Med waste upon Hospice Home death

[Janie Rodriguez]

Hi I worked hospice years ago. I recently returned to hospice home care. I've never been told about wasting meds upon death of a patient. Back in the day we would waste with a witness in the home. I worked at a different hospice last year from where I am now. I was told do not remove the meds. The only one that can physically remove meds is the doctor. Here I was told to waste but I didn't need a witness.  Last night at a death the family tells me they wanted me to remove the meds did not want to count or waste with me. And then said that the  wasting method was environmentally unfriendly. So she said she would take them herself to a pill disposal location. 
so I'm curious what do other hospice nurses do?

TIA

[NRSKarenRN, BSN, RN]

Your Hospice employer should have a policy on this as med disposal can vary by state's pharmacy regulations. In the good ole days 90's when I worked Hospice, would flush down toilet with family witness.  8 years ago, ,hospice that cared for my father had prepaid box to place unused meds that were mailed to their pharmacy for disposal.

One time post transitioning my long term  home care patient to hospice care, I attended their funeral. Family handed morphine bottle to me at funeral home --located in rundown boarded up Philadelphia area. In case of witness, I dumped out bottle into grass beside my car as didn't want to be robbed+ never had that experience to consider correct procedure.

Hope current Hospice RN can chime in.

[Been there,done that, ASN, RN]

" I've never been told about wasting meds upon death of a patient." Don't ask us... find out your employers policy and procedure.

[toomuchbaloney]

Your employer has a policy that reflects laws in your state and county.  You need to know that specific policy and life l procedure.  

Generally speaking, the medications belong to the patient.  At death of patient, the primary care giver and decision maker becomes responsible for the responsible disposal of the medications. This plan should have been discussed and documented as a portion of the hospice team's POC with the family.  In my experience, this plan is then executed by the hospice professional that provides the death visit.  

[DavidFR, BSN, MSN, RN]

I remember having to have waste witnessed when I worked in the UK. 

Just a point of interest, here in France even in hospital we don't have our waste controlled drugs witnessed. I work in Oncology where I'm frequently taking down PCAs or giving half ampoules and squirting Morphine down the sink. 

Evidently they trust us as professionals. Respectful? Or stupid?