Quick Tip for Families in Intensive Care: Why ICU Decision Making is About More Than Diagnosis and Prognosis

“Why ICU decision making is about more than diagnosis and prognosis.”

My name is Patrik Hutzel from intensivecarehotline.com, where we help families of critically ill patients in intensive care to instantly improve their lives, make informed decisions, have peace of mind, control, power, and influence, making sure their loved ones get best care and treatment always, even if you’re not a doctor or a nurse in intensive care.

So, today I want to talk about why ICU decision making goes way beyond your critically ill loved one’s diagnosis and prognosis. This is such an important topic because most families in intensive care believe that when doctors and nurses in intensive care make recommendations, suggestions etc., it’s solely based on the clinical situation, the diagnosis, and the prognosis of your critically ill loved one. But the reality is, decision making in intensive care is much more complex than that. Let’s break it down.

1. Bed management in intensive care.

Intensive care beds are some of the most expensive and most valuable resources in a hospital. There are only a limited number of ICU beds, limited number of ICU staff, whether it’s doctors, nurses, physiotherapists, etc. Hospitals are constantly under pressure to free up those beds for new admissions.

This means that if your loved one is critically ill and requiring prolonged treatment, the ICU team may start to “sell you on doom and gloom scenarios” to justify moving your loved one out of ICU even if they still need that level of care. They also might want to sell you on an “end of life” situation and saying that it’s “in your loved one’s best interest” to die. Keep that in mind, at all times.

2. Financial management drives decisions.

ICU care costs the hospital thousands of dollars per day, probably in the vicinity of $5,000 to $6,000 per bed day. Prolonged ICU stays are not only resource intensive, but also very expensive.

Hospitals are under financial pressure, just like any other business, and are incentivized to reduce costs, that means they may push for withdrawal of treatment, futility of care, or early discharge into hospice or long-term care facilities, depending on which country you’re in, not necessarily because it’s in your loved one’s best interest, but because it helps the hospital financially, it’s actually in the hospital’s best interest. You have to read between the lines.

The worst case scenario for an ICU is actually to look after a patient indefinitely with an uncertain outcome. If you’re watching this, your loved one is most likely in this situation, your loved one might present the hospital’s worst case scenario.

3. Staff and resource management

ICU staff including doctors, nurses, and allied health professionals are all limited resources. The more time, energy, and staffing it takes to look after your critically ill loved one, the more it drains a particular intensive care unit.

If a patient needs 1 to 1 nursing, frequent suctioning, proning, dialysis, or ventilator adjustments, that requires significant staff allocations. ICU teams might, therefore try to steer families towards limiting care.

Again, just like I mentioned before, they might want to “sell you” on an early discharge. They might want to sell you on end of life as being “in your loved one’s best interest.” It’s not always based on clinical need, but on staff and resource management.

4. Doom and gloom narrative

You’ve probably heard it before:

“There’s no hope.”

“Your loved one won’t have any quality of life.”

“They won’t survive.

“It’s time to let go.”

These doom and gloom statements are often less about medical facts and more about shaping your decision-making. They want to lead you down slippery slopes. The ICU team uses these narratives to regain control, often leaving families feeling powerless, guilty, and pressured into agreeing with their recommendations.

You can read on our testimonial section on our website at intensivecarehotline.com, how many families in intensive care we’ve actually helped to turn these situations around. We’ve also got interviews on our intensivecarehotline.com podcasts with families.

5. The control ICU teams want

ICU teams are used to being in charge and they’re not used to families questioning their decisions. They often make it seem as if you have no choice, when in reality, you do. You, as the family have the final say when it comes to consent and decision making for your critically ill loved one. But if you don’t know how ICU really operates behind the scenes, bed management, financial pressures, resource allocations, the creation of negative narratives, you’ll be at a disadvantage. That’s why you need to understand the bigger picture.

ICU decision making is about far more than just diagnosis and prognosis. It’s about money, resources, control, staying in control of narratives and lastly, it can also sometimes be about medical research, depending whether your loved one’s case is actually bringing in research money as well, but that’s going to be for another whole entire video.

So, the biggest question here now is, how can you take control back?

Here at intensivecarehotline.com, we advocate for families, like yours, in intensive care all around the world every day. We help you through the doom and gloom, through the smoke and mirrors, ask the right questions and make sure decisions are made in your loved ones’ best interest only, not in the interest of the hospital. So, go to intensivecarehotline.com and contact us now so that you can stop the ICU team from driving their hidden agenda so that your loved one gets best care and treatment always.

I have worked in critical care nursing for 25 years in three different countries where I worked as a nurse manager for over 5 years in intensive care. I’ve been consulting and advocating for families in intensive care since 2013 here at intensivecarehotline.com. I can very confidently say that we have saved many lives with our consulting and advocacy because of our insights. You can verify that on our testimonial section at intensivecarehotline.com. You can verify it on our intensivecarehotline.com podcast section where we have done client interviews because our advice is absolutely life changing.

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.

That’s why we help you to improve your life instantly, making sure you make informed decisions, have peace of mind, control, power, and influence, making sure your loved one gets best care and treatment always. That’s why you can join a growing number of members and clients that we have helped over the years, saving their loved ones’ lives.

That’s why I do one on one consulting and advocacy over the phone, Zoom, WhatsApp, whichever medium works best for you. I talk to you and your families directly. I handhold you through this once in a lifetime situation that you simply cannot afford to get wrong. When I talk to families directly, I also talk to doctors and nurses directly, asking 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.

We also do medical record reviews in real time so that you can get a second opinion in real time. We also do medical record reviews after intensive care if in case you have unanswered questions, if you need closure, or if you are suspecting medical negligence.

We also have 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 if 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. All of that will help you to improve your life instantly, make informed decisions, have peace of mind, control, power and influence, making sure your loved one gets best care and treatment always.

All of that you get at intensivecarehotline.com. Call us on one of the numbers on the top of our website or simply send us an email to [email protected] with your questions.

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, share the video with your friends and families, and comment below what you want to see next, what questions and insights you have from this video.

I also do a weekly YouTube live where I answer your questions live on the show. You will get notification for the YouTube live if you are a subscriber to my YouTube channel or my intensivecarehotline.com email newsletter at intensivecarehotline.com.

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.