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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!

This is another episode of “YOUR QUESTIONS ANSWERED“  and in last week’s episode I answered another question from our readers and the question was

My Husband In The ICU Is Doing Better? Why Does The ICU Team push for Withdrawal Of Treatment?

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

In this week’s episode of “YOUR QUESTIONS ANSWERED“  I want to answer the succeeding questions from one of  my clients Melanie as part of my 1:1 consulting and advocacy service! Melanie is asking about the steps involved in getting best care and treatment for her sister. 

My Sister in the ICU Deteriorates With Treatment Limitations! What Should I Do?

“You can also check out previous 1:1 consulting and advocacy sessions with me and Melanie here.”

PART 1

Melanie:  Yes, that would be, that would be good, too.

Patrik:   Yeah.

Melanie:   Yeah. St. Ernest’s, Kuringa. It’s actually probably, yeah, yeah, any of those.

Patrik:   Yeah. And look there’s private ICUs in the western suburbs. There’s the Vintage Public, there’s even Hillsborough Private I believe.

Melanie:   Is Hillsborough Private any good?

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Patrik:  I don’t know to be honest with you. I can tell you that Vintage Hospital, Hillsborough Private, and Mona Lisa Private, I have no concerns there.

Melanie:  Yeah, let’s speak with those, let’s speak with those.

Patrik: The southern suburbs I’m not all that familiar with their private ICUs.

Melanie:   The other thing, too, that might be going with us for Hillsborough Private, is that my sister’s respiratory specialist he’s been seeing for years is actually based his clinic is at Hillsborough Private.

Patrik:  Okay. Have you got the direct contact there?

Melanie:   To contact him?

Patrik:  Yes.

Melanie:   I tried to do that but I couldn’t get past his secretary.

Patrik:   Okay. Because that might be a person who might get your sister into this hospital.

Melanie:   Okay, but if he’s unavailable tomorrow we might have to go with the director, the CEO, but let them know that he’s under the care already of Dr. Miller.

Patrik:  I think that is definitely, I think if we can go back to Hillsborough Private and can say we’ve got a patient of Dr. Miller, is that his name?

Melanie:  Miller.

Patrik:   Miller. I think that puts a whole different spin on it straight away.

Melanie:   Mm-hmm (affirmative).

Patrik:   So, if you can show them this is actually a patient of yours, there’s no harm in that whatsoever.

Melanie:  Would they object if you signed on our behalf instead? I’ve got a client I’m working with.

Patrik:   Probably not, because what I can do, I can tell you what my first phone call would be, will probably be with the bed manager at Hillsborough Private. The bed manager is the one who wants to fill beds on behalf of the director of nursing, CEO level. That is probably the first person that I’m going to contact, and if that doesn’t go anywhere then it can be escalated onto a director of nursing level.

Melanie:  Yes.

Patrik:   We’ve had a client recently here in Melbourne was at Monty Public ICU. Again, similar story, wanted to withdraw life support. The family eventually wanted to transfer the patient to a private ICU which eventually happened, right? And I made lots of phone calls to private ICUs, so it’s definitely something I’m very happy to do.

Melanie:   Yeah, yeah, I’d really appreciate that.

Patrik:    Yes, absolutely. And if they wanted to talk to you, you know which they may want to do because you’re the closest kin then we’ll do that, but as a starting point, that’s what we’ll start to do. I’ll speak to a bed manager.

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Melanie:   Yeah

Patrik:   Find out whether they have beds and what not.

Melanie:   Yeah. And then so what would happen beyond that? Say they hypothetically they say, “yes we can take the patient”

Patrik:   Yes, the next thing they will as is either, does your sister have private health insurance?

Melanie:  Yes.

Patrik:  Okay that’s great. Okay. So that’s taking one worry away, then the next thing they’ll ask is who is going to refer this patient to whom? It would be great if this Dr. Miller can admit your dad into Hillsborough Private, that would be the best way. So, would he see a respiratory physician?

Melanie:   Yes, he’s a respiratory specialist that my dad’s been with for number of years, and my sister has sleep apnea, so he got her CPAP organised for him. Yeah, he sees her on a regular basis for that.

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Patrik:   Okay. So, the next store there is a respiratory physician would admit patients into ICU. At one point or another respiratory physician has patients in ICU, which again I believe makes the whole thing easier. If for example there was a dermatologist rarely has a patient in ICU …

Melanie:    Yeah, yeah, yeah.

Patrik:   Right? But the respiratory physician has patients in ICU, maybe not on a regular basis but certainly every now and then.

Melanie:    So, if he’s not available tomorrow, what would happen then?

Patrik:    What would happen then is one of the ICU specialists would have to admit the patient. The other thing that I am wondering is whether some of the ICU consultants at Hollywood are ICU consultants at Hillborough Private. There’s a very high chance that there’s overlap.

Melanie:   You think so?

Patrik:   I’m just, I will do that research a bit later. I will have a look on those websites. I do know that, yeah, certain public hospitals send consultants to certain private ICUs, and I know that nobody from xxxxx ICU for example works at xxxxxxx.

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Melanie:   Yeah.

