My name is Patrik Hutzel from intensivecareathome.com, where we provide tailor-made solutions for long-term ventilated adults and children with tracheostomies, where we provide tailor-made solutions for long-term ventilated adults and children on BiPAP (Bilevel Positive Airway Pressure) and CPAP (Continuous Positive Airway Pressure), without tracheostomy. We provide tailor-made solutions for tracheostomy care at home without ventilation, home ventilation weaning, home cough assist management, home TPN (Total Parenteral Nutrition), home IV (intravenous) potassium, home IV magnesium, home IV fluids, home IV antibiotic infusions, PEG (Percutaneous Endoscopic Gastrostomy), PEJ (Percutaneous Endoscopic Jejunostomy) tube management, nasogastric tube, nasojejunostomy management at home, IDC (Indwelling Catheter), SPC (Suprapubic Catheter) as well as palliative care at home.

So, in Episode 1 of our pediatric series, I told you that bringing your child home with a tracheostomy, even on a ventilator, even with a tracheostomy is absolutely possible.

I know some of you watched that video and thought, “OK, but what does that actually look like on a day-by-day basis?”

Because when I say 24/7 nursing in your home, I know the first thing many parents picture is a clinical environment, beeping machines, a stranger in your living room. Your child’s bedroom looking like a hospital ward and you think, is that really home?

So, today I want to walk you through what daily life genuinely looks like when your child comes home with Intensive Care at Home in 24-hour critical care nursing. What happens during the day? What happens overnight, what it looks like for your family and what it looks like for your child. The equipment, the routines. The reality, all of it.

So again, this is why I do episode 2 today, a day in the life, what home looks like with 24/7 nursing for your child and just, you know, what makes me qualified to make a video like this. I am a critical care nurse by background and I have worked with many adults and children in critical care in Hospitals, as well as with Intensive Care at Home, and if you haven’t watched episode one yet, go back and watch it after this one, and if you’re new to this channel, please hit the subscribe button. We release free clinical education for families in navigating pediatric tracheostomies, ventilation and pediatric ICU discharge every week.

So, let’s walk you through what a typical day looks like.

Let’s start with the morning.

Your child’s day shift nurse arrives at 7 a.m., 8 a.m. It depends a little bit on your preferences. In most cases, the same nurse or the same nurses will be with your family multiple days a week. We build continuity wherever possible because consistency matters, both your child and your family because we know that having the same people that you know, like and trust coming over and over again is critically important for your child and also for you as a family, of course.

Next is the night shift nurse hands over. This is a clinical handover. They review overnight observations. Any changes in ventilator settings, how your child sleeps, how much suctioning was needed, any issues with the tracheostomy or any equipment, any issues with medications. This happens at the bedside quietly, professionally. Your child is probably still asleep. You don’t have to be part of the handover but you’re more than welcome to be part of the handover if you want to hear what happened overnight. Once handover is done, the night nurse leaves and the day shift begins.

So, what does the morning look like? The day nurse starts by doing a full clinical assessment, they check your child’s oxygen saturations, heart rate, respiratory rate, temperature, all the vital signs. They listen to your child’s chest with a stethoscope, they look at the tracheostomy stoma site for any redness, swelling, or discharge. They check the tracheostomy tape, making sure it’s all secure so that the tracheostomy can’t fall out. They check that the ventilator circuit is intact. The humidification is working, that the oxygen supply is adequate if oxygen is needed. This might take about 15 to 20 minutes. It is thorough. It is professional, but here’s what I want you to understand. It doesn’t have to feel clinical or cold. The nurses we place with families know how to do all of this whilst also being warm, calm, and present with your child. They talk to your child. They make eye contact. They move gently. Many of our pediatric ICU nurses are parents themselves. They understand what it means to care for a child, not just manage a patient.

After the morning assessment, your child day begins. Breakfast if they’re eating orally or being fed with a PEG tube, PEJ tube, nasogastric tube or nasojejunostomy tube, nappy change, washing, getting dressed, playtime, the therapy time if your child has physiotherapy or occupational therapy or speech therapy scheduled. The nurse is there for all of it, not hovering, not taking over, but present, observing, managing the clinical side so that you can be present as a parent, or, they might go to school and our nurse will come with them, or they might go to kindergarten and our nurse might come with them.

Here’s the most important thing I can tell you about what daytime at home or at school looks like. You get to be a parent again, not a nurse, not a full-time carer, a loving parent. You can make breakfast for your other children or for other family members. You can sit on the floor and play with your child without constantly watching the monitor. You can answer a phone call, have a shower, go for a walk, meet a friend for coffee, maybe take your other children to school, because there is a qualified ICU nurse in your home who’s managing your child’s clinical needs. Every single moment. That is what the day shift gives you, gives you your life back.

