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“ and in last week’s episode I answered another question from our readers and the question was
My Dad In ICU Is On A Regular CPAP Machine. Why Does The ICU Team Tell Me That We Cannot Connect His Trache On To The CPAP Machine?
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 the succeeding questions from one of my clients Peter as part of my 1:1
consulting and advocacy service! telling that his Dad in ICU has pressure sores and asking if it’s a sign of a bad nursing care.
My Dad in ICU has pressure sores. Is it a sign of a bad nursing care?
“You can also check out previous 1:1 consulting and advocacy session with me and Peter here.”
PART 1
PART 2
PART 3
PART 4
PART 5
Peter: Yes, He was.
Patrik: So that’s okay.
Peter: I’m glad we don’t have bad things to talk about right now.
Patrik: Sorry.
Peter: I said I’m glad we don’t have bad things to talk about.
Patrik: That’s right. I mean it’s still like your dad is in hospital but at least he’s moving forward.
Peter: Yeah. And that bothers me now, you know?
Patrik: Of course. I mean, yes he’s moving forward. We don’t have bad things to talk about for now, but at the end of the day he will need care and support.
Peter: Probably, a lot yeah.
Peter: He was telling me about how sedation kind of floats around in your blood for a couple of days, right?
Patrik: That’s right. That’s right. And you’re still in the hospital 24 hours a day?
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Peter: Yeah but this weekend my brother’s going to come in and we’re going to swap.
Patrik: Good.
Peter: I’m just gonna stay in.
Patrik: Yeah. You need a rest.
Peter: So yeah. At least I’m glad that he got into that
Patrik: Yeah. That’s helpful.
Peter: The doctors and the RN personnel, I think it all helps.
Patrik: Oh, for sure. And what we might be able to help you with down the line is when he goes home, especially with overnight care, we might be able to help you set up something. As I said to you, we do home nursing here in Melbourne. And I can’t see why we couldn’t do the same somewhere else. As long as we can source nurses. But that would be for a whole other conversation. I guess, for now, the goal is to get onto rehab and then see what
happens next.
Peter: Yeah. I mean so… I’m hoping this fatigue, he gets past this.
Patrik: Yeah.
Peter: I tell you he was more awake yesterday with the tube hanging out of his neck.
Patrik: Right.
Peter: Maybe the relief will come and everything gone.
Patrik: Well and he would have had anesthetics yesterday when they did the trach. He would have some mild… And keep in mind, with all the sedation he’s had while he was on the breathing tube, that’s still sort of… It takes awhile to wash out, you know?
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Peter: Yeah. He was on a couple of different things. They told me yesterday.
Patrik: Right.
Peter: He had a procedure that ain’t exactly easy. You know they gotta cut your neck open.
Patrik: That’s exactly right.
Peter: But they did a nice job.
Patrik: It sounds like things are moving forward. That’s the main thing for now.
Peter: I’m thinking in the future, we should probably keep this opening in his neck just in case he ever needs to. What do you think? I would keep that right?
Patrik: You mean the tracheostomy?
Peter: Yeah.
Patrik: Nope. It really depends.
Peter: Fine.
Patrik: Look. It’s really depends what the next few days or weeks. I mean, if he gets stronger. I guess on the one hand, it’s a good sign he’s off the ventilator quickly but let’s wait and see what the next few days or weeks brings. It’ll be hard to say today whether he can get rid of
the trach all together or not. That’s something time will tell.
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Peter: Okay. Well, just hoping that he can figure that out. Maybe I’d like to say it’s all the sedation he got.
Patrik: Yeah. I would give it a few more days and hopefully with the change in environment of him going to rehab. Hopefully, that will sort of help with this neurological condition as well. Just give it some time.
Peter: They said his bottoms a little sore too.
Patrik: That’s no good. That’s no good.
Peter: They use all this cream and stuff.
Patrik: Right? Well.
Peter: What’s your view into this?