Patrik:  Right, I know that much. I’m just thinking about proximity. There’s a good chance that xxxxxx ICU consultants might work at xxxxxxx, but doesn’t matter.

Melanie:   But the thing is it’s still difficult, very difficult. Are they going to support us in moving him to a private facility?

Patrik:   Look, they may because in a private hospital the rules are different. In a private hospital, your sister or any patient for that matter is more of a customer, and not a burden.

Melanie:   Yeah.

Patrik:   Right? At the moment your sister is seen as a burden.

Melanie:   Yeah.

Patrik:   Right? So, in a private hospital if they have beds available, I don’t see why they wouldn’t take him. 

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Patrik:  So, I’m just on xxxxxx ICU website. There are names of consultants. I will have a look whether some of those names are xxxxxx ICU as well.

Melanie:   Do you want to read out some of those names?

Patrik:   Yes. Dr. Bring.

Melanie:   No. Don’t know.

Patrik:   Lucas Park.

Melanie:    No. No.

Patrik:  Peter Gobart.

Melanie:    No.

Patrik:   Bridget Glibb .

Melanie:  No.

Patrik:  Jason Degest.

Melanie:  No.

Patrik:   Francis Hillary.

Melanie:  No.

Patrik:  And associate Professor xxxxxxx.

Melanie:  No.

Patrik:  Okay. Okay. And that’s it because it says there are seven specialists and there are seven names. So, you would, okay so we can safely say there is no overlap. Okay that’s out of the way for now. So, what we need is we need a bed in ICU and we need an intensivist at xxxxx …

Melanie:   Oh…

Patrik:  Yeah, go on.

Melanie:  I just had a thought. Oh, my goodness. My friend is a, she’s a surgeon at I know it’s xxxxxx, could she do private? I think she’s at private.

Patrik:  Most likely.

Melanie:  She’s an orthopaedic surgeon. I wonder if she could help us.

Patrik:   Absolutely. Speak to her if you can. Definitely speak to her.

Melanie:  Okay.

Patrik:   Definitely speak to her.

Melanie:   Alright. I’ll try and get a hold of her tomorrow.

Patrik:  And do you know is your dad at the moment, is she a private patient at xxxxx hospital?

Melanie:  Yes.

Patrik:  A private patient? Okay. Well that’s good to a degree, and the reason I’m saying that if he is fully covered, because sometimes with private patients sometimes some things are not covered in ICU, but because he’s had the whole lot that’s good because sometimes with private health funds they may not cover one hundred percent of the things in ICU, but given that your sister has been through everything Hillsborough won’t have any concerns in terms of what the health fund’s paying for and whatnot because that’s all been covered so far. So that’s good.

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Melanie:   Yeah. Yeah.

Patrik:   Ummm. Okay so here’s another question. Now that I know he’s a private patient in ICU at xxxxx, so we’ve had this client here at Monty ICU and one of the strategies we pursued then, because that client at the time was admitted as a public patient, and because they had private health insurance we were trying to admit them as a private patient in the public ICU so that they wouldn’t stop treatment.

Melanie:   Mm-hmm (affirmative).

Patrik:  Right? There’s usually more money to be made for them through a private patient, right? And that bought us a little bit of time then, but given that he’s already a private patient, you’re certain about that?

Melanie:   Yeah, I had to find all the forms for a private health fund.

Patrik:   Okay. Well that’s not an option then. What does your family think about getting your sister into a private hospital?

Melanie:    They’re supportive. Lucy is supportive of me moving her. Is Tommy?

Patrik:    Yeah.

Melanie:    Yes.

Patrik:   Okay good. Good. No, no, that’s important. Okay. Well I think the next steps are can you send me your sister’s name, date of birth, health fund name, and also membership number or something like that?

Melanie:   Yeah.

Patrik:   Can you send me the name of the respiratory physician.

Melanie:   Yeah. Yeah.

Patrik:   And I think that’s it for a starting point.

Melanie:   Okay. My friend definitely works out of xxxxx Private. She’s a surgeon.

Patrik:  Mm-hmm (affirmative). That’s good. That helps.

Melanie:   But if I can’t contact her, maybe just tell them that she’s the friend of xxxxx.

Patrik:   I’ll just … …

Melanie:  Sarah Joslyn, and she’s an orthopaedic surgeon.

Patrik:   I’m sure I can google her. Orthopaedic.

Melanie:   And she’s under Dr. Miller’s care for respiratory.

Patrik:  How do you spell that?

Melanie:   Jos-lyn

Patrik:    Oh Jos?

Melanie:   It’s Sarah Joslyn, her full name.

Patrik:   And has your sister ever been an inpatient at Hillborough Private?

Melanie:    She’s been an inpatient at the public under Miller two times.

Patrik:   Okay. How long ago was that?

Melanie:   Maybe five years ago or maybe about five?,

Patrik:  Alright, but not at the private as an inpatient?

Melanie:   No, she hasn’t been at, not one I can remember. No, I don’t think she’s been an inpatient there.

