Calling all NHS workers!!

[Nc4post99]

I apologise that this isn’t an aibu.

but I really need some clarity from some ITU workers preferably consultants or anyone who has experience there.

its nearly a year since my dad died in ITU. It was harrowing. A rollercoaster of hope and despair. I’m struggling. This has been made worse by the fact my mother is insistent that they (drs)killed him, and did all in their power to make sure he died. She says they put that line into your arm and after that you’re a goner, apparently they did it to my grandmother too. I’ve told her this is nonsense. But it’s clearly psychologically impacting me as I’m having regular nightmares.

please, is this a thing? Do you have any clue what she’s talking about? I can go into detail with what happened, it’s massively outing but I don’t care, if that helps.

(im On a wait list for grief counselling btw)

Even if it’s only for patients who ‘could’ survive it doesn’t mean everybody will. The chance of survival could be 5%, 20% or 80% and you can’t know which patients are going to be the lucky and unlucky ones, just because there is a chance of survival doesn’t mean some or even most people with a particular condition won’t die on ICU. It’s also often not clear how likely the chance of survival is when a patient is admitted; I had a parent admitted to ICU after a massive bleed on the brain, it was only after tests and scans that it became clear it was not survivable and the decision was made to remove the ventilator and move to end of life care. Had the bleed been less severe or in a different part of the brain it may have been survivable but it wasn’t possible to tell any of that prior to admission.

No I don’t know the OP at all. I was just giving my experience of working with EOL patients. It looks like the OPs father died of multiple organ failure and couldn’t be saved.

OP - one thing that stands out for me here is actually what you say about your mother: "In truth she loved the drama"

What your mother is saying is obviously causing you a lot of trauma and anxiety, but try to be objective here. Do you genuinely think her statements are based in truth? It can be very easy at times of grief and raw emotion to get swept away in other people's dramas, but it's not a healthy position to be in. Sometimes it's important to take a step back for our own mental health.

@headstone we withdraw certain treatments or don’t escalate them or sometimes patients have a cardiac arrest and we can’t resuscitate them. Not all EOL care is about a patient not having food and drink and as you know, most patients as they are dying won’t eat and drink.

Do you know how no win no fee works? I do because I looked into it. What happens is that your Mum (or someone) would buy a specialist insurance policy to cover the cost of the legal action if she doesn't win. Policy cost can vary depending on the details of the case. The policy purchase is an upfront cost so that the legal team always get paid. Its never cheap.

OP do you genuinely believe he had poor care or are you basing what’s been said by your mum? You blatantly have a poor opinion of her behaviours - love for drama being one. If he was in ITU for 11 days that would suggest they felt he might have a chance of survival. With bed shortages it would be easier surely to suggest EOLC. I think you need to determine if you believe your mum or not.

OP back to your original question. My 775 year old dad was in ICU last year, he had sepsis from a post-op infection, he was on a ventilator for a few days. Thankfully he has made a full recovery. He had various lines into his arms and god knows where else, and no they didn’t kill him.

He received excellent care. It was made clear to us that there was a good chance he may not make it, because anybody on ICU is at risk of death, they are as sick as you can be. Had the warts happened it would have been because of how I’ll he was, not because somebody decided he wasn’t worth saving.

your mum is obviously having a hard time processing. Lashing out and trying to assign blame is normal. Try not to let it run off on you. There is no conspiracy to kill off patients. But if you are concerned at the standard of care he got, investigate this even if just to put your mind at rest.

I don’t actually but someone to see if there’s actually a case there because I don’t know if the correct clinically protocols were followed or not, if every effort was made… I don’t know if he was written off due to being old and difficult.. I don’t know

My brother was in ICU for nearly 5 months after catching covid, he unfortunately passed away mid May. They threw everything they could at him to help him but unfortunately covid did it's lasting damage. With ICU patients, their conditions can change drastically in a short period of time, one minute they could be looking to be improving, next something will change and take a turn for the worse.

ICU admissions are traumatic for the patient and for the family, but all I can say from our experience is that all those looking after my brother did their best and never gave up despite many set backs. We always want our loved ones to recover but unfortunately the body sometimes just can't recover from the damage that has already occurred.

they listed 4 causes:

multi organ failure
transitional cell carcinoma (but according to urology he was cancer free in ITU)
copd
i swear osteoporosis was listed too

OP - would knowing that "every effort was made" make you feel better? What you describe is a very sick man, and you say that his health was like that of a 90 year old. And if he was on ICU they were obviously making substantial efforts to treat him.

However, depending on the circumstances, there are interventions that would be considered justified for a fit, healthy 30 year old, but unjustified for a frail 80 year old. And that's ok - making every effort isn't always right or kind.

I think it would be really useful for you to see if the hospital will talk you through his notes and care, and answer your questions. Don't rely on your mum - approach PALS yourself and ask for a debrief.