Patrik: I can tell you what my view is. I’m all for cream, but what I think is way more important that cream is taking pressure off his back every couple of hours. That is way more important. And if somebody has pressure sores, that’s a sign that they probably haven’t done enough of this. And also, do you know whether he’s on an air mattress?
Peter: Yeah. They got an air mattress. I pushed for that.
Patrik: And how long has he had the air mattress for now? Days?
Peter: Probably four or five days. Yeah, he’s been on it for a while.
Patrik: Yeah. Okay. Well four or five days given his hospital stay, they should have done that earlier. Especially since he’s now got pressure sores. My advice would be to keep asking them about It because it’s a sign that it’s not good nursing care if he gets pressure sores.
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Peter: Yeah. You know what it is? They keep all these pads under him.
Patrik: Yeah.
Peter: And they ruin the effect of the air mattress.
Patrik: Yeah. That’s causing friction.
Peter: Yeah. So many pads, you know. You don’t get the… you get two pads under there.
Patrik: That’s causing friction.
Peter: They don’t like me telling them what to do.
Patrik: Well they probably don’t but at the end of the day, if he has pressure sores it’s a sign that somethings not working for them or what they’re doing. That’s really a sign of bad nursing care.
Peter: I recommended the mepilex or the duoderm because I had good luck with that stuff.
Patrik: Right.
Peter: It’s a miracle. Four to five days to come it off. It’s all healed under there.
Patrik: Duoderm is fantastic. Mepilex can be good. Yeah. Duoderm is definitely fantastic. There’s no question about that but you shouldn’t need duoderm in the first place if you’re doing your job right.
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Peter: Yeah. Well I don’t know. Any good solutions?
Patrik: The solution is quite simply if he’s in bed, they need to take the pressure off his back every couple of hours. That’s the solution.
Peter: Okay.
Patrik: That creates work but that’s what needs to be done. You know?
Peter: Yeah. They’re trying.
Patrik: Okay.
Peter: They are moving him. They come in and move him. They just moved him. That’s why I’m getting something to eat here while they’re moving him right now.
Patrik: Right. Right.
Peter: Alright. I don’t want to hold you.
Patrik: No. No. It’s fine. You call me whenever you need me.
Peter: Okay.
Patrik: Alright.
Peter: Let me ask you one question.
Patrik: Yeah. Please.
Peter: How does this work with the… You know how they say I pay you so much for what is it? Seven days for different input advice.
Patrik: Well what it is is…. What it’s based on?
Peter: What I was asking, how much time… Is there so much time per day, if I ask you one question in one day, does that count as the whole day?
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Patrik: Not really. Not really. What I count is if we have a proper conversation like today. That I count. But if you called me again today, I wouldn’t. It’s unlimited really or we had a couple of days, I think, where we emailed.
Peter: Yeah.
Patrik: You know, I’m not, sort of… I haven’t got my notes in front of me, but really you signed up for 14 days. And again, that doesn’t have to be consecutive days. You have, I don’t know, at least another five days or so left at least. You know?
Peter: Yeah. Right.
Patrik: You and its-
Peter: How you time it, you know?
Patrik: Yeah. With some clients, and it really depends on their situation, you know. Sometimes I talk to clients three times a day. It really depends on situational, you know. And if I think, you know, you need more time, we’ll do that. It’s not-
Peter: I was just wondering.
Patrik: Absolutely. Absolutely.
Peter: Because I asked, maybe with a short conversation would it be… I don’t know how to… I don’t know what I’m… I’m just trying to figure out how-
Patrik: Yeah. How it works. And look, as I read to you, it’s almost different for people and clients. Yeah, you’re calling every couple of days and we have a chat for maybe an hour or whatever. That I count. But at the same time, if you called me again in a couple of hours, that’s part of one day. I’m not-
Peter: That’s reasonable. No that’s-
Patrik: Yeah. So I really want to make sure you get value out of this.
