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“Why Zoe’s daughter needs 24-hour CCRNs at home instead of support workers?”

My name is Patrik Hutzel from intensivecareathome.com, where we provide tailor-made solutions for long-term ventilated adults and children with tracheostomies at home, which includes home care for medically complex adults and children, including tracheostomy care without ventilation, ventilation without tracheostomy, Home TPN (Total Parenteral Nutrition), home IV potassium, home IV magnesium infusions, central line, PICC (Peripherally Inserted Central Catheter) line, port and Hickman’s line management as well.

So today, I want to talk about Zoe’s story, which was shared publicly in a recent video, and I’ll link towards that video from the Global Tracheostomy Collaborative. It’s from 32 minutes to 49 minutes where Zoe describes how she took her daughter home from the Royal Children’s Hospital in Melbourne with a tracheostomy. Her daughter was discharged with disability support workers trained by complex care at the hospital, rather than 24/7 critical care registered nurses.

Now, this is a very important and also very concerning issue. Unfortunately, we know of at least 5 or 6 adults and children with tracheostomies and/or mechanical ventilation in Melbourne, Sydney, have died in the community because of support worker models in the last 8 to 10 years, that’s about 1 a year. This is because support workers, no matter how well-intentioned, do not have the clinical skills, critical care training, or experience to manage life-threatening emergencies at home.

For adults and children with a tracheostomy or ventilator, emergencies can happen in seconds, tube blockages, accidental decannulations, aspiration, low oxygen levels, all potentially leading to cardiac arrest. These situations require an immediate, highly skilled response from critical care registered nurses, not support workers. Delays in recognition or action can be fatal.

Zoe also describes in her story that she had to stop working. Her husband had to cut back hours significantly, and there were huge delays getting their daughter home. This is a direct result of not having the right model of care in place.

With Intensive Care at Home, families can go home much faster and much safer because we provide the only evidence-based, safe alternative to ICU, which is 24/7 critical care registered nurses who are following best practice and the evidence-based Mechanical Home Ventilation Guidelines that you can find on our website at intensivecareathome.com, and I’ve linked towards it. You will find that in the Mechanical Home Ventilation Guidelines, it’s documented and it’s evidence-based that exclusively critical care registered nurses with a minimum of 2 years critical care nursing experience can safely look after ventilation plus minus tracheostomy clients at home.

Here’s a warning for families: the risks of the support worker model. Support workers are not trying to manage blocked or dislodged tracheostomies. These emergencies can kill within minutes. Ventilator failures require immediate troubleshooting. Only critical care registered nurses, or CCRNs, have training to act fast and prevent death. Aspiration or sudden oxygen desaturation, without advanced critical care skills and advanced airway management, these events often end tragically.

Evidence shows multiple preventable deaths in Australia in recent years when patients with tracheostomies or ventilation were sent home with support workers and not critical care registered nurses. Some of those deaths were actually in Melbourne, including children, and also in Sydney.

So, if your loved one has a tracheostomy plus minus ventilator, accepting a support worker model, even registered nurses without intensive care nursing experience, is unsafe, and it’s against best practice guidelines. The only safe solution is 24/7 critical care registered nurses at home, which you can get here at Intensive Care at Home.

Let’s look at CCRNs versus support workers: “What’s the difference?” I’m glad you’ve asked.

Let’s look at training and skills. CCRNs, specialist nurses with years of ICU experience, advanced airway management, ventilation skills, and critical care knowledge. Support workers, no ICU background, limited or no medical training, not equipped to manage life-threatening emergencies, let alone an unstable airway, which a tracheostomy is an unstable airway.

Now, with all respect to support workers, I’ve seen support workers having worked in a supermarket last week, and then all of a sudden, they’re meant to look after a ventilator and a tracheostomy, which takes years of training and studying to safely look after. So, it is a dangerous, dangerous model.

Let’s look at emergency management. CCRNs can immediately respond to blocked or dislodged tracheostomies, ventilator failure or cardiac arrest. Support workers, limited ability to recognize or manage emergencies, delays, and escalation can be fatal.

Let’s look at evidence and guidelines. CCRNs, care is fully aligned with international, but also local Mechanical Home Ventilation Guidelines, ensuring safety and quality of life. No evidence for support workers whatsoever, not supported by any evidence or guidelines for tracheostomy or ventilation care. Like I said, not even a registered nurse without intensive care or critical care experience can look after a tracheostomy and a ventilator at home safely.

Let’s look at family impact. CCRNs enable families to go home sooner, reduce stress, allow parents to work, or look after other family members, and live more normal lives. Well, with the support worker model force, it forces families into becoming unpaid carers, leading to burnout, financial hardship and unsafe care.

Let’s look at some real case examples here how to safely transition home with 24/7 CCRN so that you can actually see it can be done.

One of our clients with a tracheostomy and ventilator dependency was stuck in ICU for months. Hospital initially suggested a support worker model, but the family knew this wouldn’t be safe, and they reached out to us here at intensivecareathome.com.