Patrik:   Okay. Okay so what I’ll do tomorrow morning I will touch base with Hillborough Private, probably start with a bed manager and see what the situation is and get back to you. If you could contact Dr. Miller directly, I think it would help. Have you, when you said you’d spoken to the secretary, did you explain the situation?

Melanie:   No because it was early days at that point. My sister had just fractured his ribs and it was the first week, and things hadn’t escalated to what they are now, but she basically said, “oh he doesn’t work out of that hospital so they’re welcome to contact us if they need to speak to us, to speak to her.” But yeah, I told xxxxx hospital at the time to call him and they said there was no need because it didn’t relate to what was happening at the time, her cardiac issues and things like that.

Patrik:   Okay. Let’s just say I’m just sort of trying to look ahead, it looks like your sister is making small improvements, however if he deteriorates, the doctors have made their point, they’ve drawn their line in the sand. God forbid, if she deteriorates and they’re not prepared to do what it takes to keep your sister alive, how do you feel about escalating your concerns onto a CEO level at xxxxxx or to a director of nursing level at this point in time? Because I don’t think you are getting heard at the moment. 

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Melanie:  No, so what would be involved in that I’d have to contact them, and then what? What would happen from there?

Patrik:   I don’t know what would happen from there, but even, if you, okay in a hospital if you bring a complaint onto the CEO, director of nursing level, they have to respond. They have to respond. And the reason they have to respond is, so hospitals are accredited against healthcare standards, and one of the healthcare standards is related to patient satisfaction, and if a patient comes, well if they’re concerned, it falls back to the next of kin or to the guardian, so they definitely have to respond. I also believe that if I was the CEO of a hospital I would want to know about things like that or if I was a director of nursing. I was up, in the past, I was up to the deputy director of nursing level, and that was private, but still even in a public hospital they would want to know about those conflicts. They do.

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Melanie:   Mm-hmm (affirmative).

Patrik:   But I also understand your, you know I understand you’re sick and tired of all this.

Melanie:   I am. I am. I am totally sick and tired, and I don’t want to invest energy into something that’s not going to bring much gain, and frankly even if, that complaint process could take days before anything’s done about it.

Patrik:   Look, I can hear your frustration and I totally get it, right, but given that you have been banging your head against the wall with any of those consultants, I do believe you’re not achieving anything in there, and I’m almost bound to say you’ve got nothing to lose by escalating it. The end, if your sister deteriorates and they’re not doing anything, that could be the end of it, but if you do escalate it, you will get a response. You will get a response there’s no doubt about that.

Melanie:   But it doesn’t mean they’re going to do anything if she does deteriorate and we’re in this complaint process, that the doctor’s going to change his mind on anything.

The 1:1 consulting session will continue in next week’s episode.

How can you become the best advocate for your critically ill loved one, make informed decisions, get peace of mind, control, power and influence quickly, whilst your loved one is critically ill in Intensive Care?

You get to that all important feeling of making informed decisions, get PEACE OF MIND, CONTROL, POWER AND INFLUENCE when you download your FREE “INSTANT IMPACT” report NOW by entering your email below!

In Your FREE “INSTANT IMPACT” report you’ll learn quickly how to make informed decisions, get PEACE OF MIND, real power and real control and how you can influence decision making fast, whilst your loved one is critically ill in Intensive Care! Your FREE “INSTANT IMPACT” Report gives you in-depth insight that you must know whilst your loved one is critically ill or is even dying in Intensive Care!

Sign up and download your FREE “INSTANT IMPACT” REPORT now by entering your email below! In your FREE “INSTANT IMPACT” REPORT you’ll learn how to speak the “secret” Intensive Care language so that the doctors and the nurses know straight away that you are an insider and that you know and understand what’s really happening in Intensive Care! In your FREE report you’ll also discover

• How to ask the doctors and the nurses the right questions

• Discover the many competing interests in Intensive Care and how your critically ill loved one’s treatment may depend on those competing interests

• How to eliminate fear, frustration, stress, struggle and vulnerability even if your loved one is dying

• 5 mind blowing tips& strategies helping you to get on the right path to making informed decisions, get PEACE OF MIND, control, power and influence in your situation

• You’ll get real world examples that you can easily adapt to your and your critically ill loved one’s situation

• How to stop being intimidated by the Intensive Care team and how you will be seen as equals

• You’ll get crucial ‘behind the scenes’ insight so that you know and understand what is really happening in Intensive Care

• How you need to manage doctors and nurses in Intensive Care (it’s not what you think)

Thank you for tuning into this week’s YOUR QUESTIONS ANSWERED episode and I’ll see you again in another update next week!

Make sure you also check out our “blog” section for more tips and strategies or send me an email to [email protected] with your questions!

Also, have a look at our membership site INTENSIVECARESUPPORT.ORG for families of critically ill Patients in Intensive Care here.

Or you can call us! Find phone numbers on our contact tab.

Also check out our Ebook section where you get more Ebooks, Videos and Audio recordings and where you can also get 1:1 counselling/consulting with me via Skype, over the phone or via email by clicking on the products tab!

This is PatrikHutzel from INTENSIVECAREHOTLINE.COM and I’ll see you again next week with another update!

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