I contacted the hospital to speak to a consultant after about 3 months ago and was told they can’t say anything to me as I’m not next of kin…
I’ve no idea how to investigate anything, how do I know if they did the right thing or not?

i do believe mistakes were made an negligence occurred in the months leading up to his death but I don’t know how I prove this.. but this includes him and my mother and sibling too… he’d be refusing food and drink and clearly deliriously confused (signs of severe infection) and my mum would wait until Monday morning to call the GP, when he needed to be taken in an ambulance to a and e, with all his notes.

That’s what they said, the dialysis line fell out of his leg but his platelets were too low to put it back in again, they said they could do a platelet transfusion to put it back in again but they weren’t sure if it would be enough and he could bleed out. The consultant said he took an oath to ‘do no harm’. It would make a difference if I knew for a fact that it was his time, and every effort was made, if it was preventable then it would kill me, I didn’t ask the right questions, fight hard enough. I lived far away and couldn’t be there often due to having a child in childcare and him being so high risk for catching covid. If I was there, maybe I’d have forced the issue of a joined up care plan. I’m many ways I blame myself

COPD and decreased kidney function are significant comorbidities. If they admitted him to ITU in the first place they obviously felt he might pull through. Why would they admit him to ITU to end his life?

Thing is though, patients on ITU with serious pre-existing conditions (such as your dad) can decline rapidly.
Patients who are at end of life often refuse to eat and drink too.

3 days before he died he has a fantastic day, i mean amazing! They were talking about discharge to ward and how they were all wrong when they called he didn’t have long the week prior.

the next day, I could hear his breathing was watery and i knew it wasn’t good.
the following day he woke up and was joking with the nurse but then got gradually more and more out of it as the day went on and didn’t wake back up, not really, in and out of consciousness I’d say. He died the next day

Would it help if you tried to speak to his g.p about his illnesses, the itu consultant would have made decisions based on what benefit different treatments would have, it sounds like it has been a very difficult time and perhaps feeling guilty does make you question things more. Not everyone in ITU survives but thet dont deliberately harm anyone .

I think you'd benefit more from talking to a grief counsellor than a lawyer.

You're describing a very sick man with very serious conditions, and it sounds as though the medical staff have already explained their rationale for at least some aspects of his care (e.g. the dialysis line).

Firstly intense care is a very full on and scary place for most relatives and you do sound like you need some counselling.
But some basic info
Firstly ICU is very much a full on last attempt to save a patient where the patient is unlikely to survive without that level of support. This in reality means all patients there are extremely sick and yes often they do die.
But they go there in an attempt to save them not to kill them.
All patients have a lot of lines and tubes some patients get better and obviously some don't.
The lines and tubes are there to keep them alive and comfortable.
Often drugs are given to keep patients sedated and comfortable in the same way as terminal care. These drugs do not kill the patient but ensure they are pain free and settled.
Without these often death can be very very distressful for the patient and relatives. Thus many people associate the syringe driver or IV infusions of morphine as a sign that someone is dying. This is often the case but I really need to emphasize here that a peaceful death is the aim,.
You say your father had multi organ failure this is not easy to treat and does often cause death.
Honesty it sounds like he was a very sick man who very sadly just couldn't be saved.
You need to sit down with the Icu outreach / bereavement nurse who will be able to explain everything that was done and why. Strangers on the internet will not be able to help you if they don't know the full facts.

As someone who did a 3 week ICU experience as next of kin with a parent who didn't make i have huge sympathies OP. It's a really difficult time for patients and families and you're also not always able to take things in or remember clearly as you're going through a trauma and your brain sort of shuts down in some ways.

From what I know as a family member, they will admit someone to ICU when there is a chance that there interventions will mean a good outcome for the patient, but because these patients are so critically unwell things can absolutely change in a matter of hours.

As to whether negligence or poor care may have contributed before he was admitted to ICU there is no way to know without his medical records.

Ultimately in the end you can't change the outcome however much you might want to. You also need to realise that the reasons you couldn't do more at the time are completely valid. Heavily pregnant and with a small child is no picnic and incredibly demanding.

I would say the grief counselling is where you're likely to get the most help. They may be able to help you access any information you need to help you process what happened but also help you to process the information and recollections that you do have. Coming to terms with the fact there is nothing that could be done is incredibly hard. I did a lot of 'what ifs' in the year afterwards as well. All the best and I hope you find some peace from it.

If your father had palliative medication administered via a syringe driver he would have been stepped down to a ward, this wouldn't be done on ICU.

There is often a ‘good day’ just before the final decline. I’ve seen it with both my Nans. They suddenly seem like they are getting better but it’s actually a sign their body is about to start to let go.

Its actually a documented phenomenon. There’s a name for it but I can’t remember it.

ive tried them and they won’t talk. They said they were explicitly told what to do by the discharging hospitals but it’s the nice guidelines to have management plans but they wouldn’t even do a blood test or take his blood pressure

That’s helpful, thank you!

ive tried to reach them re the grief counselling and no calls have been returned. My mum says this is because they’re hiding something. It’s just affecting me mentally

^ hit send too early, she’s also got in my head that they’d cover it up and never tell the truth anyway so there’s no point, they’d never admit wrong doing

He was never taken off itu