The order of Ministry of health about the open admission in the intensive care unit in the format 24 hours a day, 7 days a week was approved on 29 June 2016, and that volunteers and activists took several years. But two months later, widespread progress in solving the problem.

Read more: Chamber in a strict regime. Why do parents need access to intensive care

“I guess we’re all accustomed to impunity. Some doctors think that this order is not for them, and they don’t need to carry it out. Otherwise I find it difficult to understand what the problem is and why the relatives are denied access to intensive care,” – said in comments ЛІГА.net one of the initiators of the order of admission to the intensive care unit Anastasia Leukhina.

What happens in hospitals

“As far as we know, in some hospitals, the order began to run in one degree or another, but a global change has occurred, and there are many doctors who are still not allowed relatives,” explains Anastasia Leukhina.

One of the community initiatives on open access in intensive care was born after in intensive care alone had died eight month old Elisha. His mother Irina Kudinova almost a month was forced daily to beat the doctors the right to enter the house to your child. After the death of the son of Irina Kudinov together with Anna Karachevskoy have created a public organization “poruch Bootie. Reanimat, drain to ditini”.

“The order of the Ministry came into force and must be implemented. But we know that some hospitals that might not know. Yet everything comes from the top down to the most specific hospitals it’s a long story, told in an interview with ЛІГА.net Anna Karasevskaya. – Those doctors who have Facebook and who are actively interested in, communicate with their colleagues in the course. But these progressive doctors, to be honest, before any problems with the tolerance was not.”

Many hospitals opened the doors to intensive care just at a certain time, for example, from 9 to 18. Many continue to openly not to allow relatives in the resuscitation. In General, whatever you like, – Irina Litovchenko

According to her, the situation with children’s intensive care has improved, but with tolerance in adults worse – many doctors provide a sharp resistance. “Nobody was ready for this or some relatives or doctors,” – said Karasevskaya.

“Many hospitals opened the doors to intensive care just at a certain time, for example, from 9 to 18. Even so – it is generally two hours were given. Many continue to openly not to allow relatives in the resuscitation. In General, whatever you like,” stated ЛІГА.net co-founder of Pills Irina Litovchenko.

A set of arguments that lead hospitals to refusal of admission in the ICU, standard and unchanged for many years.

“First, referred to sanitary risks. But the view that visitors will drop the infection – a myth. All over the world already came to the conclusion that much worse than nosocomial infections, – says Anastasiya Leukhina. – The second argument – that it will interfere with the doctors to perform their duties. To a large extent also a myth. Those hospitals, which have long been practicing open access, saying that the visitors and especially parents, on the contrary, help to care for the sick, relieve medpersonal. And the third argument, which is manifested in a recent case in Zhytomyr – that all visitors inappropriate, will conflict with doctors and prevent them to save lives in intensive care. I think this is a very controversial issue about which we have the percentage of inadequate people in society. And it’s good that we not raise the question of the doctors themselves, because sometimes when I listen to the stories from hospitals, I have a doubt about the adequacy of the medical staff”.

Opponents in Parliament

“The Committee on health consciously, by a majority of voters did not support a bill that allows open access to relatives in the intensive care unit for adults, realizing the danger to the life and work of doctors and the health of other patients, which can create uncontrolled access by untrained relatives in a Department where every second of a doctor gold,” he wrote in early August on the page in Facebook the head of the Committee Olga Bogomolets.

A bill authorizing the access of relatives in intensive care, was introduced in Parliament in may. It served the people’s Deputy Olena Sotnyk, which itself faced with the problem of closed intensive care – four days it was not allowed to see her husband in intensive care.

“Closed intensive care unit is a Soviet throwback. They are closed because behind these doors there are three main problems. The first counted the number of drugs that is given or perhaps not given to patients. The second uncontrolled care. In fact, you don’t know, had your own or a child care or not. And third, relatives are the greatest inspector of medical service”, – commented on his bill Olena Sotnyk.

According to her, in all countries the ICU opened, and not only advanced Germany, USA, Israel, but others that are close in their economic development have gone from Ukraine. “Because there is ethics and people have nothing to hide,” she said.

Any society consists for 99% of sane people and 1% of people with initially deviant behavior. This requires a police response, but that doesn’t mean they need to close access to the intensive care unit – Anastasiya Leukhina

But offer the Centurion not to move forward the parliamentary Committee. “The Verkhovna Rada couldn’t stand to vote for this bill, and no decision was taken,” wrote the petitioner. In the same message it brings condolences to the head of the intensive care hospital in Zhytomyr, who allegedly broke the nose of inadequate visitor. “I will demand from law enforcement agencies of cruel punishment of the person who paralyzed work of the whole Department,” she promised.

