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Forcing My Dad Out of ICU with Tracheostomy, Can He Go Home Instead?

Hi, it’s Patrik Hutzel from intensivecareathome.com, where we provide tailor-made solutions for long-term ventilated adults and children with tracheostomies, and where we also provide tailor-made solutions for hospitals and intensive care units whilst providing quality services for long-term, ventilated adults and children with tracheostomies, medically complex patients at home including Home TPN, Home IV potassium infusions, Home BIPAP (bilevel positive airway pressure), Home CPAP (continuous positive airway pressure) ventilation as well as IV antibiotics. We are also providing services for adults and children at home with tracheostomies that are not ventilator- dependent. We also provide port management, central line management, PICC (peripherally inserted central catheter) line management as well as Hickman’s line management, as well as palliative care.

Now, in today’s blog, I want to answer a question from one of our readers who says,

Hi Patrik,

They are forcing my dad out of ICU with the tracheostomy. Is this safe?

Well, that’s a great question and that is from Anne Marie. And Anne Marie, that is a great question and I argue it’s not safe. It’s sort of what hospitals do. It’s the one size fits all and we know that people are different and people don’t fit a one size fits all profile and hospitals have created pathways for people that often don’t work, and that have shown not to work.

So, if you are sick of being in hospital with your dad, you should be looking at Intensive Care at Home. I tell you why it’s not safe going from ICU to a hospital ward or a hospital floor. It’s quite frankly, on a hospital ward or on a hospital floor, he will end up in a bed and he won’t have the ICU nurse that he inevitably needs with the tracheostomy. He’ll end up on a nurse to patient ratio of 1:5, maybe 1:10, even, definitely 1:10 overnight. It’s probably going to be very unsafe very quickly.

And here is the evidence for why I am saying that, if you look on our website at intensivecareathome.com, you will find a section that the Mechanical Home Ventilation Guidelines, which are evidence-based. In the mechanical home ventilation guidelines, you will find that when patients go home with the tracheostomy, they need to have 1:1 nurse to patient ratio with critical care nurses 24 hours a day. And those critical care nurses need to have a minimum of two years’ critical care nursing experience.

And I can tell you that you won’t get that on the hospital ward or on the hospital floor with the tracheostomy therefore, it is like you said, they are forcing your dad out without providing evidence-based care. And the reality is that people have died because of no critical care nurse is looking after tracheostomy clients. And this is exactly what’s happening here.

Case in point, we have had clients at home with the tracheostomy and or ventilation, that needed 24-hour nursing care with critical care nurses with a minimum of two years, critical care nursing experience as documented and evidenced in the mechanical home ventilation guidelines and they died during times when critical care nurses were not present due to lack of funding.

So for example, we looked after clients at home that were only funded for critical care nurses overnight, but weren’t funded during the day and then family members or support workers, that with all respect might have worked in the supermarket last week. Now all of a sudden look after an ICU patient with the difference that they’re at home. And of course, that’s a disaster waiting to happen.

It’s the same in a hospital, if your dad is going to a hospital ward with often, no tracheostomy competent nurses because they’re lacking the ICU experience. Your dad, could easily die or have complications or suffer from any complications and suffer from medical emergencies.

Our clients who are at home, tracheostomy, ventilation, BiPAP, CPAP, they are at home predictably and they can improve their quality of life. I doubt that your dad will improve his quality of life if he’s going to hospital ward, hospital floor, he will improve his quality of life when he’s going home. That’s rather self-explanatory.

Now, there’s one exception here, Anne Marie. The exception is that if your dad is having the tracheostomy removed in the next few days, he won’t need Intensive Care at Home. But if he’s faced with the outlook of having a tracheostomy for a prolonged period of time, for whatever reason. You absolutely should be looking at home care because, we can do the speech therapy at home, we can do the physiotherapy at home and definitely has the ICU nurses at home. So there’s really no issue in sending your dad home if he needs a tracheostomy, long-term.

