Is It True that Support Workers Can’t Handle Safely Ventilated Patients with Tracheostomies at Home?

1 year ago
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https://intensivecareathome.com/is-it-true-that-support-workers-cant-handle-safely-ventilated-patients-with-tracheostomies-at-home/

Is It True that Support Workers Can’t Handle Safely Ventilated Patients with Tracheostomies at Home?

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So some families actually come to us, they have a loved one at home on a ventilator with a tracheostomy. Sometimes it’s only a tracheostomy, sometimes our clients don’t have a tracheostomy, but they are requiring BiPAP ventilation without a tracheostomy.

And sometimes our clients are not even ventilated, but they are medically very complex and they do need an ICU nurse 24 hours a day because of their medical complexities and often it is to manage their unstable airways. And again, that is a specialist skill that can only be handled by intensive care nurses.

So a situation that we see over and over again is that ventilated clients are at home with support workers and support workers quite frankly, can’t handle ventilated patients with tracheostomies safely. So why do I say that?

If you look at a hospital environment, any ventilated patient is in intensive care. They’re not on a general ward because a ventilated patient, whether it’s with a tracheostomy or with a breathing tube or noninvasively ventilated, such as BiPAP or CPAP need intensive care nurses full stop.

There is no room for negotiation here. Absolutely no room for negotiation. It’s a specialist skill, it’s life support. People are in life support, and that’s why they go into intensive care. So why would anybody in their right mind send a support worker into somebody’s home when somebody’s on a ventilator or medically complex? That is simply, I argue, it’s a criminal act. That’s how I see the situation there.

Because even in a hospital or even at home, not even a general nurse is capable of looking after ventilated patient with a tracheostomy because it’s a specialist ICU nursing skill.

So the reasons why sometimes ventilated patients end up with support workers at home is simply that most people that are dealing with the funding of those clients are not medically competent and they’re not medically trained. They just look at it from a business perspective.

Whilst we can cut the cost of an ICU bed by 50%, we certainly can’t cut the cost of an ICU bed by 80%. That’s just not doable. If you do that, you’re putting lives at risk. And we know for a fact, we have evidence that people have died at home because they were looked after by support workers instead of intensive care nurses.

We have evidence that people have more readmissions back into ICU when they’re being looked after by support workers or by general nurses that have no ICU training, as opposed to being looked after by us when we have intensive care nurses.

Now don’t get me wrong, this is a reasonably high risk for us as well, looking after ventilated patients at home because people at the end of the day are on life support, but it is a risk that we believe we can manage much better with a team of highly skilled, highly experienced intensive care nurses.

As a matter of fact, we’re employing hundreds of years intensive care nursing experience in our business. That also includes pediatric intensive care nursing experience. So compared that to support workers, I mean, anybody can be a support worker. You can literally pick people off the street and put them in an environment where they look after ventilated patient, but they don’t know what they’re doing.

Continuation...
https://intensivecareathome.com/is-it-true-that-support-workers-cant-handle-safely-ventilated-patients-with-tracheostomies-at-home/

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