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 Brother is with Chronic Illness in ICU. Is it True that Long-Term ICU Management is Falling Down?
You can check out last week’s question by clicking on the link here.
In this episode of “YOUR QUESTIONS ANSWERED” I want to answer a question from one of my clients Megan, as part of my 1:1 consulting and advocacy service! Megan’s brother is bed-bound in
the ICU and the ICU team has a proactive plan going on for her brother. Megan is asking why is it in contrast to what they are telling her.
The ICU Team Has a Proactive Plan Going On For My Brother But Why is it in Contrast to What They are Telling me?
“You can also check out previous 1:1 consulting and advocacy sessions with me and Megan here.”
Part 1
Part 2
Part 3
Part 4
Part 5
Part 6
Part 7
Part 8
Part 9
Part 10
Patrik: Is there going to be a change of doctors tomorrow?
Megan: Yes. Tomorrow. Female is coming.
Patrik: Friday is the change of doctors?
Megan: Yes.
Patrik: Okay.
Megan: That’s what he told me.
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Patrik: Look, it’s up to you. I’ll be guided by you. What I would like to know, and that could be just a simple phone call to the nurse asking why they’re putting in that PICC line. That would be my most pressing question for now.
Megan: I mean-
Patrik: That could be as simple as making a phone call saying, “Hey, can I get an update from the bedside nurse?” That would sort of, that could be really simple.
Megan: And that could be the beginning.
Patrik: That’s right.
Megan: That could break the ice.
Patrik: That’s right. That’s right. Look and here is another, that’s a question for you.
Once I get to talk to the nurses, let’s say, especially to the nurses, I can relate to them as a nurse and you can say to them, “Oh, you know, it’s Patrik, he’s married to Mary and he’s also a nurse.”
Megan: I’ve told them this. I said you’re a very experienced nurse and that you run a unit. I said.
Patrik: Right. I have done. I have done it.
Megan: Yeah. I thought so. I really put you forward as somebody not to be messed with.
Patrik: Right. Because I can relate … I’m not threatening to them. To the nurses.
Because I can talk to them on their level without threatening them.
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Megan: Yes. And they can be probably more open and honest with you than they will be with me.
Patrik: That’s right.
Megan: They get defensive with me.
Patrik: That’s right. With the doctors, they might get their back up straighter but again, I can be confrontational but I don’t think it’s at that point.
Megan: No.
Patrik: We only want to be confrontational if there’s no other way.
Megan: If we have to be.
Patrik: That’s right.
Megan: And the other thing about being confrontational, I think it’s something to keep up our sleeve.
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Patrik: Yes. Yes.
Megan: Because they’ve ambushed me and I think we can ambush them.
Patrik: Absolutely.
Megan: They think I’m so, “Oh, she’ll just roll over. She’ll just roll over.” They could have a big surprise.
Patrik: Yes.
Megan: I’m not rolling over.
Patrik: That’s right. You’re not rolling over. Also, most families do roll over and that’s why they’re doing what they’re doing because they know that most families do a rollover.
Megan: Yes.
Patrik: Right. So they’re just waiting for you to roll over.
Megan: Yes. Yes. Yes.
Patrik: I wouldn’t worry about that at the moment. You know what they’re doing.
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Megan: Yes.
Patrik: Just matter of managing it.
Megan: Yes. And also, if they ask you, they might say, because you know that my dad was a surgeon. I think, it’s not that likely they’re going to ask you but my mother was an actress. A very beautiful actress and a model, and my father was a general surgeon at St. Therese hospital.
Patrik: Yeah. Yeah. Okay. If you can put all of that in an email.
Megan: In an email. It’s just that the sorts of things, because they saw some of the pictures and they might say, “Oh, isn’t Megan and his mother beautiful?” And you’ll be going, “Oh, yes.” But is she? Was she? I don’t think it’s very likely that they’re going to ask you but they did see the pictures. You never know and once they’ve asked the question and you don’t know the answer, we don’t want them catching that.
