LTAC<\/u><\/a>, they had nurses coming in that was still in nursing school working with patients in ICU like for visits.<\/p>\nHelene:<\/strong>\u00a0 I mean, I can understand nurses maybe touring an ICU but literally hands-on that will… And sometimes not even guided by someone else, oversight a training nurse. They were allowing that to happen. And some of them, other nurses who come from straight out of nursing school working-<\/p>\nPatrik:<\/strong>\u00a0 For sure.<\/p>\nHelene:\u00a0 <\/strong>… by themselves in ICU. And that just really-<\/p>\nPatrik:<\/strong>\u00a0 It’s dangerous.<\/p>\nHelene: <\/strong>… alarmed me.<\/p>\nPatrik:<\/strong>\u00a0 It’s dangerous. And this has always been-<\/p>\nHelene:<\/strong>\u00a0Very dangerous.<\/p>\nPatrik:<\/strong>\u00a0This has always been an issue in healthcare. How do you integrate junior staff, whether it’s doctors, nurses? You put them through training programs but you still have to learn on the job. And with COVID, that’s become worse, not better. It was challenging before COVID, where some of the staffing levels in ICU were pretty low with a lot of junior staff and it has become worse.<\/p>\nHelene:<\/strong>\u00a0Yeah. And at this particular hospital Patrik, they had no standard, or sanitizing equipment, or hospital bed. I mean, they gave my mother a bed that a patient had just used. And my mother ended up getting hepatitis C in the hospital, as well as… Firstly, they did not wash it down or anything. And I’m like, “Aren’t you supposed to sanitize this thing before you put her on it?” “We don’t have the time.”<\/p>\nPatrik:<\/strong>\u00a0 Yeah.<\/p>\nHelene:<\/strong>\u00a0 I mean, there was no standard. And you know the port to draw blood? The IV port when you’re supposed to wipe them down alcohol swabs and replace the top? They wouldn’t even have… This hospital didn’t even have the alcohol swabs to wipe those outside port. And I fortunately had some in my car that I just got a new shipment in as supply for my mom. And they had to use her personal supplies because I’m like, they had none. None. And then the green caps that they had supposed to screw on there to protect it, they wouldn’t even replace them at times. Either they leave it open or they kept reusing the old one.<\/p>\nPatrik:<\/strong>\u00a0 Yeah. Yeah. Helene, I’ve got another caller. I’ve got another caller wanting to ask some question. No, no, that’s okay. That’s okay. It’s all good. I’ve got to let another caller in. Thank you.<\/p>\nHelene:<\/strong>\u00a0Okay.<\/p>\nPatrik:<\/strong>\u00a0Thank you so much for sharing your… I know it’s been very sad with your mom in particular. And I appreciate that you are sharing this so freely with everyone here, because I think it’s important that everyone is hearing it, that they need to be very vigilant while they have a family member in ICU. It’s that people have to be definitely as soon as they go in. Thanks Helene for sharing. I’ll just got to let another call later in. Thank you.<\/p>\nHelene:<\/strong>\u00a0 Okay.<\/p>\nPatrik:<\/strong>\u00a0 Thank you. Bye-bye.<\/p>\nHelene:<\/strong>\u00a0 Thank you.<\/p>\nPatrik: <\/strong>\u00a0So Traca, I’m just going to call you now. I know you tried to call.<\/p>\nTraca:<\/strong>\u00a0 \u00a0Hello?<\/p>\nPatrik<\/strong>:\u00a0 Hi Traca, it’s Patrik here. How are you?<\/p>\nTraca:\u00a0 <\/strong>Hi, I’m good Patrik.<\/p>\nPatrik: <\/strong>\u00a0That’s good. You’re live now. Sorry that I couldn’t-<\/p>\nTraca:\u00a0 <\/strong>Oh, okay.<\/p>\nPatrik<\/strong>: Well, I’ve seen your emails, so I have an up to date. So update from your end. What’s your burning question now?<\/p>\nTraca:\u00a0 <\/strong>What I’m trying to find out, because my dad, they de-capped him on first on Tuesday and he hasn’t desatted or anything. They were actually going to decannulate him on Thursday, but he’s got mental confusion that’s developed now. So they felt that it was safe to still keep it in. But other than just the confusion part, he’s doing well and the LTAC wants to maybe discharge him on Tuesday. They wanted to go to a skilled nursing or a subacute facility. But my mom has home healthcare and so she wants to bring him home. So I was just trying to see what our next steps should be as far as safety, if they do decannulate him before we go home, if that was better or..?