Blog

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.

What the doctors and the nurses behaviour in Intensive Care is telling you about the culture in a unit

Culture in ICU MP3

Your loved one has just been admitted to Intensive Care and is being treated for their critical illness.
You feel like some of the doctors and nurses are talking at you and over you and don’t necessarily talk with you or talk to you. You feel like you are not in a good place and you may feel like there is a big barrier between you and the health professionals that are in charge of your critically ill loved one’s destiny.
You may have been asked to get out of the room or the cubicle every time the doctors are doing their ward round and examine your loved one and you may have wondered whether they’ve got anything to hide. When you are allowed to come back, they have already moved on and the bedside nurse is giving you a summary of the plan ahead. Of course you can wait for one of the doctors to talk to you later in the day what is going to happen to your critically ill loved one.
About 10 minutes later the bedside nurse is asking you kindly to leave the room again, as she wants to “quickly” turn your loved one to the other side so that he or she doesn’t get a pressure sore. 10 minutes go by and even half an hour, before you are “allowed” to get back in. You realise that you have little or no control, let alone have a say of what’s happening to your critically ill loved one. The very person that you share a house with, the very person that you love or the very person that is of your own flesh and blood. All of a sudden there are people creating all these barriers around you and you feel like you are in this big machinery that you can’t control. You wonder whether the doctors and nurses would want their own family be treated like that.
It doesn’t have to be that way, but most Intensive Care Units or even some individual health professionals are still creating those barriers between health professionals, Patients and their Families. Some units are more progressive than others, but you probably have a feel by now of the things that could be improved in order to make you and your family more comfortable with what is happening with your critically ill loved one. Health professionals in Intensive Care are like fish in water and they often don’t even realise how the people who are not in the water may feel.
A recent article suggested that “Decisions to forgo life support may depend heavily on the ICU where patients are treated”. The article explains how the culture in an Intensive Care unit or in a hospital impacts on the care provider’s decision making around life support or withholding CPR or withholding mechanical ventilation. The article suggests that the ICU culture is the biggest influence on a Patient’s treatment, coming before Patient and Family preferences.

Here is a link to the article Link (The article suggests that the ICU culture is the biggest influence on a Patient’s treatment, coming before Patient and Family preferences)

Instant impact report
Get your FREE “INSTANT IMPACT” report by signing up with your email and instantly improve your and your critically ill loved ones situation by learning the secrets about Intensive Care and the instant action steps you need to take!
You can also look at our FREE “get your questions answered” section “ 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

Sincerely, your Friend

Patrik Hutzel

Family meetings in Intensive Care or the elephant in the room

Elephant in the room MP3

Have you ever wondered what is really happening in Family meetings in Intensive Care? Have you ever wondered what the elephant in the room is during those meetings? As a starting point, Family meetings in Intensive Care normally only take place if the situation of your critically ill loved one is dire and serious. That could mean that your critically ill loved one is so sick that the odds are against his or her favour. It could also mean that your critically ill loved one is about to die. That’s at least what you and your family get told and that’s how the Intensive Care might frame the situation. How do you react? How do you know it’s true? What do you do in order to validate what you have just been told? Can you validate the information you are given at all, if you have no or only a basic understanding of Intensive Care and medicine? Let’s take the emotion out of the situation for a moment. The emotions that Families are usually feeling when their loved one is critically ill in Intensive Care is fear, frustration, overwhelm and the feeling of vulnerability. What I also often see is that Family’s are more often than not paralysed with fear. And it’s extremely difficult to eliminate these emotions. So, you are going into a Family meeting and you are feeling all these overwhelming emotions and that’s certainly not a good starting point to go into any meeting. And then there’s the perceived power dynamics. On the one hand is the Intensive Care team, doctors and nurses with lots of perceived power and then there’s you and your family with little or no perceived power. How does the Intensive Care team positions your critically ill loved ones situation? How are you and your Family positioned? Are you positioned at all? Are you close to a nervous breakdown, so that positioning is the last thing on your mind? To come to the point, depending on what is happening in the Intensive Care Unit such as the number of beds available in the Intensive Care Unit or the number of Patients awaiting admission into the ICU, the positioning of the Intensive Care team not only varies from person to person, it also varies depending on what’s happening behind the scenes. The position of the Intensive Care team might also vary, depending on the ICU consultant’s/physician’s outlook on things, whether they are an optimist or a pessimist. Some Consultants/Physicians might have a more positive outlook on things than others and therefore they may be more optimistic for your critically ill loved ones future or at least they are more willing to listen to your concerns and questions and show real empathy. The bottom line is that you should always listen very carefully what is being said and also what is not said. It is also crucial in your situation that you are having an opinion and a position, irrespective of what the Intensive Care team is telling you. Just because you are not an Intensive Care insider, doesn’t mean you shouldn’t have an opinion on your critically ill loved one’s situation. I see so many families not having an opinion, because they are paralysed and overwhelmed by the whole situation that they often don’t have a say or a choice of what’s happening to their critically ill loved one. Have a say, get involved and ask as many questions as possible. That’s not only your right, it’s your duty! Are you lacking impact and influence while your loved one is critically ill in Intensive Care? For crucial tailor made information sign up for our FREE “INSTANT IMPACT” report and learn behind the scenes secrets of what’s really happening in Intensive Care and how it impacts on your critically ill loved one’s care! Thank you and see you next week in another update
Sincerely, your Friend
Patrik Hutzel