The sooner you can get home with your dad, the better. And the bigger the improvement in his quality of life, the bigger the improvement in your quality of life, I would imagine you’re spending day and night in hospital and other family members do as well. So you probably have to put your life on hold to be there with him. So going home is definitely the better option for everyone.

It’s also the better option from a hospital and financial perspective. Hospitals need beds, hospitals need staff, they need equipment, they need to free up beds, they need to free up staff, they need to free up equipment and they’re trying to cut the cost of hospital beds. And one way for them to try and cut the cost of hospital beds is by providing an unsafe care, which is if he’s going to a ward that is unsafe with everything that I’ve said just now, which is evidence-based. And he should be going home, cut the cost of an ICU bed by about half, and everyone is winning.  So, how can you make that happen?

Well, just contact us and we can walk you through how you get funding for your dad. We are currently operating all around Australia. Intensive Care at Home is currently operating all around Australia in all major capital cities as well as regional and remote areas. And we are an NDIS (National Disability Insurance Scheme) approved service provider. We are a TAC (Transport Accident Commission) approved service provider in Victoria, ICare approved service provider in New South Wales and NIISQ (National Injury Insurance Scheme in Queensland) approved service provider in Queensland, DVA (Department of Veteran Affairs) approved service provider all around the country. We have received funding through public hospitals, Departments of Health as well as through private health funds. So please reach out to us if you need any help. And if you’re in the U.S., in the U.K. and you need help, we can help you there privately, please reach out as well.

We are also providing Level 2 and Level 3 NDIS Specialist Support Coordinations. If you need help, we’re also providing NDIS nursing assessments if you need help with that.

And if you are a critical care nurse and you’re looking for a career change, we want to hear from you. If you have worked for a minimum of two years in critical care ICU or ED, and if you have completed a postgraduate critical care qualification, we currently have jobs in Sydney, Melbourne, Brisbane, in Albury Wodonga, on the new South Wales, Victorian border in Bendigo, in Country Victoria, as well as in Warragul Country in Victoria. And we want to hear from you if you have your expertise to offer to us.

Just one more insight there, we are not a nursing agency. We are a service provider and we only want to hear from you if you can commit to some of our clients because our clients want consistency. They want the same people over and over again, which is also a major difference compared to a hospital where you might be looking after different patients every single day. Whereas with us, there is consistency, there’s continuity which is what we want, which is what our families want. Please don’t apply with us if you want to come and go then you’re much better suited of joining an agency.

We are a service provider. We provide tailor-made solutions for our clients, which includes consistency of care with the same staff over and over again. Also, if you have a loved one in intensive care in a similar situation, please reach out to us or you might be at home already. And now you’re realizing you don’t have the right support, you have gaps in your roster, you have insufficient support, you have insufficient funding. And we can help you with all of that because we have been doing the advocacy of our clients from day one and we have been doing it successfully otherwise we wouldn’t be in business.

Now, if you are an intensive care specialist, we are currently expanding our medical team as well. And if you’re an intensive care specialist and you have bed blocks in your ICU, which I know you have, then I also encourage you to reach out to us as well. We can help you eliminate your bed blocks in ICU by taking your patients home, which also includes palliative care for some of your patients.

We are also providing an ED (Emergency Department) bypass service for the Western Sydney local area health district. We send our critical care nurses into the home to avoid emergency department admissions. So if your ED is bed blocked, we can help you eliminate those bed blocks by bypassing ED and by providing some ED services at home.

And if you are a hospital executive watching this, we also want to hear from you cause again, we can help you eliminate your bed blocks in ICU and ED. Please reach out and if you are an NDIS Support Coordinator and you’re looking for nursing care for your participants or you’re looking for a nursing assessment for your participants. Please reach out to us as well. We can help you. We can also help you with the funding if you’re unsure about how to obtain funding for nursing care through the NDIS.

Thank you so much for watching.

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Thank you so much for watching.

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

Take care for now.