Patrik: No, no.
Megan: And I said Patrik, that you’re in Australia.
Patrik: Yeah. Yeah. But I’ll tell you what I have found, most of the time, when I enter those situations, it’s fine just to say, “Oh, yeah he’s a relative. He’s a cousin.”
Or whatever. It’s usually fine. They’re busy. It would have to take something extraordinary I think for them to really question.
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Megan: Question you. Yes. I agree. I just wanted to cover the bases.
Patrik: Yeah. Yeah. No, absolutely.
Megan: Caught out by them.
Patrik: Yeah. No.
Megan: Patrik, I’m going to put all these in an email to you right now.
Patrik: Please.
Megan: I’ll put the direct number to the bed, well the bedside area. Which are the four beds? I’ll put that in. The young girl, she’s not very experienced, but she’s very nice. I’ll put that in the email.
Patrik: Please.
Megan: She’s very sweet but she’s a bit nervous because she’s very new.
Patrik: Right.
Megan: So they’ve obviously put a very new, inexperienced nurses with Ryan.
Again, that shows a bit I think.
Patrik: It does and I’m not surprised because the rest of the staff are probably a little bit fed up.
Megan: Yes.
Patrik: Right? It’s not sort of … It’s getting boring, you’re going after the same patient over and over again.
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Megan: Yes. There’s nothing very exciting going on.
Patrik: No. So that could be part of it. You know, it’s not to say that they won’t have any of the experience to look after him again, but again, I know from experience that’s often what happens.
Megan: Yes. Indeed. So, I did mention you to her this morning. I just said that because of what the doctors had said to me yesterday, I had been in touch with you because I was quite upset, quite shocked. So I was very anxious that Ryan should be put out in the chair and I gave her a little bit of family history and she got so bored with the family history she just went, yes, yes, yes.
Patrik: Right.
Megan: Because she’s seen pictures of my grandfather at my parent’s wedding because they asked me to bring pictures in and I was explaining to her that Peter, who is also a doctor, this is his brother, son, and actually it was rather good because she got so confused she didn’t know what I was talking about.
Patrik: Right.
Megan: She was like, oh please. Yes it’s fine. Thank you. So I did kind of introduce you as married to my cousin and that you were very concerned.
Patrik: Absolutely. Now, when you ring them up yourself, do you speak to the nurses, or do you get a doctor on the phone as well? How do you manage that?
Megan: Right. You never get a doctor. They’re too grand to pick up the phone.
Never have I got … As far as I know, they have a receptionist woman who sometimes picks up the phone, and sometimes the nurses will just pick up the phone because it’s right there. And then I say, “Hello, it’s Megan. I’d like to speak to the nurse in charge of looking after my brother, Ryan in bed eight.” That’s what I say and they say, “Oh, Megan, yes. Hold on, we’ll put you through.”
Patrik: Sure.
Megan: That’s how it works. Sometimes you get the bedside, you might get a doctor, I think it’s unlikely. They seem to be too grand for that. And then there’s another woman who is a sort of receptionist that is very good. This is how I play it.
Patrik: Right. But if you had a serious concern, would you ring up there and ask to speak to one of the doctors, would you do that? Do you think you would get one?
Megan: I would ring up there and ask to speak to one of the doctors.
Patrik: Okay.
Megan: Yes, that’s exactly what I’d do. I’d probably wait to go in to speak to them but if I wanted an answer right now, I’d ring this number and I’d say, blah, blah, blah, it’s me. Is there a doctor available, I’m very concerned, blah, blah, blah.
That’s what I’d do. And there’s usually a doctor around.
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Patrik: Okay.
Megan: It seems that when you ring this particular number, it does go to the bed area. But sometimes it gets picked up at the main reception.
Patrik: Okay.
Megan: So if you wanted a doctor, you could get one on the same number.
Patrik: Yeah, sure. I think that would be the next step. Or we can play it whichever way you want.
Megan: By ear.