Instant impact report Get your FREE “INSTANT IMPACT” report by signing up with your email and instantly improve your and your critically ill loved ones situation by learning the secrets about Intensive Care and the instant action steps you need to take! You can also look at our FREE “get your questions answered” section “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 

What you need to do if your loved one is dying in Intensive Care(part two)

End of Life2) MP3

In last week’s blog I was talking about how critical it is that you are bringing yourself and your family into the end of life process, if your loved one is dying in Intensive Care. I was also briefly touching on what an emotional rollercoaster this journey can be for you and for your family. Today I want to give you five action steps and I also want to shed more light on how you can achieve peace of mind.
Peace of mind is critical for you and for your family so that you know that the death of your critically ill loved one is a “good death”. Again, Intensive Care Units and individuals are different in their approaches towards end of life care, therefore don’t assume that “they know it all”, as end of life care is challenging even for the most “seasoned” end of life carer in Intensive Care.
I have seen a lot of families in Intensive Care that are going through the process of losing a loved one in Intensive Care to their critical illness and they are more often than not paralysed by fear, frustration and Family’s generally tend to be helpless. It doesn’t have to be that way.
Get involved, have an opinion and have a think and a vision of how the end of life situation should look like from your perspective. Remember, the death of your loved one is a “once in a lifetime” situation and the specifics and the details will stay with you and your family for the rest of your life. It’s therefore important that you make it a good memory and a good experience.
Also, remember, I mentioned last week that being involved in end of life care from a health professional point of view is a privilege. Now, think about this for a moment. If some health professionals think that it’s a privilege, can you shift the feeling by looking at the situation differently? What if you shifted the feeling from fear, frustration and helplessness to making it a privilege? Is it a privilege that you and your Family can be involved in the last phase of the life of your loved one? Is it a privilege that this “once in a lifetime” situation can be looked at differently?
In order to get from point A to point B, with point A being the fear, the grief, the loss, the frustration and the helplessness and point B being “a good death”, peace of mind and a privilege, we need to shift the feeling and take control of the things that you can control. Furthermore, you need to change the situation to “a death on your terms”. If you don’t do that it’ll be a “death on the Intensive Care Unit’s terms” and that might leave a bad taste in your mouth.
In order to achieve the end result, in order to achieve that critical peace of mind for you and for your family and in order to achieve “a death on your terms”, you need to get involved, you need to start asking questions and you need to have an idea and a vision of what the end of life of your loved one needs to look like so that you can have peace of mind.
Do you need more time? Do you want to have other family members or friends involved? Do you want to have your loved one dying at home? Do you want to address certain spiritual, cultural and/or religious needs? What would your loved one think should happen?
Also, think about your loved ones life. Has he or she lived a good life? Do you and your family want to celebrate their life? Would this approach help you to find peace of mind?
In order to shift the feeling and in order to achieve a “death on your terms” here are five simple action steps how you can achieve that

1. Know that “truth” is a very thin concept in Intensive Care
The “truth” is something health professionals in Intensive Care are trying to “sell” to you, with the “truth” being the clinical and tangible facts such as your loved one having a certain critical illness and therefore a certain tangible prognosis.
What is your “truth”? What do you think about the situation? How do you think your critically ill loved one is coping with the situation? Besides all the ‘clinical facts’ that doctors and nurses are telling you, how do you feel about your critically ill loved one’s ability to deal with adversity and setbacks? Do you think that your critically ill loved one can deal with the ‘clinical challenges’? Do you think that he or she can beat the odds? If you think so than you should move heaven and earth to make your voice heard. Don’t let the pessimism and the ‘clinical opinion’ of other people inhibit your inner voice.

