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Hi, it’s Patrik Hutzel from intensivecarehotline.com with another quick tip for families in intensive care.
Today, I have an email from actually one of our clients and I will read out the email and I will give context as I go along. It is another stern and stark warning against LTACs in the United States.
Cutting a long story short, we’ve been working with this client for quite some time. She had their mother in an LTAC facility in the United States in the Midwest and things were going recently well, considering that it was an LTAC. She came, this lady had a stroke (it’s the client’s mother), and she had a tracheostomy. She was slowly but truly weaned off the ventilator, even came close to having the tracheostomy removed. However, the LTAC decided to move her to a Skilled Nursing Facility against the patient and families or without the patient family consent.
Lo and behold, the minute she went into a Skilled Nursing Facility, she bounced back into ICU. It was only really because of the client having a very good handle on what was happening in LTAC because we were giving her the second opinion. We were guiding her one day at the time step by step, that was why she was able to move things in the right direction.
But let me read out the email from our client so you can actually make up your own mind and paint your own picture. She says,
“Hi Patrik,
This is a story that you have to notify the public about. You need to put this on your YouTube channel as a cautionary tale.”
Like I said, this was a client who was appealing her mother’s discharge from the LTAC which wasn’t the right place to begin with to go to a Skilled Nursing Facility. When patients go from LTAC to a Skilled Nursing Facility with ventilation, and tracheostomy, things go from bad to worse. Unfortunately, this situation illustrates that in no uncertain terms.
So, she continues in her email, “Note from the case manager said that my mother would be discharged on July 9.” Now, me reading out this email is July 6. “I was not aware that my mother was scheduled to be discharged on July 3, six days earlier, which is when she did get discharged. She knew that I was appealing discharge. She took advantage of the fact that I was tied up at work all day to dump my mother at a Skilled Nursing Facility that had 22 Medicare citations in the last 36 months.”
That’s why I’m saying you have to look up the online review of those places. You have to look up what’s really going on. You have to look up what patients and their families are saying about what’s going on in those facilities, because that’s how bad it is. You can’t make this stuff up, but that is what’s actually happening. Then she continues in email.
“She emailed my personal email although she knew that I would be tied up in conference call meetings all day and not check my personal email. I have never consented to this. I appealed the discharge with Medicare through Laventa and I won my appeal per Medicare. There was not enough documentation from the physician to support discharging my mother.
On July 3, my mother was taken to Lakeview post-acute. July 4, my mother was rushed by ambulance to the nearest hospital because she had a temperature of 102. The PEG (Percutaneous Endoscopic Gastrostomy) was infected and draining the GI (gastrointestinal) was clogged. She has sent us pictures of the PEG. It looks horrendous. It looks like it hasn’t been cleaned for days and weeks. My mom’s heart was racing, and the blood pressure was elevated.
The hospital did a CT (Computed Tomography) scan of her head and noticed the swelling inside her brain. She was then rushed to another hospital for emergency brain surgery. I can confirm she had a subarachnoid hematoma which is basically a bleed in the brain. The emergency surgery to remove the clot that was placed in a head that was also infected, created a hematoma that warranted the second surgery this morning.
My mother went from four facilities in less than 24 hours and has undergone two brain surgeries. She is on massive doses of antibiotics because every source was infected. The tracheostomy site was infected. The PEG (Percutaneous Endoscopic Gastrostomy) was infected. The shunt that she had after the stroke in March was infected.
Please get out this message to your clients and everyone that tricks feeding tubes should only be the absolute last resort. The irony is that now her feeding tube is through her nose, which is what you recommend in the first place, which is exactly what we recommend in the first place.
Please log into her medical charts or I’m not going to mention the hospital to see her status and provide updates to me.”
How many videos have I made over the years saying do not give consent to a PEG tube? Keep the nasogastric tube in. How many times have I mentioned only give consent to a tracheostomy after you had a second opinion? ICUs in the U.S. in particular, rush tracheostomy and rush PEG tubes and then they’re sending patients to LTAC (Long Term Acute Care). LTACs are dangerous places. Just have a look at what the reviews say online for LTACs in the US. They then rush people out to a Skilled Nursing Facility and that this is what I’ve said over and over and over again, that when patients go to LTAC to SNF, they bounce from place to place because those places are not equipped to handle critically ill patients.
At the end of the day, if someone has a tracheostomy, or a ventilator, they are critically ill, they are on life support. Those patients have to be under the right care, the right people, which means often intensive care doctors, intensive care nurses, respiratory physicians, respiratory therapists, and the list goes on. LTACs, let alone Skilled Nursing Facilities, are often run down places, they don’t have the skills or the staff to make things happen. Like I said, they’re just pushing people from place to place. The system is so broken, it’s unbelievable. We have to keep publishing here. We have to alert the general public about this because that’s how bad it is.
So, thank you Debra, our client here, to share this. It’s heartbreaking because we thought that things were on the right track but obviously the LTAC pull the stump and put your mother in a life-threatening situation. That’s how bad it is, that’s how bad the system is, that’s how broken the system is in the United States in particular and things need to change. Any policymakers watching this, and you can connect the dots, things need to change.
So, I have worked in critical care for nearly 25 years in three different countries where I also worked as a nurse manager for over 5 years. I’ve been consulting and advocating for families in intensive care since 2013 here at intensivecarehotline.com. We have been saving many lives with our consulting and advocacy. You can verify that on our testimonial at intensivecarehotline.com. You can also verify it on our podcast section where we have done client interviews.
That’s also why we created a membership for families of critically ill patients in intensive care and you can become a member if you go to intensivecarehotline.com if you click on the membership link or you 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. In the membership, you also have exclusive access to 21 eBooks and 21 videos that I have personally written and recorded. It’s part of my extensive critical care nursing experience.
I also do one-on-one consulting and advocacy over the phone, Zoom, WhatsApp, Skype, whichever medium works best for you. I talk to you and your families directly. I handhold you through the process. I give you, well, what I believe is world-class advice when it comes to management of intensive care teams so that you manage them, and they don’t manage you. Because if you don’t manage them, all sorts of things can happen. You are in a once in a lifetime situation that you can’t afford to get wrong and you need to be able to make informed decisions, have peace of mind, control, power and influence, making sure your loved one gets best care and treatment. I also talk to doctors and nurses directly, ask them all the questions that you haven’t even considered asking but must be asked when you have a loved one critically ill in intensive care.
I also represent you in family meetings with intensive care teams. Once again, making sure you make informed decisions, have peace of mind, control, power, and influence, making sure your loved one gets best care and treatment, which is also why we’re doing medical record reviews in real time so that you can get this crucial second opinion in real time. We also offer medical record reviews after intensive care if you have unanswered questions, if you need closure, or if you are suspecting medical negligence.
All of that you get at intensivecarehotline.com. Call us on one of the numbers on the top of our website or send an email to [email protected].
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Thank you so much for watching.
This is Patrik Hutzel from intensivecarehotline.com and I will talk to you in a few days.
Take care for now.