In our blog you will find information about everything related to Intensive Care and Critical Care and how it can help you and your Family whilst your loved one is critically ill in Intensive Care. The blog wants to provide value, resources and tips to Families of critically ill Patients in their difficult and challenging situation.

Helping hospitals and Intensive Care Units in particular, freeing up beds and staff
Friday, 17 May 2013

This blog post was first published at our sister site http://intensivecareathome.com.au a specialised home care nursing service, providing Quality of Life and/or Quality of end of life for long-term mechanically ventilated Adults& Children with Tracheostomy and their Families, as a genuine alternative to a long term stay in Intensive Care.

In last week’s blog I was talking about “What an extension of Intensive Care looks like in the real world”. If you haven’t read it you can read it further below in our blog section.
In this week’s blog I want to highlight and focus on how INTENSIVE CARE AT HOME can help Hospitals and Intensive Care Units in particular, to free up beds and staff, which are both valuable and expensive resources for any Intensive Care Unit.

By taking a long-term ventilated Adult or Child with Tracheostomy out of Intensive Care into their own home, your organisation wins on both ends. You would be having an empty bed that can be allocated and used for a more acutely unwell Patient and you would also be having staff available to accommodate a new and acutely unwell Patient. Your organisation would most likely also save to book an expensive agency staff member or book overtime or a casual staff member to accommodate that new admission. And if you think about your staff satisfaction, your nursing and your medical staff most likely also prefer to look after a new admission, rather than after the “day 60 Trachy” on a ventilator that isn’t going anywhere soon. You can leave that to the specialists such as INTENSIVE CARE AT HOME and you can worry and focus about what you do best which is acute Intensive Care, just like we can then focus on what we do best which Intensive Care At Home.

What INTENSIVE CARE AT HOME can also do is to accommodate short term and temporary respite for your long term ventilated Adults& children with Tracheostomy by taking them home for up to two weeks or for however long you deem to be an appropriate time frame, before returning the Patient back to Hospital. Chances are that if your Patient is long-term ventilated and a difficult and slow respiratory wean that by taking the Patient out of the Intensive Care Unit into their own home that they will blossom by being at home and you have an empty bed, staff and it will cost less than an ICU bed.

I was giving a talk a couple of weeks ago at the ACPEL(Advanced Care Planning and End-of-Life care) conference in Melbourne and a couple of Intensivists asked me about doing short term and temporary respite for some of their long-term Patients as they felt that this would speed up their recovery process as they also thought that the difficulty in weaning somebody off the ventilator is partly a psychological issue, which is often related to the Intensive Care environment and the lack of Quality of Life in ICU.

What are your thoughts and what would you like to see in Intensive Home Care nursing services doing for your Patients and for your hospital? Send us your comments to support@intensivecarehotline.com or patrik@intensivecareathome.com.au

Intensive Care at its best?
Wednesday 15th May 2013

In last week’s blog I described that INTENSIVE CARE HOTLINE wants to help our readers and subscribers by providing the best and most valuable website and blog for Families and Friends who have a critically ill loved one in Intensive Care. That’s a bold statement to make that INTENSIVE CARE HOTLINE wants to be the best and most valuable website and blog for Families and Friends who have a critically ill loved one in Intensive Care.
Why do we want to achieve that, how do we do it and where did it all start?
We want to achieve our bold claim and bold goal, because I personally think that with all the difficulties, challenges and issues that a Family of a critically ill Patient is dealing with when their loved one is admitted to Intensive Care, there is simply not enough support for those Families. There are no or not enough dedicated and tailor made resources for Families and Friends who have a critically ill loved one in Intensive Care. One thing that I have seen and noticed when doing my research when I first started thinking about launching a platform for Families of critically ill Intensive Care Patients was that there are a million websites out there about clinical pictures, about Intensive Care, Critical Care, diseases, illnesses etc… But here’s the deal. Most of these websites are from health professionals for health professionals. Very few websites- if any- and resources are purely designed for Families of critically ill Patients in Intensive Care with the goal of improving their lives by giving them insights, strategies and resources. The support in Intensive Care units for Families is more often than not falling short and information from health professionals in Intensive Care need to be taken for face value. This can be a good thing and I am not suggesting that you can’t trust that information. But especially in difficult and challenging situations, such as end of life, long- term ventilation and/or severe critical illness with expected future Quality of Life issues, who is actually helping Families to cope with the burden that they and their critically ill loved one are facing? Who can give Families of critically ill Patients in Intensive Care perspective and advice when it comes to their critically ill loved one approaching their end of life? Who is giving Families of critically ill Patients in Intensive Care perspective and advice if their critically ill loved one has been in Intensive Care for more than 40 days on a ventilator with Tracheostomy with no outlook of improvement? Who is giving Families of critically ill Patients perspective and advice if their loved one has just had a major accident or a cardiac arrest and their critically ill loved one is looking forward to an uncertain future, with a possible negative impact on their future Quality of life? How do Families and their loved ones cope with such massive dilemmas? Who can point them in the right direction and who can show them how to cope during their stressful, overwhelming, challenging, emotional and difficult journey in Intensive Care, whilst their loved one is critically ill? Who can show them how to effectively deal with their fears, frustrations and vulnerabilities? Who can show Families of critically ill Patients in Intensive Care how to manage the doctors and nurses more efficiently so that they have more control, more power and are able to influence decision making? Who can show them the mistakes they are making whilst their loved one is critically ill in Intensive Care that is holding them back in managing their situation more effectively and efficiently?
Health professionals in Intensive Care tend to be extremely time poor and they are not trained to give you answers to the more fundamental questions once your critically ill loved one has been admitted to Intensive Care. And with the more fundamental questions I mean the questions that refer to you and your Family and how you cope and deal with the situation and how much you know and how much you understand in the situation. We believe that INTENSIVE CARE HOTLINE has a lot of answers to those questions and challenges and because of what I mentioned before, there is no other resource and website at this point in time that can offer such succinct and tailor made advice than we do and at this point in time it’s all free of charge. All you need to do is to browse the website and enter your name and email and you’ll get your first FREE “INSTANT IMPACT” report!
You can also look at our FREE “get your questions answered” http://intensivecarehotline.com/your-questions-answered where I answer a weekly question of a reader and I’m sure you’ll find useful information there as well!
With this in mind I hope you are enjoying this website and our information and send us your questions and comments to support@intensivecarehotline.com. I answer emails personally and usually within less than 24 hours!