Patrik: Yeah. We can play it by ear. We can play it whichever way you want. The other thing we can do down the line is if you can set it up, we can set up a three-way call where I would dial your number, and then you would dial the doctor’s number whatever then we could talk on a three-way call.
Megan: Yes.
Patrik: No, no, I’ve done that. Basically all it is-
Megan: Oh, you’ve done it? Right.
Patrik: Yeah. I’ve done it. I would call you or you call me and then we call … We can dial somebody in. We can set up a three way call.
Megan: A three way call.
Patrik: I’ve definitely done that.
Megan: That’s something we could also do. The doctors there are very, very hurry up. They’re very much, you are a bit of a … Their attitude is, we are the doctors, we’ve got very important things to do, and really what … It’s really quite, “What do you want?”
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Patrik: That’s right. Talking to you is not one of the important things we have to do.
Megan: Indeed. You’re doing me a huge favor and could I please hurry up.
Patrik: Yeah.
Megan: Have you got any other questions? Right. Fine, goodbye. I find them quite offensive. I’ll be quite honest with you, Patrik. Their attitude maybe offensive, is a bit strong but it’s pretty unpleasant.
Patrik: Okay.
Megan: They’re not … They’ve always got something else they should be doing.
They’re all … It’s quite unpleasant and quite unnerving. I would say. They always act as if you’re an innocent. I’m an innocent.
Patrik: Yep. Okay. And because-
Megan: You’ve been there.
Patrik: Oh, absolutely.
Megan: Sorry?
Patrik: Because of that it is really time to push back a bit.
Megan: Yes. Yes. I think so. But I think we’ve got to that point anyway that we have to push back at them. Don’t you think? I mean … Yes. With that conversation last night, I do think today, I don’t like this PICC line thing at all but I do think today, apart from that, it sounded good but-
Patrik: If they were really putting in a PICC line to do a really nasty thing, they wouldn’t be sending him out of bed.
Megan: No. And having a plan. She said, this is the plan. And she said that means sitting in the chair. Then we’re going to do the weaning, then we’re getting back in the chair tomorrow, then on the weekend, we’re going to do this. And it did seem to me it was quite an, as they say, the proactive plan going on. Which was in contrast, in stark contrast, to what they said to me last night.
Patrik: Yeah. And besides what we talked about the DNR, you know with the policy and whatnot, you can also drop some hints around, “Oh, wouldn’t it be time after eight weeks in ICU, that he can have a shower?” You know, drop those hints.
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Megan: Yes.
Patrik: So that you’re not even going into any … You’re going in the other direction.
Megan: Yes. Yes. Start with a hint.
Patrik: Dropping hints. Wouldn’t it be nice that after all this time, he could have a shower? You know? All of that.
Megan: Yes. Definitely. It would be transformative. It would make him feel so human again.
Patrik: Yeah.
Megan: And really good for his skin.
Patrik: Oh, absolutely.
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Megan: And these bedsores as well, that’s not very good but-
Patrik: At this stage, and if they say things like, oh we don’t have the facilities or we don’t do that or we can’t do it, then you can say things like, well, I’ve heard in other units they do it. And it helps patients. And it does.
Megan: And it does. Yes.
Patrik: You know?
Megan: I can imagine a real game changer. A real game-changer. You know yourself how even in the morning, you have your shower you just feel different immediately. Imagine no shower for a month, or no bath.
Patrik: Exactly. You’re going in the other direction. The hint, well, it’s not a hint, it’s something you would be asking for is to get the policy for the DNR because again, you’re going in the other direction.
Megan: Yes. I’m going in the complete opposite direction to them. But in defense of the nurses, I would say that they do … obviously, they have to be very diplomatic.
But they do appear to be very, very genuinely very pleased when he does well.
They really do seem-
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Patrik: Yeah. Because they are there. The doctors just drop in for a few minutes, they look at a piece of paper while the nurses are the ones who know Ryan by now. I would hope.
Megan: They do. Indeed.
Patrik: They hopefully have a bond with him as well.
Megan: I think so.
Kind Regards
