Pushed out of ICU after 10 weeks because they needed the bed

[SLF777]

HI everyone...I am so glad that I found this site. I am reading these posts like a sponge.

My boyfriend ended up in ICU after a brain aneurysm rupture, then strokes from the vasospasms afterwards (at brainstem).  After many life threatening episodes, and a failed brain shunt, he was moved out yesterday to a step down IICU unit.  They didn't notify us and I walked into his room last night at 730pm and saw an empty bed.  After digging, I found out that because he was breathing on a trach collar (off vent) for over 24 hourse, they felt he was the best candidate to move.  The dr. that signed his release from ICU is denying that was the case, even though a PA told me so.

When I found him across the hall, he was in distress (sweating profusely and 02 level lower than I had seen in ICU ).  The nurse had no clue about anything to do with him.   He was also moved to a small room that had no ventilation. I made the ICU PA come over and see him.  What concerned me the most was

that he was only off vent for a 1.5 days after the final shunt repair surgery, and the new room has no vent.  The bag (hand pump for breathing) wasn't even there..found out they forgot to move it with him.

I made them go get one before I could leave for the night.

Thoughts? I am extremely agitated and stressed.

[muncii]

SLF - what a terrible experience you are having. My sympathies. Unfortunately, your poor boyfriend is not alone in being moved out of ICU at short notice (and you not being informed)  When I was an ICU patient, I was moved, suddenly, on to 'ordinary' surgical wards twice - not even high dependency-  (and then back to ICU on each occasion) and it was all because the hospital needed the ICU bed for someone apparently more urgent. One of these moves took place at 2.30 in the morning. My poor family arrived later and didn't know where I was. Neither did the ICU staff.

I think it's brutal and unforgiveable. It sounds like you are having to keep watch on his care if you can't trust the nurses to look after him properly. That must be very worrying indeed.  I'm sure you are doing all you can, and more, and your boyfriend will appreciate this. But I'm not surprised you are agitated and anxious, it's natural in the circumstances. Please look after yourself, and I wish your boyfriend a good recovery.

[angelrock]

Please try and remain calm and supportive, your boyfriend is the best medical hands in this country and the medical staff are wonderful as well as being rather stressed. I was admitted into ICU after an operation for a misdiagnosed appendicitis which ruptured causing all sorts of problems. I finally made it and am a survivor. 

[explorereb96]

I understand your distress.  If I found him in distress and found that he had a nurse that did not know what to do with him I would have a fit myself.  After working with trachs and vents for more than a decade, I have one thing to say about it.  When someone has a tracheostomy, that is the only way in which they can breath, period, end of sentence.  When a trach tube is blocked by secretions, a mucous plug, or anything that occludes it...they cannot breathe.  They cannot breathe through their nose.  The tracheostomy tube is the only airway they have.  At the very least this emergency bag should be set up bedside for any trach patient.....within the bag should be (and ALL clearly labeled...you don't have time to read)  1.) another trach tube of the same size...in case the occlusion is so bad that you cannot suction whatever it is out.   2.) another trach tube of a smaller size (called a step down trach) in case there is swelling within the trachea that you cannot get the same size in. 3.) Both suction and O2 should be preset up at all times 4.) an ambu bag that is set up with a trach fitting.  5.) scissors- to cut the trach collar in an emergency trach change. 6.) another 2-3 trach collars to secure the emergency trach change.  There is no need to have another ventilator in the room, as he has been breathing on his own for more than 6 hours.  If they need one..the respiratory therapist will bring one up and set it up.  If he needed to be placed back on it is more than likely all his settings would be changed to what he needs at that moment.  The nurses would have to use the ambu until the vent is there.  I am surprised that they transferred this patient AND accepted him into the room without any of his necessary supplies.    When he is in distress, he needed to be suctioned, correct?  If he is able to understand you and follow what you are saying...do this....calm him....call the nurse to have him suctioned, and make sure he knows it's a little hard to do at first but it is possible to cough some of it out.  Don't let that nurse tell you to wait a minute either...because suctioning is paramount.   Make friends with a respiratory therapist and ask if you could learn how to help him.  It's not that hard to learn.  I worked with pediatric trach/vent for 17 years and part time weekends at an adult trach vent unit for 3 years. 

Karol