How do you guys handle getting consents signed for procedures such as EGD or biopsies. I refused the other day to do this for the doctor b/c felt MD should talk to pt. Supervisor became upset and got it signed herself.
I feel that the doctor needs to get the consent signed in case the patient has questions. My co-workers and HN feel the same way. We have no problems from the doctors either on this.
Jan 31, '03
For inpatients having procedures, the docs have talked to the patient and so the nurse upstairs gets consent and the patient has it when they get to us (cath lab). For outpatients, the docs have seen the patient in the office and explained the procedure, so when they come in to us, we get consent because we then premedicate them with PO Valium and want them to have signed the consent before we do!! If the patient still has questions (our consent form is very detailed and procedure specific) that are out of our comfort level (most of them are just how the procedure is performed, etc) we wait and have the doc talk to them and then get consent and then give them meds after that (if at all). Most of our docs arrive right before the procedure starts and the patient is already on the table and draped.
Jan 31, '03
I make sure that the doc has explained the procedure to the patient and ask them if they have any questions or concerns. If they do, I immediately call the doctor doing the procedure and tell them they need to come and talk to their patient. If the doc gets his shorts in a twist, too bad. I am not signing my name as a witness to a consent if the patient has even the tiniest bit of concern or doubt. If the supervisor wants to put her name on it fine, it will be her butt in the wringer, not mine. It is the MD's responsibility to explain the procedure, benefits, and risks......not nursing....way too much liability there......
Jan 31, '03
Originally posted by deespoohbear I am not signing my name as a witness to a consent if the patient has even the tiniest bit of concern or doubt.
Nor should you...or the patient!
It is also important to remember that the patient has to be able to give informed consent as well -- if they have had meds that make them loopy or something organic, like dementia, it is also important not to sign OR LET THEM SIGN.
I know you all know this. It's just a reminder.
(getting valid informed consent is an integral part of MY job!)
Feb 1, '03
Oh yeah....if the patient has dementia.....no way in you know where am I even attempting to get consent from them. Straight to the Health Care POA, or the next of kin....and the doctor can explain the risks and benefits and all the other stuff to the person who is consenting to the procedure....Had a doc get upset the other day because I didn't have a consent signed for a central line placement. Well, let's see. He hadn't been up to discuss it with the patient (which wouldn't have done any good sense she has a documented history of dementia and schizophrenia), nor did he talk to the person who was the POA...I told surgeon it was HIS responsibility to obtain consent...wasn't happy, but finally he was able to discuss it with the POA....and got the consents that we needed...I have told doctors right to their face that I was not signing a consent as a witness if I feel like they have been inadequately informed, nor am I letting the patient sign until all his/her questions have been answered satisfactorily...doesn't make real popular with the surgeons at times, but I don't go to work to win a popularity contest. I go to work to be a nurse.....
Feb 1, '03
Once when I was a newbie I went to get a consent for surgery. The patient flipped out because she didn't know she was going to have surgery. The surgeon wanted consent without "consenting" the patient. Which is illegal.
Never, ever to I get consent unless the patient is informed.
However, here we are only witnessing that the it is the patient or POA signing the consent. If the patient winds up not being informed, it's even if we are signed on the form, it's an MD problem. Especially, if there is an order for the nurses to get the signature on the consent.