2. Find meaning in adversity
Finding meaning in your situation could be critical for your and for your Family’s peace of mind. Is there a meaning in your difficult situation? Does it bring your family closer together? Is there a lesson to be learned?
I’ll give you an example. I lost an uncle in Intensive Care at the young age of 51 and it was an absolutely devastating situation. I was only a teenager at the time, but it was still awful. It didn’t occur to me until later in life that his death had a meaning, but I needed to understand critical parts of my family that I hadn’t understood when I was a teenager. The rest of my (adult) family knew when he died, why he died. It still was devastating but I think that it gave the rest of my family some peace of mind.

3. Appreciate and celebrate the life your loved one had
Even though the life of your loved one may have been cut short, you should still celebrate the time your loved one had with you. Look at the positives. Wasn’t it a privilege to have your loved one in your life? No matter how hard the loss of a loved one is, you had the privilege of knowing him or her. Be grateful for that.

4. Acknowledge your fear, your loss and your grief
It’s nothing to be ashamed of. Just be yourself. It’s okay to go through the motions. It’s ok to be sad. It’s ok.

5. Acknowledge whether it is a good or bad end of life situation
As I have mentioned before, in order to have that critical peace of mind, you might have to have a vision of what the death of your loved one should look like. If you don’t feel comfortable on how the situation is getting handled, step in. Don’t be afraid to speak your mind. I do really believe that any situation can be improved, especially an end of life situation.
What are your thoughts? Do you have experience with end of life care? Leave your comments below.

Instant impact report

Get your FREE “INSTANT IMPACT” report by signing up with your email and instantly improve your and your critically ill loved ones situation by learning the secrets about Intensive Care and the instant action steps you need to take!
You can also look at our FREE “get your questions answered” section “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 

Sincerely, your friend
Patrik Hutzel

The following 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.

Length of stay in ICU and how INTENSIVE CARE AT HOME can reduce it

ALOS in ICU MP3

The Average length of stay in Intensive Care varies from unit to unit and is often dependent on a number of factors, including the acuity of Patients, Patient’s age and co-morbidities, admission scenarios, complications etc… Chances are that if you have a couple of long-term ventilated Patients in your unit across any financial year that your (Average) Length of stay is increasing dramatically. INTENSIVE CARE AT HOME can help you reduce your average length of stay by providing Intensive Home Care services that create a win-win situation. You can free up your beds that are occupied with long-term ventilated Patients with Tracheostomy and you can therefore focus on admitting more acutely unwell Patients requiring an Intensive Care bed. You will therefore also have the opportunity to use your highly skilled workforce to look after more acutely unwell Patients in need for Intensive Care. Furthermore, think about what even a temporary stay at home could do for your long-term ventilated Patients with Tracheostomy, their Families and for your unit. It would certainly relieve some of the frustrations for the Patients, their Families and for your unit. Also, my experience has shown that taking long-term ventilated Patients with Tracheostomy out of Intensive Care is making all the difference to those Patients. In fact those Patients BLOSSOM in a home environment. Going home after many weeks or sometimes many months in Intensive Care is putting a different spin on the Patients and their Families Quality of Life. What are your thoughts on this topic? Do you think that Average length of stay in Intensive Care can be reduced by taking long-term ventilated Adults& Children home? How do you feel about taking long-term ventilated Adults& Children with Tracheostomy home temporarily? Leave your comments below or visit http://intensivecareathome.com.au Have a great week.
Sincerely, your friend
Patrik Hutzel

What you need to do if your loved one is dying in Intensive Care(part one)

