspondence with you if you are interested in logging it (removing personal details) as a resource on your site - although it's use might depend on the final outcome.

Even though this has all been pretty horrible I've learnt so much and I certainly feel empowered by this experience. The doctor I was mainly dealing with was massive and I am very small. The size difference was a metaphor for all the rest of the power differentials. Yet we stood our ground. In a powerless situation we had something positive to do, something that really helped, we had PEACE OF MIND.

We owe you a huge debt and will try and repay that debt by finishing our own small campaign at the hospital.

I would like to add that a couple of years ago my grandmother died in the same hospital following being out on the Liverpool Care Pathway - I don't know if you know of this, but following a national scandal it is no longer (explicitly) used. I was overcome by grief at that time and my grandfather was full of praise for the hospital (a mistake I think) so I didn't take my objections further. I deeply regret not being one of the voices that helped overturn a cruel practice that put budgets over people. I will not make the same mistake again.

Thanks again Patrik for your time, your detailed correspondence, fantastic site and wonderful support.

I look forward to doing an interview for the site, and will keep you updated if you wish. And please do let me know if there's anything I can do to further support your amazing and important work in the future.

Best wishes

Trudie

Hi Trudie,

Thank you for keeping me informed with those positive developments!

I am very glad to hear that your mother has moved out of ICU, well done!

I am also very pleased to know that my advice has helped you through this challenging situation! It has been a pleasure to do so.

Standing your ground, doing your own research  and not being intimidated by the “perceived power” and the “perceived authority” of the Intensive Care team always helps and always pays dividends.

I am not surprised that other Families you have met and spoken to have been delivered “bad news” by the Intensive Care team.

This from my experience is often about positioning. One thing that I keep repeating on my blog is that the positioning of the Intensive Care team of a critically ill Patient’s prognosis and diagnosis is almost always dependent on what’s happening “BEHIND THE SCENES” in Intensive Care. And as I have pointed out before, what’s happening “BEHIND THE SCENES” in Intensive Care is so powerful that if Families are unaware of it, they may well miss the boat completely.

By that I mean that the financial interests, the medical research interests, the staffing issues, the bed management pressures and the limited resources in Intensive care always almost imply that the Intensive Care team is painting a “doom and gloom” picture of the prognosis and diagnosis of a critically ill Patient!

This leaves plenty of room for the Intensive Care team to then “twist and turn” the clinical facts and to also keep Families of critically ill Patients at “arm’s length” so to speak.

You and your family weren’t officially “groomed for the worst”, because the Intensive Care team at one point or another realised that they are dealing with a powerful family who questions, who doesn’t take “no” for an answer and who simply is prepared to do whatever it takes to have PEACE OF MIND, control, power and influence!

Unlike other Families of critically ill Patients who have no idea what they walk into when they are first meeting with the Intensive Care team!

That’s why I created some blogs about Family meetings with the Intensive Care team. Check them out here.

• Family Meetings in Intensive Care or the Elephant in the Room
• How can I be prepared, be mentally strong and be well positioned for a Family meeting with the Intensive Care team?(PART 1)  
• How can I be prepared, be mentally strong and be well positioned for a Family meeting with the Intensive Care team?(PART 2)

This often negative positioning of the prognosis and diagnosis of the Intensive Care team also leaves plenty of room for the Intensive Care team to “sell” a “withdrawal of treatment” or a “limitation of life support” as being “IN THE BEST INTEREST” of a critically ill Patient.

Related article: The 5 questions you need to ask when the Intensive Care team is talking about “Futility of treatment”, “Withdrawal of life support” or about “Withdrawal of treatment”!

As you and your father have correctly pointed out, the “seeds have been planted” without Families realising that often a “withdrawal of treatment”, “a limitation of life support” and/or a “DNR”(Do not resuscitate) order or an “NFR”(Not for resuscitation) order is easier to be “sold” to families if the negative positioning and the “doom and gloom” was “sold” in the first place.

The problem however is that from my experience many “withdrawal of treatment” situations are a direct result of the many competing interests “BEHIND THE SCENES” in Intensive Care such as the financial interests, the medical research interests, the staffing issues, the bed management pressures and the limited resources in Intensive care and they almost always play a role when it comes to crucial and literal “life and death” decisions.

I’m also glad to hear that you and your father have identified that other Families do feel intimidated and would never dare to be “difficult and demanding”!

This is exactly what I refer to when I say that 99% of families of critically ill Patients in Intensive Care have no PEACE OF MIND, no control, no power and no influence! They just witness an event, in fact a “ONCE IN A LIFETIME” event and they are just passive bystanders, rather than being pro-active!

