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!

In the last blog I talked about

Simply, thank you! You helped saving my grandmother’s life!

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

In this week’s blog I want to talk about

Family meetings in Intensive Care, how to avoid the pitfalls!

Before I get into today’s topic I want to share a quote with you that I wrote on today’s topic and the quote says

Most families of critically ill Patients in Intensive Care are oblivious to the power dynamics when it comes to family meetings with the Intensive Care team!

Family meetings in Intensive Care tend to be highly emotionally charged meetings and the Intensive Care team usually only calls a family meeting to deliver bad news!

Most families of critically ill Patients in Intensive Care don’t see it coming, they are unaware of what to expect in a family meeting and therefore they are usually negatively surprised and taken aback by the outcomes of such meetings!

The truth of the matter is that family meetings in Intensive Care are the ultimate display of the “perceived power” and the “perceived authority” from the Intensive Care team and if you and your family are unprepared, you will stand no chance in those meetings to make informed decisions, have peace of mind, control, power and influence.

The Intensive Care team is hugely aware of the power dynamics in family meetings and they know what to say, how to say it, when to say it and they know what not to say!

If you are unprepared, don’t know about the power dynamics in those meetings, if you don’t know what questions to ask and you don’t know the importance of your positioning in those family meetings, you will most likely become a victim of the circumstances and chances are very high that the Intensive Care team can get their mainly “hidden agenda” accomplished and get what they want!

You therefore need to be prepared as much as you can before those meetings, because chances are that you’ll be so overwhelmed by the dynamics and the psychology during those meetings that there is a very high likelihood of you getting overwhelmed by your emotions!

So let’s get into today’s topic.

Family meetings in Intensive Care are one of my favourite topics and I have seen so many and have participated in so many family meetings in Intensive Care with the Intensive Care team that I could write and talk about it for hours!

Family meetings and avoiding the pitfalls!

Family meetings in Intensive Care are one of the biggest pitfalls for families of critically ill Patients in Intensive Care!

Family meetings in Intensive Care are literally very often “life or death” meetings without families of critically ill Patients in Intensive Care knowing what’s happening and what is at stake!

It’s bad enough that families of critically ill Patients in Intensive Care can’t really get prepared for any of the challenges that this situation brings along, it’s even worse that nobody prepares them for those all crucial family meetings with the Intensive Care team!

Here’s the thing.

Family meetings in Intensive Care are usually only held to deliver bad news and yet, families of critically ill Patients in Intensive Care don’t see it coming.

Think about it for a minute.

If your critically ill loved one is tracking well… the doctors and the nurses can give you an informal update at the bedside, it’s that simple. There are no formalities necessary… it’s no big deal…

If on the other hand things are not going so great, if your critically ill loved one is not improving and the Intensive Care team is wanting to make sure that they formally tell you what their plan of action is then they call a formal family meeting!

How do I know?

I have seen it over and over again in more than 15 years Intensive Care nursing in three different countries, where I have literally worked with thousands of critically ill Patients and their families, as well as when working with Clients one on one in my 1:1 counselling and consulting over the phone/Skype or via my email counselling service, I know I have seen my fare share of the struggles that families in Intensive Care are going through.

I have also worked as a Nurse Unit Manager in Intensive Care for more than 5 years and I have gotten enough insights into the world that is Intensive Care so that I can confidently say that I can and want to share with you all the insights that I have gathered over the many years.

The fact of the matter is that if your critically ill loved one is either

• very unstable and in a very critical condition

• in a life threatening situation

• not “waking up” after an induced coma

• in Intensive Care for long-term treatments and long-term stays (including long-term ventilation)

• 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” for your critically ill loved one

• approaching their end of life in Intensive Care 

and is not doing so well that the doctors will discuss your critically ill loved one’s case, their diagnosis and their prognosis behind closed doors and once they’ve made up their mind that they think it’s “in the best interest” for your critically ill loved one to “withdraw treatment”, to “limit treatment” or to issue a DNR(Do not resuscitate order) or an NFR(Not for resuscitation order) that they want to inform you in a “formal family meeting”.

That sets the tone from the start of those meetings.

The Intensive Care team usually has their mainly hidden agenda mapped out from the start for such a family meeting with you and your family.

The Intensive Care team has decided that your critically ill loved one is “doomed” that they won’t improve and also they don’t want to invest anymore physical as well as emotional resources to get your critically ill loved one out of Intensive Care alive!