End of Life1) MP3

If you are confronted with your loved one approaching their end of life in Intensive Care your world has probably just turned upside down. Maybe you did see it coming or maybe it came out of the blue. Every case is different of course and yet I believe that there are some similarities when it comes to death and end of life in Intensive Care. No matter the situation you are in, I believe that there are a few things that all families want if their loved one is dying in Intensive Care, such as peace of mind that all the right decisions have been made along the way. Sometimes time can be your enemy and in some situations your critically ill loved one may approach their end of life quickly and unexpectedly where it might take you and your family a long time before you can ever find peace of mind. Also, keep in mind that the situation you and your critically ill loved are facing is what I would like to refer to as a “once in a lifetime” situation. You therefore want to have things done in a certain way so that you can feel that critical peace of mind for you and for your family. If you have the time in your situation, how do you want to approach the end of life situation of your critically ill loved one? Having been involved in many end- of- life situations in Intensive Care myself, I have found that every situation is different and requires an individual approach. Some families are happy to let go of their loved one quickly whereas other families need more time to say goodbye and come to terms with the end of life of their loved one. Neither approach is right or wrong or good or bad. It’s very individual and it has to be respected. It’s critical that you bring your views into the discussion with the Intensive Care team on how the end of life situation of your loved one needs to look like from your perspective. Also, don’t think that just because the Intensive Care team is dealing with end of life frequently that they can master those challenging situations without difficulties. Even though Patients in Intensive Care frequently approach their end of life, no Intensive Care Unit can claim to be perfect when it comes to end of life care. Having worked in many Intensive Care Units in three different countries, I believe that there is a lot of room for improvement, also because every end of life situation is very challenging for the Intensive Care team as well. Some Intensive Care Units do it better than others. Some individual health professionals in Intensive Care do it better than others. Some Families and some individuals within the Family deal with the situation better than others. I personally believe that being involved in end of life care in Intensive Care is nothing short of being a privilege. This statement might come as a shock to you, however I can tell you that being involved in the last phase and the last stages of a person’s life can be a huge burden but also a huge privilege. Generally emotions run high and as a health professional you have to manage your own emotions, the emotions of your colleagues and the emotions of the family who is just losing a loved one in Intensive Care. Strong emotions can be both, a good thing if they are directed in the right channels and emotions can be a bad thing if they are not managed correctly and if they are taking over. But emotions are a healthy sign in general. It shows that you are fully alive and that you are not disconnected from what is happening all around you. It’s healthy to show your sadness and your grief if your loved one is approaching their end of life in Intensive Care. It’s also a healthy sign that if you want to be involved in the end of life situation and it’s healthy to have your say and to ask questions. Again, just because health professionals in Intensive Care are involved in end-of-life situations regularly and often doesn’t mean that they “know it all” or that they do it impeccably. Some Intensive Care Units may do it well, others may not. Some individuals in Intensive Care may do it well, others may not. I think that one important part for you and for your family is to look for your own truth in this challenging situation and also look for some meaning if your critically ill loved one is dying in Intensive Care. Maybe you can find some positives when you are looking for meaning and truth. Truth is a very thin concept, especially in an environment such as Intensive Care. One minute you might get told that your critically ill loved one is stable and the next minute you might get told that your loved one is not going to survive their stay in Intensive Care. The reality is that things vary and things change. In next week’s blog I’ll tell you why it’s critical that you find meaning in adversity and I will also give you five action steps on how to deal with the end of life situation in Intensive Care.
Instant impact report Get your FREE “INSTANT IMPACT” report by signing up with your email and instantly improve your and your critically ill loved ones situation by learning the secrets about Intensive Care and the instant action steps you need to take! You can also look at our FREE “get your questions answered” section “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 

Sincerely, your friend
Patrik Hutzel
What you and your Family need to do if your critically ill loved one is very sick in Intensive Care and faces an uncertain future with the possibility of future Quality of life impairments