So, what would our nurse actually do clinically throughout the day? Let me walk you through the core tasks would be.

1. Suctioning is the most frequent task the nurse will perform, especially with tracheostomies. This means using a suction catheter to clear mucus and secretions from inside your child’s tracheostomy tube and trachea. How often? This needs to happen, depends on your child. Some children need suctioning every 30 minutes, others every few hours. Some children might need it even more frequently. The nurse monitors your child continuously and suctions as needed. It’s not on a rigid schedule. This is a skilled task. The nurse knows how deep to insert the catheter, how much suction pressure to apply, how to minimize discomfort for your child, and how to recognize when secretions are normal versus when they indicate an infection or a problem. You don’t have to do this, our nurses do that every single time.
2. They also do stoma care, the skin around your child’s tracheostomy, stoma needs daily care. The nurse cleans the site with sterile saline, checks for any redness or breakdown of skin, changes the dressing under the tracheostomy tube flanges, and ensures the tracheostomy ties or tube holder are changed and secure, but not too tight. This is done at least once per day, sometimes more if your child has sensitive skin or a lot of secretion.
3. They do tracheostomy tube changes. Most children have their tracheostomy tubes changed weekly or fortnightly. This is not an emergency task. It is a planned, routine procedure. Our nurses are trained to do this safely at home. You will always be asked to be present during a tube change if you want to, but you do not have to perform it yourself unless you want to learn.

Before I go to number 4, I forgot to mention one thing, they also might change the inner cannula if your child has an inner cannula with the tracheostomy, that might happen multiple times a day.

4. Ventilator management. If your child is on a ventilator, our nurses monitor and manage the ventilator throughout every shift. They check that the settings are correct, that alarms are functioning, that the circuit is not obstructed or leaking, that humidification is working. They respond to ventilator alarms immediately, appropriately and accordingly. Disconnection, high pressure, low pressure, low battery, and they know how to troubleshoot and fix issues without panic.
5. Medication administration. If your child has medications scheduled during the day or night, the nurse administers them. This includes nebulized medications, oral medications, medications via feeding tubes, or medications via central line, PICC line, port if your if your child has IV access. Our nurse documents every medication given and monitors for side effects or reactions.
6. Monitoring and documentation. Every shift our nurse documents vital signs, clinical observation, suctioning frequency, ventilator settings, medications given, and any concerns. This documentation is reviewed by our clinical team and shared with your child’s pediatric and respiratory specialists as needed. You are never in the dark about what is happening clinically with your child. All of these tasks happen seamlessly throughout the day and night. Our nurse will not ask you to help. They’re not teaching you how to manage emergencies unless you want to be trained. They’re doing their work so that you can focus on being your child’s parent.

One of the most common questions we get from families is this:

• Is there a nurse in my home 24 hours a day?
• Does that mean I have no privacy?
• Does that mean my house feels like a hospital?

 

I understand why that is a concern, so let me speak to it directly.

So, how the nursing setup works in your home?

The nursing space in your child’s room or in a designated area of your home where your child spends most of their time, that becomes the clinical space, the rest of your home, your bedroom, your kitchen, your living areas remains your space. Our nurses do not follow you around. They’re not in your kitchen making themselves tea in the middle of your family dinner. They’re professional, they are respectful and they understand boundaries.

Most families set up a small area in that child’s room or nearby where our nurses can sit, document, have a cup of tea, take a break during quiet periods. Our nurses bring their own food. They do not use your kitchen as their break room. They are there to work, not to live in your home and they are professionals.

Here is what we hear from families after a few weeks of having nursing in place. They stop noticing the nurse is there, not because the nurse is invisible, but because life becomes normal again. Your child plays, your family eats meals together, siblings run around, you watch TV in the evening, and our nurse is just quietly there in the background making the clinical side seamless. It stops feeling like an intrusion and starts feeling like security and safety.

What about family time? This is your home and your home only, and, you know, you are allowed to direct our nurse when you want to be alone with your child. If you want to take your child outside into the garden or into the park and the nurse does not have to be holding your hand, if you want to read your child a bedtime story and have that moment privately, our nurses will step back. Our nurses are there for clinical safety, not to take over your role as a parent. If you want to take your child to a family gathering, to a park, to a medical appointment, our nurses will come with you if needed, or if the outing is short and low risk, you may be able to go without the nurse for a short period, if that’s what you want. We work with families to balance safety and independence based on each child’s specific clinical needs. The goal is always the same, to give you a life, not a different kind of hospital, a family life instead.