Volunteers with this position of the relevant Committee disagree. “Any society consists for 99% of sane people and 1% of people with initially deviant behavior. And this applies not only resuscitation, but also streets, schools and clinics. The 1% requires a police response, but that doesn’t mean they need to close access to intensive care,” – said Anastasia Leukhina.

According to her, the emotional escalation usually occurs on both sides. “And very often, in fact, provoke her doctors that they: a) do not let relatives in the intensive care unit, and b) do not give them any information, do not explain anything, and thus bring people into extreme despair. If there will be a normal communication between the patient, family and physician, we have all the chances to bring such situations to a minimum,” she said.

In any case, and regardless of the position of the Committee on health, said Anastasia Leukhina, the order of the Ministry of health on admission in intensive care acting, and nothing should interfere with its execution. “The bill was introduced in Parliament only in order to secure this right at the legislative level and more clearly defined it in the law on the fundamentals of health. But, in fact, the acceptance or rejection of this bill by Parliament will not affect the execution of the order. Just the act could ensure that in the Ministry of health will not come up with someone new and do not cancel it with the stroke of a pen,” she explained.

The position of the new head of the Ministry of health

According to activists, more than a month, the order had been in the Ministry almost without movement: it does not descend down to the hospital, was not the promised extended selector for the leadership of oblzdrav. With the arrival of the acting Minister Uliana Suprun, the situation changed. August 12, the health Ministry held a meeting Suprun with volunteers, where she promised full support. “The order of Ministry of health of the public emergency rooms went by region, and we are not changing anything… If there’s a problem that immediately appealed to us, and so we can respond,” – said the Minister.

Photo project “Buti charging” from open intensive care units: an exhibition in the Ministry of health

“They really spent and instructed all oblzdrav about the fact that this order is in force and binding. Ulyana Suprun promised us at the meeting to take maximum measures”, – says Anastasia Leukhina.

The position of the new head of the Ministry confirmed the Fund Tabletochki. “Uliana Suprun has held a teleconference with oblzdrav and drew their attention to the fact that intensive care have full open access. Now community activists are trying to organize the work of monitoring resuscitation. We asked the Ministry to make a list of intensive care areas for these offices has prepared information materials on the rights and responsibilities of doctors. And that run hotlines, which will be able to complain, for example, relatives”, – said Irina Litovchenko.

What to do if you are not allowed

“For us, a very important official. Because if not, then the problem either. It is very important that the people themselves were not silent, not sitting in the door of the intensive care units, and appealed to hospital administration, showed the order with the requirement to provide access, and if addressed to the Ministry of health directly,” – said Leukhina.

Anna Karasevskaya advice always comes in intensive care with the text of the order, because its existence is still not known by everyone: “With the text of the order. To explain: we agree with all the restrictions, but a right that is guaranteed by the order, have the right. Any violations should be reported. Otherwise it won’t work”.

“The easiest thing is to print this order. Perhaps the hospital has not yet reached this information. You can bring and show it to the doctors. If that doesn’t work, then go to the head office, the chief physician. If you still get no feedback, then it is necessary to record the refusal in writing, write a complaint to the chief physician, to apply to the Ministry of health. Because if we do not fix these cases if the people will be silent and will not begin to fight for their rights, we will never move this problem and achieve its solution,” warns the coach.

The telephone hotline of the Ministry of health 0-800-801-333 only available on weekdays.

To come into conflict with the doctors at the time when the child is in intensive care, I would not recommend it. I do want to find a middle ground, doctor Paul Silkovsky

Paul Silkovsky – anesthetist of the Rivne regional children’s hospital, where the long practiced open access to the children-patients, warns: efforts to defend their rights the main thing – do not overdo it and to stay out of the conflict.

“Parents here are in the least advantageous position. To come into conflict with the doctors at the time when the child is in intensive care, I would not recommend it. I do want to find a middle ground, ” he said ЛІГА.net.

The doctor admits, on the one hand, there are a large number of doctors who actually oppose and don’t want to practice open intensive care unit: “But there are quite aggressive relatives who come and begin to quarrel, come into conflict. This is harmful to the treatment process and children. So I think that this is more the responsibility of our activists and journalists who notice, give voice to and cover similar cases. I’m all for evolutionary way. And when doctors make and break, is not useful, it is counterproductive”.

Admission to intensive care: does the hospital order of Ministry of health 23.08.2016

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