There is a new trend sweeping the nation called “hospital-at-home” which are hospital organizations that provide hospital level care in the patient’s home as a full substitute for acute hospital care.

Nurses are up in arms about this because they believe that this will decrease the need for nurses in the hospital setting while putting those getting the home care at risk.  Proponents say this provides more nurses in facilities where the hospital-at-home solution will not work.

According to a Johns Hopkins study comparing similar hospitalized patients, the hospital-at-home patients experience better outcomes, lower risks of developing delirium, lower rates of mortality, decreased use of restraints and better satisfaction to the patient and their family while keeping the patient in their own home.

Also, there is a cost savings compared to traditional inpatient care and lower average length of stay.  However, this type of program does not address whether there is a decrease in medical malpractice claims as a result.

Nothing can replace the services of a registered nurse.  By keeping patients in their home with untrained, unskilled, and unpaid family members relying on an iPad to monitor them is a recipe for disaster.

Nothing replaces the hands-on assessment of a nurse and, more importantly, nothing replaces a nurse’s intuition, that feeling when one walks into a room and instantly senses that something is wrong.

What if a patient is suffering a stroke, heart attack or pulmonary embolus?  By the time a first responder can arrive and remove the patient to the hospital, it may be too late.

It is interesting that these articles say that there are lower rates of mortality given that emergency care is miles away.

In addition, hospitals take a dim view of babies being born at home with the service of a midwife.  But what is the difference here?  It is that mothers in the past always had babies at home until our modern health care system became the overwhelming alternate option.

The difference here is that these patients are sick and require hospital care yet are being managed at home.

What if a patient needs a CT scan?  No one can come out to a home to do this.

Again, while I love the idea that patients can stay at home, there are reasons for a hospital and that primary one is for nursing care.  Replacing nursing care with someone on an iPad to monitor patients, to me is nothing more than babysitting.

While hospital-at-home does allow physicians to perform an assessment online, they cannot hear chest sounds, they cannot feel the skin turgor, they cannot check reflexes, perform neurochecks or cranial nerve evaluation.

While I like the creativity in having new ways to care for patients, I believe this particular area is a disaster waiting to happen which will lead to an increased number of malpractice claims.

However, the hard part would be proving those claims because the patient is not being properly monitored so if something happens, we cannot know if it could have been assessed sooner.

What are your thoughts about Hospital at Home?  Let me know in the comments below.

Last year I wrote a couple of blogs about scams taking place against nurses in Idaho and Missouri.  Well, now it’s hitting closer to home and is reaching into Indiana.

The office of the Indiana Attorney General has received numerous complaints of nurses receiving calls from scammers posing as FBI agents telling them that their licenses are suspended and will not be lifted until a fine of thousands of dollars is paid.  The thieves ordered that the money be wired to them as a government security bond fee.

It is inconceivable that nurses, who are the hardest work professionals on Earth, are being victimized by these swindlers.

Unfortunately, home addresses and phone numbers are readily available through a public records request.  This provides the scammers with a massive and almost complete list of victims for this scheme.

Should you receive such a letter or phone call claiming you owe this debt, realize without hesitation that it is F-A-K-E!  Then follow these steps.

1. First and foremost is to check with the Indiana Professional Licensing Agency’s website at www.in.gov/pla/license/free-search-and-verify/ to see if your license is officially listed as “active.” If it is, then you are safe and your license truly is NOT suspended.
2. The scam approach will order you to not disclose anything about this matter to a third party. This is a red flag because, as you can surmise, an attorney is a third party to whom you have every right to speak with.
3. Should you ever be asked for a wire payment for anything, this is a huge red flag that a fraud ploy is afoot because such payments are difficult to trace or reverse.
4. The Board will never request a refundable government security bond.
5. Note too that the Licensing Board can issue fines that come to no more than $1,000 per violation based on agreed settlement or final adjudication of an Administrative Complaint. If someone is demanding you pay a large fine without an
   Administrative Complaint, be very guarded and suspicious.
6. The Licensing Board will never directly call you unless you have an emergency suspension hearing or a pending matter.
7. Be suspicious if you feel the caller is using “high pressure” tactics.
8. Report any suspected fraudulent activity immediately to the Professional Licensing Agency at (317) 234-2043 or at pla2@pla.in.gov.

It should go without saying that anyone accused in a licensing matter be given an opportunity to be heard.  The only time in which that may not occur is if there is an emergency suspension for which notice is required, however, that could mean a phone call or email the day of the hearing.  But, again, you will be afforded an opportunity to be heard.

Be a savvy conscious nurse and share this article with your colleagues.  Tell them to report any suspected fraud to the appropriate authorities.

This is the best way to fight these unlawful activities.