Peter: Yeah.
Patrik: And also, if for whatever reason after those two weeks, you want to continue, I would make sure you get a generous discount. Because as time goes on, things get easier. For me too because I know the situation much better, you know?
Peter: Yeah. The early part it was kind of tough, you know?
Patrik: That’s right. I continue keep getting to know the situation, you usually need to spend more time. But as time goes on, usually it gets easier for me too.
Peter: Yeah. That’s true. I don’t know. Did you ever deal with a lawyer?
Patrik: Oh, yes I have. Many times. It’s part of-
Peter: I had a lawyer once. I emailed them how much do I owe you and he charged me for the email asking how much I owed him.
Patrik: Right. I can tell you-
Peter: The fee was $25. I said what’s that for? “Well you know. You communicated with me. Asking me how much I owe you.” I said look, I’m just trying to pay. You’re charging me for asking? I thought it was so funny. Every little thing. Even if he emails and asks you how you’re doing, you get a bill.
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Patrik: Right. That’s what lawyers are like.
Peter: How somebody, I was just wondering. That’s why I wanted to ask you. But I can see.
Patrik: I’m not like a lawyer, you know. I’m not charging by the minute or by… That’s not what I do.
Peter: I think it’s reasonable. You have a certain expectation. I don’t think anything. I think you’re doing good. I wouldn’t be back again. You’re tipping off to what to look for, what to ask for. I think it’s a very good service you’re doing.
Patrik: Yeah. Well, thank you. Thank you so much for those kind words.
Peter: And you know, one of the doctors said today that when I asked a question or something, supposedly this is what another nurse told me. The doctor said “Boy. He asks good questions.” You beyond help.
Patrik: That’s good.
Peter: You have given me some help to be more informed. Supposedly they were saying he asks some good questions.
Patrik: Right.
Peter: Now that’s good. I just thought I’d run it by.
Patrik: That’s great. Thank you for that feedback.
Peter: You take care now, eh.
Patrik: Thank you.
Peter: Alright. I’ll take that. I’m just worried about with Dad.
Patrik: Absolutely.
Peter: Just give it a few more days do you think?
Patrik: Yeah. Look, give it two more days. Maybe he’s off the ventilator completely. But it sounds to me like he will need some overnight ventilation because he’s had it before. The question really is will he need overnight ventilation with a permanent tracheostomy or can he go back on the mask? That I believe will be the question of the future.
Peter: Yeah. Do they have to close that trach?
Patrik: No. I have never seen it. I think the question will be around can they take the trach out? Or if they can’t take it out, he will need the ventilation with the trach? Right? That will be-
Peter: What about the balloon? I heard they can deflate the balloon.
Patrik: Yes they can. They can. But then if they deflate the balloon and he has some heart ventilation, there’s a high chance that the air would escape through the trach.
Peter: Oh. There’s not another space huh? I think we’ll probably end up using the ventilator for his night time CPAP, I guess.
Patrik: That’s what it looks like at the moment. That’s what it looks like at the moment. And it will come down to whether they think they can remove the trach or not. That’s what it’ll come down to.
Peter: I just hate to put him through all that again. I’m beginning to think it would be nice if he could keep the thing. But then he can’t talk as much though.
Patrik: That’s right. Can’t talk, can’t eat.
Peter: Yeah. He doesn’t eat anyway. But the talking I worry about, you know?
Patrik: Right. Right.
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Peter: I don’t want to put him through all that again, you know?
Patrik: What’s he eating? Right. What’s he eating?
Peter: He was on a feeding tube. So he’s still on a feeding tube right now.
Patrik: Right. Right. Okay.
Peter: But I’m sorry. That’s-
Patrik: Don’t be sorry. Don’t be sorry. Alright. I’ll talk to you later.
Peter: Alright. Take care now.
Patrik: Take care. Bye.
The 1:1 consulting session will continue in next week’s episode.
Kind Regards
Patrik