Within a few weeks, we established a 24/7 critical care registered nurse service and roster at home. The client was discharged safely, avoided multiple readmissions to ICU. The family finally regained some quality of life. Both parents, if they wanted to, were able to go back to work at least part time. Other family members could spend time together, and the client just really thrived at home with the right clinical support.

This is exactly what Zoe’s daughter needs—safe, evidence-based 24/7 CCRN care at home—not a support worker model that puts her life at risk. This is what we do every day at intensivecareathome.com. We keep ventilated and tracheostomized patients out of ICU. We prevent readmissions, and we provide the highest quality of life for patients and families safely.

So, if you are in a situation like Zoe’s, and you want to go home safely with a loved one on a tracheostomy and/or ventilation, don’t settle for a support worker model that is unsafe and has already cost lives. Contact us today at intensivecareathome.com. We’re here to help you and your family go home safely with the right model of care, 24/7 CCRNs instead of support workers or registered nurses without intensive care training.

Now, with Intensive Care at Home, we are currently sending our ICU and critical care nurses into the home, 24 hours a day. We are providing the following:

• Home care services for ventilated adults & children with tracheostomies  with critical care nurses 24 hours a day
• Genuine alternative to a long-term stay in intensive care or at long-term acute care
• Tracheostomy care for clients without ventilation
• Home care services for patients on non-invasive ventilation such as Home BIPAP (Bilevel Positive Airway Pressure), Home CPAP (Continuous Positive Airway Pressure)
• Home TPN (Total Parenteral Nutrition), which is also known as IV nutrition
• Home IV potassium and home IV magnesium infusions, IV fluids, and IV antibiotics
• Providing central line management, PICC (Peripherally Inserted Central Catheter) line management, Hickman’s line management, as well as port management at home.
• Providing nasogastric tube  and PEG (Percutaneous Endoscopic Gastrostomy) tube management at home
• Use cough assist machines for our clients for airway clearance at home
• Palliative care services at home
• Ventilator weaning 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.

That also means, we’re also in a position to cut the cost of an intensive care bed by around 50%. An intensive care bed costs between $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. Most importantly, we’re improving the quality of life for patients and their families, which is a win-win situation for all stakeholders. Of course, quality of life is much improved surrounded by families and by a team of dedicated intensive care nurses in the home care setting instead of in an intensive care unit.

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 work with NDIS (National Disability Insurance Scheme) clients all around Australia, TAC (Transport Accident Commission) and WorkSafe in Victoria, Department of Veteran Affairs (DVA) all around Australia. 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 having policies and procedures for Intensive Care at Home nursing and we’ve built all the intellectual property for Intensive Care at Home since 2012. No other provider in Australia 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’re watching this, or you’re stuck in an ICU long-term, or if you’re going to the hospital and ED all the time, and you realize that you don’t have the right level of support at home, or if you are stuck in an ICU, I’ll give you a real-world example today, how we can help you.

One of our first clients when we first got started in 2012 was a client who was at home initially on a ventilator with a tracheostomy with a support worker model 24/7. Of course, support workers are not equipped to look after a client at home on a ventilator with a tracheostomy. That is dangerous and it’s simply negligent. Having support workers looking after a client at home on a ventilator with a tracheostomy is like flying the airplane with a cabin crew instead of the pilot. Because anyone on a ventilator with a tracheostomy is at very high risk of medical emergencies 24/7, or even at high risk of dying if they don’t have a team of dedicated critical care nurses looking after them 24/7 at home. This is actually evidence-based and is documented in our Mechanical Home Ventilation Guidelines that you can find on our website at intensivecareathome.com.

Think about it, in an intensive care unit in a hospital, you wouldn’t have support workers looking after your critically ill loved one or after any critically ill patient on a ventilator with a tracheostomy. So, why would anyone in their right mind do that in the home care environment in the community?

So, this client at the time found out about us eventually, and the ICU that he was basically living in also knew about us and eventually reached out to us. We were proving our concept with this client very fast. When we worked with this particular client, we sent him critical care nurses, 24 hours a day. He never ever went back into ICU ever again, as long as we were working with this client.

We can do the same for you if you’re not safe at home and help you with keeping you at home predictably. Otherwise, we would not be in business. Again, the same is applicable for those stuck in an ICU, similar to this case study that I’ve just given you, or if you’re going back to ED all the time, please reach out to us. We can help you with taking you through the right steps, including how to get funding with different funding bodies.

This is also why we are providing 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. 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 need more evidence for nursing care, we are also writing NDIS nursing assessments with legal nurse critical care consulting nurses.

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’re employing hundreds of years of critical care nursing experience combined. You can join this high performing team if you are a critical care nurse.

If you are looking for a career change as a critical care nurse, we’re currently hiring for jobs for critical care nurses in Melbourne, Sydney, Brisbane, in Albury, Wodonga, in Bendigo, in Geelong, 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 do have a disclaimer though, because we are offering a tailor-made solution for our clients, which includes regular staff, our clients also do want the same staff coming over and over again because they are so vulnerable and so special. 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 availabilities for shifts, and you’re really keen on building solid relationships with us and with our clients.

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 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, and you get the same level of care.

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

If you’re in the U.S. and 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].

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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.