Podcast: Play in new window | Download

If you want to know if your family member can go home after a lung transplant with the tracheostomy and ventilation, stay tuned. I’ve got news for you.

My name is Patrik Hutzel from intensivecareathome.com and I have an email today from Maeve who writes in, and Maeve says, 

“Hi Patrik,

I’ve been exhausted. My husband’s lung transplant was in May 2024 and after 6 and 7 hard months, he was finally liberated from the ventilator. I told the ICU that I didn’t think he was ready to go to the rehab. They pushed us into the decision to go into a rehab after he finally came off the ventilator.

After only one week in the rehab facility, he developed a pneumonia, which was already starting to brew, but not properly addressed by the ICU. He was back in the ICU needing full ventilator support with the tracheostomy again.

This ICU,” so she’s basically implying that he then went back to another ICU, “tried a different kind of weaning called volume support. The other ones always did the pressure support. My husband was so calm and relaxed on it and was doing very well. Then, they sent us back to the ICU where the lung transplant was taking place, and they refused to try the volume support.

My husband has been very anxious since his CO2 level or carbon dioxide levels are always high on the pressure support, and no one will listen to us. They have my husband labeled as “unmotivated and anxious”, which has changed how every ICU treats him. I want him at home and weaning off the ventilator. Please let me know how you can help.

I’m also not sure if my husband will ever be truly liberated from a ventilator and a tracheostomy, but at this point, I just want him home because we’re getting closer to the 12-month mark after the lung transplant, and I want him somewhere where he’s treated kindly.”

So, that’s very sad to hear that obviously he can’t be weaned off the ventilator, at least not to the degree that you want him, and you wouldn’t expect to, because they’re potentially refusing volume support ventilation to try and help him wean, and they’re pushing the pressure support.

Now, I can tell you, I do not have any experience with volume support ventilation. I’ve never really experienced it or heard it, but that’s okay. It doesn’t matter that it doesn’t work. It seems to work for your husband. So, why would you do something that’s not working? If something’s working, you got to do more of it, not less. That would be my advice here.

So, how can we help? We can take your husband home for sure. It sounds to me like he’s being moved around between ICUs, which is really sad because it’s very stressful for your husband. If there’s no consistent approach in how to wean your husband off the ventilator, that’s disappointing and it’s also difficult to wean him off the ventilator. He would be depressed, and he would be anxious, of course, after all this time in hospital. 

He needs to get into a better environment, and that’s exactly what we do with the Intensive Care at Home. We get patients and their families into a better much more family friendly, much more holistic environment at home, unlike in a hospital. We create teams with regular staff. We have the same people that you know, like, and trust coming over and over again which is really important when it comes to ventilation weaning as well because we want to get to know your husband, how we can help him wean, what works for him, what doesn’t work for him, what approach do we need to take? 

The cost is 50% of the ICU bed. That’s why I’m saying it’s always a win-win situation what we’re providing. We’re cutting the cost of an intensive care bed by 50%. We provide quality of life for patients and families at home, and we free up the intensive care bed, which is probably the most sought-after bed in the hospital. 

So, that is in essence, how we can help your husband and you, of course, as his wife because you’re probably living in ICU, and that’s not how it should be. You got to live at home with your husband and with your family. That is much better way to live life in a situation like that. So, we’ll continue the conversation there, Maeve, of course, and we will improve his quality of life. No doubt about that.

So, 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 a long-term stay in intensive care for ventilation, tracheostomy, Home BIPAP (Bilevel Positive Airway Pressure), Home CPAP (Continuous Positive Airway Pressure), ventilation without tracheostomy, but for adults and children with tracheostomy and without ventilation, Home TPN (Total Parenteral Nutrition), home IV potassium infusions, and home IV magnesium infusions, IV fluids, and IV antibiotics. We’re also providing ventilation weaning at home. We’re also providing central line management, PICC (Peripherally Inserted Central Catheter) line, Hickman’s line management, as well as port management at home. We’re also providing nasogastric tube and PEG (Percutaneous Endoscopic Gastrostomy) management at home, as well as 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 Area Health District, their in-touch program, saving approximately $2,000 per patient that we keep at home, instead of them going to an emergency department. 