What to do if your loved one is in ICU MP3

Intensive Care is a challenging environment to be in at the best of times and that’s usually true for all parties involved in Intensive Care. But it is without a doubt most challenging for the Patients and their Families. If you and your Family are confronted with the critical illness of your loved one in Intensive Care, you may at times not know what the next 24 hours bring. Will I get a phone call from the Intensive Care unit overnight if my loved one deteriorates, may be one of the many questions going through your mind. You may also wonder at times, whether your loved one will survive the night and whether you should stay in Intensive Care for the night, to be there in case your critically ill loved one deteriorates. You may also wonder what the implications of the critical illness of your loved one are in the future. You may have been told by the Intensive Care team that after the maximisation and optimisation of therapy, the critical illness of your loved one may have a negative impact on the future Quality of life of your loved one. If so, you may be too frightened to even contemplate what life might look like in the future for you, for your family and most of all for your loved one, who at this point in time is still critically ill in Intensive Care. The Intensive Care team might have told you and your Family that they think your loved one will survive his or her stay in Intensive Care, but that you and your family should brace for life after Intensive Care, as things and life may not be the same. But what does it look like? What exactly does “impairment of future Quality of life” mean? What will life look like after Intensive Care and after hospital? Every case is different and some people are perfectly happy with living with a “lesser Quality of life”. They are alive after all, that’s all that matters to some people anyway. What if you are uncertain and you don’t know what those impairments mean for your critically ill loved one in the future? So what exactly is Quality of life?(you’d be surprised about the answer) My answer to the question is this. I even call it Intensive Care 101. Quality of life is an abstract concept and it is perceived. Nobody, but you, your Family and your critically ill loved one need to determine the Quality of life that they are happy and content with. Nobody has the right to determine what Quality of Life looks like to you, to your Family and most of all to your critically ill loved one. The bottom line is that there are a lot of grey areas in Intensive Care and in health care in general. It’s never black and white, even though some people may want to make you think that it is black and white. As you probably know by now there are a lot of grey areas in Intensive Care, in health care and in life in general. Stay positive as a starting point. No matter what, stay positive. You can move mountains by staying positive. Your critically ill loved one and your family will feel your positivity. Why do I say this? I say this, because I have seen people living with a ’lesser’ Quality of Life, where other people would have thrown in the towel and yet, regardless of people’s ordeals, they enjoyed life and they had things that they loved living for! So what I am really saying is that • the maximisation of therapy in Intensive Care with a less than desired health outcome for your loved one and your loved ones perceived Quality of Life in the future, may just be that. A snapshot. An undesired snapshot of the here and now. It might change. It might not change. If the maximisation of therapy in Intensive Care does not bring the desired health outcome, with the outlook of a lesser perceived Quality of Life for your loved one, it may just be that. A lesser ‘perceived Quality of Life’, based on the assumptions of health professionals. Who are health professionals to judge how you, your Family and your loved one think and feel about ‘perceived Quality of Life’ from somebody else’s point of view? Somebody you don’t even know personally. So make your own judgement and wait. See what happens and do not panic. Try and get perspective about the issues at hand. Take away Action steps for you and your Family: • Withhold judgement on Quality of Life • Position yourself well mentally so that you have a strong and powerful internal mindset • Even more important, withhold judgement on ‘perceived’ Quality of Life, that is not even reality yet and something in the future • Have an open discussion with the nursing and medical staff regarding the Quality of Life or the ‘perceived Quality of Life’ of your loved one and share your viewpoints. Do not have the perception of ‘limited resources’ impact on your judgement • Know your critically ill loved one. What does he or she want? To what extend is he or she prepared to put up with ‘tangible’ impairments (i.e. Quadriplegia or ventilator dependency)? To what extend is he or she prepared to go through a prolonged period with little or no progress, before Quality of Life can be restored? • Know what external services are available in your area for discharge from hospital that can help you at home- in this day and age, even ventilation at home with Tracheostomy is a possibility, check out www.intensivecareathome.com.au • your views on those issues will mainly determine the level of control, power and influence you’ll have over the situation • 99.9% in life you can’t control. Focus on the 0.1% in life that you can control and become a master at it and you’ll be in charge of your destiny! Instant impact report Get your FREE “INSTANT IMPACT” report by signing up with your email and instantly improve your and your critically ill loved ones situation by learning the secrets about Intensive Care and the instant action steps you need to take! You can also look at our FREE “get your questions answered” section “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 

Sincerely, your friend
Patrik Hutzel
Helping hospitals and Intensive Care Units in particular, freeing up beds and staff

Helping hospitals& ICU’s MP3

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? For more information check out http://intensivecareathome.com.au Send us your comments to support@intensivecarehotline.com or patrik@intensivecareathome.com.au

Sincerely, your friend
Patrik Hutzel

Intensive Care at its best?

Intensive Care at its best MP3

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

How we can help you MP3

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

Extension of ICU MP3

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

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