Sincerely, your friend
Patrik Hutzel

How we can help you

Wednesday, 8th May 2013

In today’s blog I want to welcome you to INTENSIVE CARE HOTLINE and my goal is to provide value to Families and Friends of critically ill Patients in Intensive Care.
My goal is to have the best blog and the best website for Families and Friends of critically ill Patients in Intensive Care. INTENSIVE CARE HOTLINE really wants to provide resources, information and support and also show you action steps how you and your Family can instantly improve your life if your loved one is critically ill in Intensive Care. We also aim at giving you a ‘behind the scenes’ insight of what is really happening in Intensive Care so that you know and understand how politics(yes, hospitals and Intensive Care Units in particular are highly political environments) may impact on your loved ones care and on your loved ones treatment. We aim to clear the fog for you so that you can clearly see what you are dealing with, whilst your loved one is critically ill in Intensive Care and we try and leave no stone unturned.
We will also show you that you are making mistakes whilst your loved one is critically ill in Intensive Care and how, more often than not, those mistakes are holding you back on improving your and your Family’s situation whilst your loved one is critically ill in Intensive Care.
Whilst I believe we can provide massive value, we also need your support and your feedback whether you find what we are doing here is useful for you. So please leave your comments, questions or suggestions below or email us at support@intensivecarehotline.com
After having worked in Intensive Care as a Nurse for more than 13 years, I have found one common theme. No matter how great the staff in Intensive Care are and no matter how great the Intensive Care team is in looking after your critically ill loved one, the support that often falls short is the support for Families of those critically ill people in Intensive Care!
One thing that I say from a nursing perspective in Intensive Care, is that once the clinical things are under control and taken care of, the next big task and challenge is usually looking after the Family of a critically ill Patient. This can sometimes be a difficult undertaking because we are managing strong emotions, strong feelings and sometimes difficult family dynamics. We are also managing what I would like to refer to as ‘fish outside of water’ or people that are massively out of their comfort zone. Life usually changes for critically ill Patients and their Families in an instant, whether the reason for admission to Intensive Care is a Motor vehicle accident, a heart attack, elective surgery, pneumonia and the list goes on.
Health professionals in Intensive Care, doctors, nurses, Physiotherapists, Respiratory therapists etc… are usually like ‘fish in water’ and they are usually totally in their comfort zone when dealing with critically ill Patients in Intensive Care. That’s what they are here to do, they are usually very good at it and they generally love it! They generally feel a strong calling to something that’s bigger than them.
Having said the very skills and the very tasks that makes them very good at what they are doing and is unquestionably saving lives and improves people’s lives, doesn’t necessarily make them good or proficient at taking care of the other side of the spectrum, which are often the Patient’s families.
In Intensive Care I far too often here things such as “the Family has been difficult”, “the Family doesn’t understand”, “the Family can’t let go” or “the Family is inappropriate”. I am very frustrated by such statements and I personally think that there are no such things as “a family being difficult” because they have every right in asking questions and feel apprehensive about the situation that they find their critically ill loved one and themselves in.
Those are statements frequently used by doctors and nurses in Intensive Care when referring to Patients Family’s and it really makes me angry and frustrates me when health professionals in Intensive Care speak about Families of critically ill Patients in Intensive Care like that. Once again, health professionals in Intensive Care are like ‘fish in water’ and Families of critically ill Patients in Intensive Care are like ‘fish outside of water’ and that’s the bottom line. Their live has just been turned upside down and they are dealing with the unknown and the focus tends to be on the clinical side, in order to get critically ill Patients better. Once that has been achieved then we might start thinking about the Family, who in the meantime understands that it’s not an easy ride. A total lack of control, fear, frustration, vulnerability and other strong feelings and strong emotions start to pour in and besides the explanations at the bedside from doctors and nurses in Intensive Care, there are still a lot of black holes and rabbit holes that Families would have to crawl into, in order to really understand what they and their critically ill loved one are in it for.
Here at INTENSIVE CARE HOTLINE we crawl into these black holes and rabbit holes so that you can get comprehensive advice and support so that you can fully understand the implications of your and your critically ill loved ones situation so that you can start managing yourself and your family, but we also want you to start managing the doctors and nurses in Intensive Care. You can only do that if you have the right knowledge, advice and insights about Intensive Care.