Therefore, we’re also in a position to cut the cost of an intensive care bed by around 50%. An intensive care bed costs around $5,000 to $6,000 per bed day. Our services costs between $2,500 to $3,000 per bed day and we’re freeing up the most sought-after bed in the hospital, which is the ICU bed. But most importantly, we’re improving the quality of life for patients and their families which is a win-win situation for all stakeholders.

With Intensive Care at Home, we are currently operating all around Australia in all major capital cities as well as in all regional and rural areas. We’re an NDIS (National Disability Insurance Scheme) approved service provider all around Australia, TAC (Transport Accident Commission) and WorkSafe in Victoria, iCare in New South Wales, NIISQ (National Injury Insurance Scheme in Queensland), as well as the Department of Veteran Affairs all around Australia. Our clients and we, as a provider, have also received funding through public hospitals, private health funds, as well as Departments of Health.

We are currently 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 level of accreditation since 2012. No other provider has achieved this 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, which enables us to look after the highest acuity adults and children in the community in Australia safely.

If you’re at home already and you realize you don’t have the right level of support, or if you’re stuck in an ICU long-term, or if your family member is stuck in an ICU long-term, I’ll give you a real-world example today. One of our first clients about 10 years ago when we first got started was a client who was at home initially on a ventilator with a tracheostomy with a support worker model 24/7. Of course, it’s dangerous and negligent having support workers looking after a client at home on a ventilator with a tracheostomy. That is like flying the airplane with the cabin crew instead of the pilot because anyone on a ventilator with a tracheostomy is at very high risk of medical emergencies or even dying if they don’t have a team critical care nurse looking after them 24/7. This is evidence-based in the community and is documented in our Mechanical Home Ventilation Guidelines that you can find on our website at intensivecareathome.com where it’s clearly documented that only and exclusively critical care nurses with a minimum of 2 years critical care nursing experience can look after ventilation and tracheostomy at home safely.

Think about it, in intensive care unit, in an ICU in a hospital, you wouldn’t have support workers looking after a critical care patient on a ventilator with a tracheostomy. So, why would anyone in their right mind would do that in a home care environment in the community? People have died because of this support worker model.

So eventually, this client found out about us and the ICU that he was going back to found out about us. We were proving our concept with this client very fast. When we worked with the client, we sent him intensive care nurses, 24 hours a day. He never went back into ICU ever again and we were proving our concept there very fast.  

We can do the same for you if you’re not safe at home, which includes the advocacy for funding that goes along with it. We have always successfully advocated for our clients. Otherwise, we would not be in business. The same is applicable for those stuck in an ICU, similar to our case study, to what you’re looking for, reach out to us. We’ll make it happen for you as well. We can take you through the right steps.

This is also why we are providing Level 2 and Level 3 NDIS Support Coordination. We have a team of NDIS Support Coordinators, and they have a wealth of knowledge. I’ve done an interview with Amanda Riches, one of our NDIS Support Coordinators, and I’ll put a link to an interview with Amanda in the written version of this blog below the video. 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 from another organization 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 what evidence to provide, I encourage you to reach out to us as well. 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.

If you are a critical care nurse and you’re looking for a career change, and you want to join a very progressive, dynamic, 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 are looking for a career change, we’re currently hiring for jobs for critical care nurses in Melbourne, Sydney, Brisbane, in Albury, Wodonga, in Bendigo, in Geelong, and in Warragul in Victoria. If you have worked in critical care nursing for a minimum of 2 years pediatric ICU, ED, and you have already completed a postgraduate critical care nursing qualification, we will be delighted hearing from you.

I have a disclaimer, because we are offering a tailor-made solution for our clients, which includes regular staff, our clients do want the same staff coming over and over again because they are very vulnerable and very special, and that’s why we need regular staff. So, if you’re looking for agency work where you can come and go, this will not be the right fit for you. We are looking for consistency and our clients are looking for consistency. So please, only apply with us if you can give us regular and consistent availability for shifts and if you’re really keen on building relationships with us and with our clients. 

If you are 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 you 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 for and you get the same level of care, and you’re freeing up beds.

If you’re a hospital executive watching this and you have bed blocks in your ICU, ED, respiratory wards, home TPN of course, please reach out to us as well. We can help you eliminate your bed blocks very fast.

If you’re in the U.S. or in the U.K. 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, 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, share this video with your friends and families, and comment below what you think about this video and what you want to see next.

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.