Boom!

The Intensive Care team also makes those decisions knowing that 99% of the families of critically ill Patients in Intensive Care won’t question their decision, because those families don’t make informed decisions, don’t have peace of mind, don’t have control, don’t have power and don’t have influence!

Is it your agenda or the Intensive Care team’s agenda?

Therefore 99% of the time it’s easy for the Intensive Care team to call a family meeting, get their agenda on the table and shrewdly “sell” you and your family of what may be “in the best interest” for your critically ill loved one!

Again, more often than not family meetings are held in Intensive Care to deliver bad news, to tell families what’s “in the best interest” for your critically ill loved one and most of the time it’s that a “withdrawal of treatment”, a “limitation of treatment” and/or a DNR(Do not resuscitate order) or an NFR(Not for resuscitation order) might be “in the best interest” for your critically ill loved one!

Related:

• THE 5 THINGS YOU NEED TO KNOW IF THE MEDICAL TEAM IN INTENSIVE CARE WANTS TO “LIMIT TREATMENT”, WANTS TO “WITHDRAW TREATMENT” OR “WITHDRAW LIFE SUPPORT” OR WANTS TO ISSUE A “DNR” (DO NOT RESUSCITATE) OR AN “NFR” (NOT FOR RESUSCITATION) ORDER FOR YOUR CRITICALLY ILL LOVED ONE!

Again, most families of critically ill Patients in Intensive Care are so taken aback by this that they will be totally overwhelmed by their emotions and it often leaves them speechless, surprised, angry and even bitter!

Therefore, you and your family need to be prepared for those family meetings!

If you are not prepared for those family meetings you are falling into the 99% category of families of critically ill Patients in Intensive Care who don’t make informed decisions, don’t have peace of mind, don’t have control, don’t have power and don’t have influence!

Are you and your family prepared for the consequences?

Family meetings in Intensive Care are often “life or death” meetings and yet, most families in Intensive Care are unprepared and tend to trust blindly and are therefore negatively surprised during family meetings!

After a family meeting is held, it’s often too late. Decisions have been made, documents have been signed and I have seen many Patients die within hours after a family meeting has been held, because life sustaining treatment has been withdrawn and withheld and therefore Patients die without this life sustaining treatment!

Now, I’m not saying here that I can save your critically ill loved one’s life!

What I am however saying is that whenever you and your family are called to a formal family meeting with the Intensive Care team, you and your family need to have done your research and you need to be prepared, full stop!

Here are the things that are most important for you and your family to pay attention to before, during and after a family meeting with the Intensive Care team

• you need to know and understand what questions to ask

• you need to know and understand that “what you see is not always what you get in Intensive Care”

• you need to know and understand that there are many moving parts in Intensive Care behind the scenes that impact on how the Intensive Care team positions your critically ill loved one’s diagnosis, their prognosis, their care and their treatment

• you need to know and understand that you and your family need to have strong mental positioning during, before and after those meetings and you need to understand how you need to position your critically ill loved one’s diagnosis, their prognosis, their care and their treatment!
  

• You need to know and understand that during those meetings the Intensive Care team thinks that they will get what they want no matter what, because they think they are dealing with another family who doesn’t know a thing about Intensive Care

• You need to know and understand that the Intensive Care team are the master of playing with your emotions during those family meetings and that most of the time families are feeling grateful for everything that has been done for their loved one to this point without having perspective on the overall situation! It’s therefore easy for the Intensive Care team to shrewdly “sell” you on what they want and therefore take advantage during your moments of gratitude!

• You also need to know and understand that there are ways how you can strongly position your critically ill loved one's diagnosis, their prognosis as well as their care and treatment during a family meeting so that you have leverage and bargaining power!

Your job as always is to stay on high alert, get as much information about Intensive Care as you can. Keep looking at the power dynamics in Intensive Care, learn about them and turn them upside down!

This is the only way that you can get negotiation power and leverage in family meetings with the Intensive Care team!

Related:

• FOLLOW THIS ULTIMATE 6 STEP GUIDE FOR FAMILY MEETINGS WITH THE INTENSIVE CARE TEAM, THAT GETS YOU TO HAVE PEACE OF MIND, CONTROL, POWER AND INFLUENCE FAST, IF YOUR LOVED ONE IS CRITICALLY ILL IN INTENSIVE CARE!

Your friend​​​​​​​

Patrik