The Problems with Early Discharge During the last twenty years, hospitals' policies have shifted toward earlier discharge because it became financially advantageous to do so. This was not the result of any breakthroughs in medical research. Consequently, people are now going home with all kinds of management problems including the following: open surgical wounds unhealed skin grafts central intravenous lines inserted through the chest wall central venous lines inserted in the arm peripheral intravenous lines limb fractures with external fixators (pins sticking out of the legs or arms) neck fractures with halo splints unstable pelvic fractures requiring total bed rest Since doctors and nurses condone such discharges, the question as to whether it is appropriate in any particular case depends on how you feel about you or your loved one going home with conditions that require skilled care. The hospital staff nurses and discharge planners will try to tell you that you have to learn the skills of a registered nurse and accept the responsibility for any complications arising out of making mistakes. This is because the HMOs have decided that if their members take care of themselves, they don't have to pay for as many nursing visits. If you feel up to the task, go for it. If not, you simply have to tell the discharge planner that you refuse to have anything to do with skilled nursing procedures at home. Then the HMOs will be obliged to provide a registered nurse to perform all the required tasks.