Podcast: Play in new window | Download

Subscribe: Apple Podcasts | RSS

Quick Tip for Families in Intensive Care: Deciding if the ICU Team has Done Everything They Can

Hi, it’s Patrik Hutzel from intensivecarehotline.com with another quick for families in intensive care.

So today, I have a question from Stephanie who asks, “How can I decide if the ICU team has done everything they can for my dad in ICU?” Well, that’s a great question, Stephanie and thank you so much for asking it. So, let’s break this down.

Now, after having worked in intensive care for over 20 years in three different countries where I worked as a nurse unit manager for over five years, after having consulted and advocated for families in intensive care all over the world here at intensivecarehotline.com for the last 10 years, I know what to look for if the ICU team has done everything they can.

It’s very difficult for families to decide that because the biggest challenge for families in intensive care is simply that they don’t know what they don’t know. They don’t know what to look for. They don’t know what questions to ask. They don’t know their rights and they don’t know how to manage doctors and nurses in intensive care. Obviously, that’s becoming very clear here in Stephanie’s question.

So, when someone is in intensive care, there are dozens of things happening simultaneously starting from vital signs displaying on the monitor, ventilator settings if your loved one is ventilated, blood results, test x-ray results, CT scan results, medications he often is on, how much urine they’re making, what’s their Glasgow Coma Scale? The list is endless.

So, how do you find out whether they’re doing everything they can? Well, first off, you need to question everything, you need to question everything. You need to question the narrative, one of the narratives of the intensive care team. So, one of the things that happens when families in intensive care reach out to us, they’re saying, “Oh, the ICU team is negative.” And they’re saying, “if my loved one is going to survive, they won’t have any quality of life.”

Well, you got to question that narrative, you got to look at that 90% of patients in intensive care actually survive. So therefore, the odds are in your loved one’s favor. So, why would your loved one be in the 10% bracket? Why would your loved one be the one out of ten not surviving? So, first off, question the narrative.

Next, look at what’s actually really happening. Often what we find when we work with our clients one-on-one, we find that the negativity of the intensive care team and the doom and gloom is actually not founded on reality.

So, when we look at clinical realities, when we talk to doctors and nurses directly, when we look at medical records and do a review, we often find, there’s a lot of things working in favor of your loved one in intensive care. Then we can break it down, whether they’re doing all the right things or whether they’re not.

Now, the thing that I’ve done a couple of years ago, I’ve written a blog post and made a video, “What questions to ask in intensive care?” and I will link to that video below this video. So, you can actually have a look at what to ask. So, that will help you.

But obviously, if your loved one is in intensive care with a certain condition, it’s probably only someone that has worked in intensive care for long periods of time who could work out whether they have done all the right things or not, or whether they are doing the right things or not, or whether they are intending to do all the right things or not.

Often, we find that patients are on a DNR (Do Not Resuscitate) without families knowing, which is illegal by the way. So, in those instances as well, you definitely know that the intensive care team isn’t doing what they’re supposed to be doing.

We also find things like they’re doing things like not suggesting a tracheostomy early enough, not weaning patients off ventilation quick enough, they don’t have a tracheostomy and they’re saying things like, “Oh, they can’t be weaned off the ventilator.” Then when we look at it in detail what they haven’t even tried, or things like mobilization in ICU is very, very important to recover a patient as quickly as possible. We’re finding ICU teams have become complacent. They are not mobilizing patients early enough – very, very important.

So, really when we look at it from a bird’s eye, you will see very quickly whether they’re doing the right things or not. We can help you with that very, very quickly. It really only takes one conversation with the intensive care team. It takes a look at the medical records and then we can tell you whether they’re doing everything they can and whether most importantly, their words match their actions.

Again, most families tell us, “Well, the ICU team is negative, it’s doom and gloom.” Once again, you got to keep in mind that 90% of intensive care patients approximately survive. So again, the odds are in your oved one’s favor. There’s no need to be negative. There’s absolutely no need to be negative. It should be an optimistic outlook, but they’re not doing that because they want to manage that downside. They want to manage their liability.

Please keep in mind that if they tell you, “Well, your loved one’s got a pneumonia in ICU, we’re doing this, this, this and this, we’re giving antibiotics, we’re ventilating your loved one, putting them in an induced coma and then after a few days, we take them out and then off they go recovered and go to a hospital floor or a hospital ward.” Then, it won’t happen, or it doesn’t happen, then you could sue them, you could hold them accountable for misleading you.

That’s why they often doom and gloom and why they’re negative because that’s how they manage their downside.  If things don’t turn out well, they can tell you, “Well, I told you so from day one.” So, it’s for them, but it’s important to stay in control of the narrative so they can lead you and often mislead you.

So, I hope that helps how you can decide if the ICU team has done everything they can, it probably you can’t really without having a second opinion, without having us help you looking from the outside in and breaking it all down to you into the fine details, which is important when it comes to intensive care, often going down a rabbit hole.

But that is what is important and what you need to do if you want to make informed decisions, have peace of mind, control, power, and influence. It would be very difficult for you without a clinician on your team that can give you a second opinion.

So, that is my quick tip for today.

If you have a loved one in intensive care, go to intensivecarehotline.com. Call us on one of the numbers on the top of our website or send us an email to [email protected]. You can also book a 15-minute free phone consultation with me, and you can do that by clicking on the make an appointment button  on our website at intensivecarehotline.com.

Also, have a look at our membership for families of critically ill patients in intensive care. You can get access to the membership when you go to intensivecarehotline.com. Click on the membership section or go to intensivecaresupport.org directly. In the membership, you have access to me and my team, 24 hours a day, in the membership area and via email and we answer all questions intensive care related also.

Have a look and I do one-on-one consulting and advocacy over the phone, via Skype, via email, via WhatsApp, whichever medium works best for you. I talk to doctors and nurses directly. I talk to you and your families directly. I ask all the questions to intensive care teams that you haven’t even considered asking, but you must ask in order to find out if ICU teams are doing everything they can.

I also represent you in family meetings with intensive care teams. I would not go into a family meeting if I was you without an advocate and without a written agenda of the meeting before you go there. You will need clinical representation in a family meeting. Otherwise, you won’t stand a chance. We’ve done that hundreds of times in family meetings, you need to either not go or have clinical representation for yourself, as an advocate.

We also review medical records in real time so that you can have a second opinion in real time. Once again, it helps you to make informed decisions, have peace of mind, control, power, and influence in situations when you have a loved one in intensive care. We also review medical records after intensive care if you have unanswered questions, if you need closure, or if you are simply suspecting medical negligence.

Now, if you like my videos, subscribe to my YouTube channel for regular updates for families in intensive care, click the like button, click the notification bell, comment below what you want to see next or what questions and insights you have from this video, and share the video with your friends and families.

Thanks for watching.

This is Patrik Hutzel from intensivecarehotline.com and I will talk to you in a few days.

Take care for now.