And that may well be the right approach, if things are straightforward and if their loved one is a “straight forward” overnight admission to Intensive Care.

However, the minute a critically ill Patient is either

• 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

that’s when families need to be on high alert and they can’t just lean back, be quiet and “let them do their thing”!

I am also very glad to hear that you dealt with a friendly bedside nurse who compassionately understood your situation!

I don’t think that he will be in trouble, I constantly live and breathe my bedside nursing the way I approach my information on my blog and I haven’t been in trouble. I strongly believe that authenticity goes a long way and can’t really be challenged.

I am also very proud of you that you have even gone the extra mile and written to the hospital board with a legal argument! I would be highly interested in what comes out of the dispute and would be interested in any communication that comes from it.

Of course names would have to be removed, but I’m sure it would be a fantastic resource to share with other Families!

I can also see that you and your family had real awareness of the situation by you saying that “The doctor I was mainly dealing with was massive and I am very small. The size difference was a metaphor for all the rest of the power differentials. Yet we stood our ground”

Good for you to not only notice and also to have an awareness of the "perceived power". But you also realised that it is only perceived and not even real.

You could make that paradigm shift and yet so many families in Intensive Care can’t make that paradigm shift and that’s why they continue to feel intimidated!

Related article:

Why YOUR BODY LANGUAGE may be your BIGGEST OBSTACLE to PEACE OF MIND, control, power and influence whilst your loved one is critically ill in Intensive Care

Last but not least, I am well aware of the “Liverpool care pathway”. I am also glad to hear from a family first hand that they felt that the “Liverpool care pathway” didn’t serve their loved one in an end of life situation!

I am not surprised by this at all.

The “Liverpool care pathway” puts indeed budgets above people.

The “Liverpool care pathway” is another vehicle where I have seen families being “sold” on a “withdrawal of treatment” as being “in the best interest” of their critically ill loved one.

It’s highly questionable and for example, I am a strong advocate that even for Intensive Care Patients they should be given a choice of where to die(I.e. home care even for ICU Patients www.intensivecareathome.com.au )and the “Liverpool care pathway” doesn’t give Patients and Families that choice.

It’s a “one size fits all” package that doesn’t take into consideration that we are dealing with people(Patients and their Families) who are in an extremely vulnerable situation.

Therefore a “one size fits all” highly questionable care plan isn’t going to cut the mustard so to speak.

The “Liverpool care pathway” is a pathway that is moulded around the needs of an Intensive Care Unit or a general hospital ward, where the power play, the dynamics, the politics, the competing interests, the intrigue, the psychology and the hidden agenda in Intensive Care is often by far more important than the individual’s needs.

Thank you once again for your detailed description of the events and I am really looking forward to do a follow up interview, when you and your Family are ready!

I hope it’s all going well from now on!

Speak soon.

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!

You can also send through your stories and share them on our BLOG for our readers! Just email support@intensivecarehotline.com or leave a comment on our BLOG

Or if you want to be featured on our podcast with your story, just email me at support@intensivecarehotline.com

FREE Video Mini- Course out now!

If you are interested in more FREE education and information if your loved one is critically ill in Intensive Care, I have created a FREE mini- course 

A BLUEPRINT for PEACE OF MIND, CONTROL, POWER& INFLUENCE whilst your loved one is critically ill in Intensive Care! 

The FREE Video Mini- course consists of 4 short videos that will educate you quickly and succinctly how you can have PEACE OF MIND, control, power and influence whilst your loved one is critically ill in Intensive Care.

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http://intensivecarehotline.com/free-mini-course/

Also, our cutting edge new information PRODUCT will be released soon! We are NOW finalizing our first cutting edge information PRODUCT that will help Families of critically ill Patients MASTER, take control, have power and influence in all of the most challenging situations in Intensive Care, even if their loved one is dying!

 The information product will be an "IN-DEPTH" education product for Families of critically ill Patients in Intensive Care and a SHORTCUT for Families to have PEACE OF MIND, control, power& influence! The focus of the education product will be on PEACE OF MIND, control, power and influence during the following situations in Intensive Care

• 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
• severe head and brain injuries

The information product will be made available in Ebook, Video and Audio format so that our Customers can consume the information product in their chosen medium! 

Keep your eyes on news and updates for our cutting edge new information PRODUCT!

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If you have any questions about our upcoming products or if you have any suggestions 

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Your Friend

Patrik Hutzel

Critical Care Nurse

Founder& Editor

WWW.INTENSIVECAREHOTLINE.COM