Let me now talk about a night shift because for many families this is where the 24/7 nursing model changes everything.

At 7 p.m. or 8 p.m., you know, or any other time depending on whether there are 12-hour shifts or 3 shifts a day, 38-hour shifts, the night shift nurse arrives. The day shift nurse hands over, same process as in the morning, clinical review, anything that happened during the day, any concerns, then the day nurse leaves and your evening begins. You can put your child to bed. Our nurse is there. The monitors are on if needed. The ventilators humming quietly in the background, and then you go to bed in your own room, in your own bed with your door closed, and you sleep. You do not have to listen for alarms. You do not have to wake up every two hours to suction. You do not have to sleep with one eye open, terrified that your child’s tracheostomy tube will block, and you won’t hear it because there is an ICU trained nurse awake, alert, and monitoring your child all night long, providing their care to them as needed.

If your child needs suctioning at midnight, 2 a.m., 4 a.m. our nurse does it. If the ventilator alarm goes off because of a small leak in the circuit, our nurse will fix it. If your child has a desaturation and needs repositioning or increased oxygen temporarily, our nurse manages it, you sleep through it, because you are allowed to sleep.

Now, one of the other questions might be what if something serious happens overnight or during the day. You know, one thing that we always tell our nurses. When we even interview them, is, you know, prevention is better than cure. What one of the questions that we ask is, what do we need to do today to prevent any adverse events or emergencies tomorrow?

You know, that is a very important question, of course. Genuine emergencies can still happen, an accidental decannulation, a blocked tracheostomy tube that the nurse cannot immediately clear. A serious desaturation or bradycardia that doesn’t resolve quickly, our nurse will wake you if needed, explain the situation calmly, and tell you what is happening. If an ambulance needs to be called, our nurse calls it and stays with your child while you get dressed and prepare to go to hospital but in the vast majority of nights or days nothing serious happens. Your child sleeps; our nurse monitors, and you rest.

For many parents, the first night they sleep through the entire night after months or years of broken sleep in PICU or at home alone with their child is the night they cry with relief because they finally feel safe. That is what 24/7 nursing at home gives you, the ability to sleep, the ability to be human again. So, you might also be asking what does your home actually need to accommodate a ventilated child with a tracheostomy.

So let me walk you through the equipment and supplies that will be in your home, because I know this can feel overwhelming at first, but I also want to reassure you that we coordinate all of this. You do not have to source equipment, you do not have to call 10 different suppliers, we handle all of that.

• Core equipment in your home, ventilator if your child requires mechanical ventilation. This is usually a portable home ventilator like an astral, a trilogy, or a similar model. It runs on main power but has an internal battery backup for power outages or transport.
• Oxygen supply, either oxygen concentrator or oxygen cylinders depending on your child’s need and local supply arrangements.
• Suction machine portable suction unit mains powered with battery backup.
• Pulse oximeter continuous monitoring of oxygen saturation and heart rate.
• Some families have a bedside monitor.
• Others use a portable.
• Monitor, humidifier if your child, child is on a ventilator, the humidifier is built into the ventilator circuit, if your child breathes independently through the tracheostomy, they usually use, A heat moisture exchanger, also known as HME or Swedish nose.
• Emergency equipment, backup ventilator, backup suction machine, manual resuscitation bag, backup tracheostomy. The same size and a size smaller and a tracheostomy dilator.

Your home will have a stock of consumable supplies that are delivered regularly, usually monthly. This includes: suction catheters, tracheostomy tubes, tracheostomy ties or tube holders, dressings and gauze, sterile saline, ventilator circuits, oxygen tubing, and nasal prongs if applicable, also nasogastric tubes, PEG tubes, depending on if your child has one and our nurses can manage the supply stock if you like. If something’s running low, our nurses notify our coordination team or yourself depending on the setup and what you prefer, and we can arrange delivery. You do not have to track inventory or chase supplies if you don’t want to.

So, where does all the equipment go? Most families dedicate a corner of their child’s bedroom or a corner or another different corner of the house to equipment, a small table or trolley for the ventilator and suction machine, a cupboard, a shelving unit for supplies. It doesn’t have to take over the entire room. Many families tell us that after a few weeks they stop seeing the equipment, it just becomes part of the room, like furniture.

Here’s the truth, your child’s room doesn’t have to look like a pediatric ICU bay. You can still have their favorite toys in the shelves. You can still have pictures on the walls. You can still make it feel like a child’s bedroom. The equipment is there, but it doesn’t define the space. So that is what daily life might look like when your child comes home with 24-hour intensive care nursing with Intensive Care at Home, morning handover. Clinical care throughout the day, whether that’s at home, in school, at kindergarten, you know, wherever the day unfolds, family time, overnight monitoring while you sleep, professional nursing, medical grade equipment, and a life, not a hospital room.