Sincerely, your friend
Patrik Hutzel

What an extension of Intensive Care looks like in the real world
Monday, 06 May 2013

This blog post was first published at our sister site http://intensivecareathome.com.au a specialised home care nursing service, providing Quality of Life and/or Quality of end of life for long-term mechanically ventilated Adults& Children with Trcaheostomy and their Families, as a genuine alternative to a long term stay in Intensive Care.

In this week’s blog I want to further evaluate and further explain what INTENSIVE CARE AT HOME services look like in the real world and how they work as an extension of Hospital Intensive Care services.
So, let’s say an adult or a child has been in Intensive Care for a long period of time- and I consider a long period of time around the day 40 to day 60 mark- and the only thing that’s keeping the adult or the child in Intensive Care is the ventilator dependency with Tracheostomy. Furthermore, it’s unlikely that the long-term ventilated adult or child is going anywhere in a hurry and they are likely to stay in Intensive Care for long periods to come, which is often the case with long-term ventilated Adults or Children with Tracheostomy.

Rather than now waiting for the ventilator dependent adult or child to go through a long, slow, burdensome and often difficult weaning process with numerous likely setbacks, including developing or catching an infection in an Intensive Care environment, INTENSIVE CARE AT HOME provides a genuine, safe and a more holistic alternative and solution to the problem that the long-term ventilated adult or child, including their Family is facing. Imagine what improvements can be made in somebody’s own home by being more flexible, being more mobile, by having more social interactions with family and friends and by being less dependent on a clinical routine in a clinical environment. How much better does it feel from an emotional and psychological point of view for a Client and their Family to have choice and more control in their own home environment?

By taking a long-term ventilated adult or child out of Intensive Care a new horizon opens for the often depressed, lethargic, sometimes delirious and sleep disturbed individual and their Families. It makes a massive positive emotional and psychological difference to the Clients, as well as to the Families by having the choice and the opportunity to go home. It also opens up new and exciting opportunities for Intensive Care Units, Hospitals, as well as for health care funding organisations, whether they’d be public or private.

The service option to go home can be chosen for a long-term ventilated Adult or Child with Tracheostomy if they are likely to improve and if they are likely to be weaned off the ventilator.

The service option is also there for long-term ventilated Adults or Children who are likely to approach their end of life. Rather than spending their last few weeks or sometimes months in Intensive Care on a ventilator, how much nicer would it be to have Quality of end of life in their own home? Some Intensive Care Units are taking some of their long-term Patients home for a day before starting to palliate those Patients in a clinical environment. Palliation and Quality of-end-of-Life can be achieved in a home environment for long-term ventilated Clients and you don’t have to wait 60 or 80 days in Intensive Care before somebody is going home for a day. You can safely take those Clients home and let them spend their last few weeks at home- on a ventilator. I am sure that everybody working in Intensive Care can picture Patients who are suitable for a home care environment, even if you haven’t worked in the Intensive Home Care environment!

Imagine what it means for a long-term ventilated Adult or Child to be in Intensive Care, in foreign territory, totally out of their comfort zone very often with little dignity and little privacy. The same applies to the family of the Client. Imagine what it means for the Family of a long-term ventilated Adult or Child in Intensive Care. How much longer can they watch their loved one suffer in foreign territory?

As always, I’d like your views on this topic. What do you think? Leave a comment below in our comment section!

If you are a health professional in Intensive Care and you think you know a long-term ventilated Adult or Child with Tracheostomy and their Family who would like to improve their Quality of Life and/or their Quality of end of Life in their own home rather than in Intensive Care- even if it is to go home for a weekend- and if your organisation would also like to save money and resources along the way or if you simply have any questions check out http://intensivecareathome.com.au/ or send us an email to support@intensivecarehotline.com

Sincerely, your friend

Patrik Hutzel