<\/p>\nPatrik: <\/strong>\u00a0I think-<\/p>\nTraca: <\/strong>I’m not sure.<\/p>\nPatrik<\/strong>: Yeah, I think have a fairly simple answer for you there. Whilst confusion is not great, my advice would be to decannulate him while he’s in a hospital environment and see how he goes. Because he’s in the right place that if something was to go wrong, that they could recannulate him. But now is the time to decannulate him. When you say confused, can you describe that a little bit more?<\/p>\nTraca: <\/strong>Yeah, well, the last couple of days, he’s been confused and hallucinating saying there’s rats running around those ceiling and the vents are going to fall on me and people are crawling around on the floor.<\/p>\nPatrik:<\/strong>\u00a0So but-<\/p>\nTraca:\u00a0 <\/strong>He’s more confused when you talk to him, he mumbles and just goes off on weird things.<\/p>\nPatrik:<\/strong> Okay. But he’s talking to you with the speaking valve?<\/p>\nTraca:\u00a0 <\/strong>Yes, he has a speaking cap on.<\/p>\nPatrik:<\/strong>\u00a0 Right. Fantastic. Fantastic. So as far as I can see, there’s way more positives than negatives. I mean, confusion is-<\/p>\nTraca:\u00a0 <\/strong>Yeah, we’re doing much better.<\/p>\nPatrik:\u00a0 <\/strong>Right, right. The most important thing from my perspective is you take out the trach, can he follow commands like can he keep coughing? Can he do deep breathing exercises? It doesn’t sound to me like that would be an obstacle or do you think that might be an obstacle that he can’t follow those instructions around breathing exercises, coughing?<\/p>\nTraca:\u00a0 <\/strong>No, he totally will do everything we ask him to do. He cooperates, understanding commands very good. I was just looking at the doctor’s notes that I just got and they have them as acute respiratory failure, and then it has N-S-P-W, which I’m not sure, but unspecified maybe, but it says hypoxia or hypercapnia.<\/p>\nPatrik: <\/strong>And did you say N-S-P-W?<\/p>\nTraca: <\/strong>U-N-S-P-W.<\/p>\nPatrik:<\/strong>\u00a0 U-N-S-P-W. Never heard of that. I’ll just quickly type it into Google and see what comes up.<\/p>\nTraca: <\/strong>Yeah.<\/p>\nPatrik:<\/strong>\u00a0 Never heard of this.<\/p>\nTraca:\u00a0 <\/strong>I’m not sure.<\/p>\nPatrik:<\/strong>\u00a0 Medical. Interesting. But it sounds to me what he’s experiencing, nothing seems to come up. Nothing seems to come up.<\/p>\nTraca: \u00a0<\/strong>Maybe UNSP W?<\/p>\nPatrik: <\/strong>\u00a0P W? Yeah.<\/p>\nTraca:\u00a0 <\/strong>Yeah. P space. Yeah. I don’t know whether he has hypoxia or hypercapnia.<\/p>\nPatrik:<\/strong>\u00a0Right. No, nothing comes up that’s of significance under that. That’s strange. But I think from what you’re describing here, the issues are not so much around the airway. The issue are more around mental like hallucination, confusion. Now correct me if you think I’m making the wrong suggestion here. Once he has the trach removed, him going home is something that can be achieved reasonably quickly, would you confirm that?<\/p>\nTraca: <\/strong>Yes.<\/p>\nPatrik:<\/strong>\u00a0 Okay. So I argue that once he’s in his own environment, I would argue that the confusion will take care of itself, because how long has he been in hospital now? For months on end.<\/p>\nTraca:\u00a0 <\/strong>106 days.<\/p>\nPatrik:<\/strong>\u00a0 Right, right. I would think that him going home would deal with that confusion, don’t you think? Or what’s your outlook?<\/p>\nTraca: <\/strong>Oh, I totally agree. Totally. But they’re trying to push now due to a convalescent skilled nursing or a subacute, and I keep explaining we’re not getting any better by just moving him around different facilities. That’s just creating his confusion to get worse.<\/p>\n