I know that when you are sitting in the pediatric ICU right now, the idea of taking your child home may feel impossible. It can feel like the safest thing to do is to stay exactly where you are, surrounded by doctors and nurses and equipment, and even if that means months or years in a hospital bed.

What I want you to hear is this, home is not less safe than the pediatric ICU when you have the right support in place.

• It is not a compromise.
• It is not settling for less.
• It is giving your child and your family a life.
• I believe it is settling for more than just living in a hospital.
• Children who come home with our service grow up in their own bedrooms.
• They play with their siblings.
• They go to the park.
• They can often go to school or kindergarten.
• They have birthdays at home, they are surrounded by the people who love them, not bought by a rotating roster of hospital staff who change every shift.

That is what we do. That is what we make possible with the staff that you will know, like and trust.

Here’s what I want you to do next.

1. Subscribe to my YouTube channel. This is episode 2 of our pediatric series, and we have more coming. Episode 3 is going to cover emergency management at home and also the prevention of such, what happens when things go wrong and how our nurses are trained to handle it. You don’t want to miss that episode.
2. Go to com and explore our services. Read the case studies, see the testimonials from families we have supported.

Understand what is possible for your child and go and give us a call at intensivecareathome.com. If you want to talk to me or to one of my team members about your specific situation and your specific needs, your child’s diagnosis, your PICU discharge timeline, your concerns, your questions, we are here for you. We have been doing this now since 2012. We know what families like yours are facing, and we know how to help.

Thank you for watching.

Take care of yourself and I’ll see you in another video.

With all of that said, with Intensive Care at Home, we are currently sending our critical care nurses into the home 24 hours a day. Therefore, we are providing a genuine alternative to long-term stay in intensive care for:

• Ventilation
• Tracheostomy
• Home BiPAP (Bilevel Positive Airway Pressure) and CPAP (Continuous Positive Airway Pressure)
• Tracheostomy care without ventilation
• home TPN (Total Parenteral Nutrition)
• Home IV potassium
• Home IV magnesium
• Home IV antibiotics
• Home IV fluids

 

We’re providing:

• Cough assist management at home
• Ventilation weaning management at home
• central line, PICC (Peripherally Inserted Central Catheter) line, Hickman’s line as well as port management at home
• nasogastric tube, nasojejunostomy tube, PEG (Percutaneous Endoscopic Gastrostomy), PEJ (Percutaneous Endoscopic Jejunostomy) tube management at home
• IDC (Indwelling Catheter) and SPC (Suprapubic Catheter) management at home
• Palliative care services at home

We’re also sending our critical care nurses into the home for emergency department bypass services. We have done so successfully as part of the Western Sydney Local Health District’s In Touch program, saving approximately $2,000 per patient that we keep at home instead of them going into an emergency department.

That also means we’re in a position to cut the cost of an ICU bed by around 50%. An intensive care bed costs between $5,000 to $10,000 per bed day depending on location. Intensive Care at Home costs approximately 50% of that, and we’re freeing up the most sought-after bed in the hospital, which is the ICU bed. Most importantly, we’re improving the quality of life for patients and their families, which is a win-win situation for all stakeholders.

Our Coverage and Accreditation

With Intensive Care at Home, we’re currently operating all around Australia, in all major capital cities, as well as in all regional and rural areas. We are an NDIS approved service provider all around Australia, TAC (Transport Accident Commission) and WorkSafe in Victoria as well as the Department of Veterans Affairs all around Australia.

We’re also ISO 9001:2015 accredited. Our clients and we as a service provider have also received funding through public hospitals, private health funds as well as departments of health.

We are the only service provider in Australia that has achieved third-party accreditation for Intensive Care at Home nursing in 2025. We have been achieving this high level of accreditation since 2012. No other provider in Australia has achieved the Intensive Care at Home level of accreditation in the community and has created more intellectual property when it comes to Intensive Care at Home nursing than we have.

This puts us in a position to employ hundreds of years of critical care nursing experience combined in the community. No other service provider in 2025 employs a higher skill level in the community than we do. And that enables us to look after the highest acuity adults and children in the community in Australia safely.

If You Need Help

If you’re at home already and you’re watching this or you’re stuck in an ICU and you realize that you don’t have the right level of support, I can give you many examples where we helped clients with funding, how we advocate for funding. We had to advocate successfully for funding from our first case study to many other case studies where we had to advocate successfully for funding with the right evidence of course because it is crystal clear that disability support workers for example or registered nurses without ICU experience cannot look after ventilated clients at home whether adults or children with or without a tracheostomy and it’s simply dangerous and negligent.

