Unsafe Discharge?

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I am currently a Clinical Director for a Hospice Agency.The Hospital wanted to send a patient home who was actively dying, with a lopressor drip. This was to take place on a Friday afternoon during a snowstorm. Our Medical Director supported this plan.I refused due to lack of staff on weekends, no policy for this intervention and most of all I felt it was an unsafe discharge.What has happened to the Hospice Philosophy? Was I wrong?

Specializes in Emergency, ICU, Psych, Hospice.

I applaud him or her, too...but, why complicate matters and continue futile interventions (lopressor). With good family support, (I assume the hospice admitting nurse was at the hospital to assure support to transfer the pt home), usually the family can be educated and supported to d/c unecessary meds/procedures....or, maybe I missed something.

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w/o knowing, i'm 'thinking' pt made hospice while in hospital.

let's say primary (hospice) dx was lung ca.

but needed iv lopressor for her (separate) dx of chd.

if hospital md agreed to discharge her to home (to die), i'm sure he's trying to maintain cardiac status...

let her die from lung ca.

this may allow time to get loved ones over and say good-bye.

leslie

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Specializes in Utilization Management.

The Lopressor would've dropped the BP, but overall, the beta blocker would help the heart by slowing the rate. Suppose the patient's heart rate without the Lopressor was say, 150-160? Too fast to support someone in such a depleted state. If you take her off, she'll die before she gets home -- and she wants to die at home.

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