There are plenty of examples where clients with support worker models or even RN (registered nurse) models without ICU experience have died at home and I have evidence to back up everything that I’m saying here because it’s a bit like flying the airplane with a cabin crew instead of the pilot and it could simply be deadly.

This can be avoided by having simply 24-hour critical care nurses at home because our clients are at high risk of medical emergencies or worse without critical care nurses 24 hours. This is actually also evidence-based in the community and is documented in our evidence-based Mechanical Home Ventilation Guidelines on our website at intensivecareathome.com.

Think about it: in an intensive care unit in a hospital, you wouldn’t have support workers or general registered nurses looking after a critical care patient on a ventilator with a tracheostomy. So why would anyone in their right mind do that in a home care environment where there are fewer resources?

Clients that have found us have been at home long-term predictably and permanently with critical care nurses. Their alternative would have been to either die or stay in ICU long-term, and our clients don’t go back to ICU. They stay at home permanently and predictably and the insurance bodies save half of the cost of an ICU. But it’s a win-win situation all around.

We can do the same for you if you’re stuck in ICU or if you’re not safe at home, which includes the advocacy for funding and the network that goes along with it. We have always successfully advocated for our clients or we have the network to successfully advocate for you and for your family member, otherwise we wouldn’t be in business. The same again is applicable for those stuck in an ICU which is similar to many of our, if not most of our cases.

Our Support Coordination Services

This is also why we are providing Level 2 and Level 3 NDIS support coordination. We have a team of experienced NDIS support coordinators, and they have a wealth of knowledge. We’re also providing TAC case management and WorkSafe case management in Victoria with Lucy McCotter.

If you’re an NDIS support coordinator or a case manager or a social worker from another organization or a hospital watching this and you’re looking for nursing care for your participants, please reach out to us as well. If you’re looking for funding for nursing care for your participants and you don’t know how to go about it and how to advocate for it, what evidence to provide, I encourage you to reach out to us as well. We have the network to make that happen. We will help you with the right level of funding and with the right level of advocacy.

 

We’re also providing NDIS specialist nursing assessments done by critical care nurses with a legal nurse consulting background.

Join Our Team

If you are a critical care nurse and you’re looking for a career change and you want to join a very progressive, dynamic, successful, and high-performing team of critical care nurses in the community, we are employing hundreds of years of critical care nursing experience combined.

If you’re looking for a career change, we’re currently hiring for jobs for critical care nurses in Melbourne, Sydney, Brisbane, Albury-Wodonga, Bendigo, Geelong, Warragul, and also in Wyelangta in Victoria.

If you have worked in critical care nursing for a minimum of two years, adult ICU, pediatric ICU, ED and you have already completed a postgraduate critical care nursing qualification, we will be absolutely delighted hearing from you.

I have a disclaimer though: Because we are offering tailor-made solutions for our clients which includes regular staff, our clients do also want the same staff coming over and over again because they are so vulnerable and so special. That’s why we need regular, reliable staff.

If you’re looking for agency work where you can come and go, this will not be the right fit for you. We’re looking for consistency and our clients are looking for consistency. So please only apply with us if you can give us regular and consistent availabilities for shifts and you’re really keen on building relationships with us and with our clients. Reliability is also a must.

 

For Medical Professionals and Healthcare Executives

If you’re an intensive care specialist or an ED specialist, we also want to hear from you. We’re currently expanding our medical team as well.

We can also help you eliminate your bed blocks in your ICU and in your ED for your long-term patients or for your regularly readmitting patients with our critical care nursing team at home. We’re here to help to take the pressure off your ICU and ED beds. In most cases, you won’t even pay for it. Even if you do pay for it, it is so much more cost-effective than what you’re paying for in ICU and ED settings, and you get the same level of care and simply more patient and family satisfaction because you also want to partner with your consumers.

If you are a hospital executive watching this, we can help you free up your ICU and ED beds.

International Support

If you’re in the U.S. or in the UK and you’re watching this and you need help, we want to hear from you as well. We can help you there privately with one-on-one consulting and with hiring nurses privately.

Once again, our website is intensivecareathome.com. Call us on one of the numbers on the top of our website or simply send us an email to [email protected].

If you like my videos, click the like button, subscribe to my YouTube channel for regular updates for families with Intensive Care at Home and intensive care. Click the like button, click the notification bell, and share this video with anyone who has a family member in intensive care long-term or needs to see this.

Thank you so much for watching.

This is Patrik Hutzel from intensivecareathome.com and I’ll talk to you in a few days.

Take care for now.