Consent forms?

allnurses Guide · Dec 11, 2005

I've always gotten the signature after the doctor has explained the procedure. What if the patient claims the doctor didn't explain something, or added something in? It is a conflict of interest for the doctor doing the procedure to be the only one to witness the consent, the patient or family could even come back and say the sig was forged. The need for another witness is important.

I've been a notary public, ALL I was doing was witnessing the signature and verifying the identity of the person signing, and having them swear the contents were true. It is not the responsibility of the "professional witness", (the NP) to know what is in the document, only that it is fully filled out and true to the best of the signer's knowledge. (Unfortunately, many notaries haven't really read their handbook, and never even ask if the document is true! :uhoh3: )

As a nurse, again all I am really doing is witnessing that the patient is truly the one signing; ethically I think there is more to it, and I won't ask for consent until I'm sure the patient 1) had the procedure adequately explained by the MD or NP, 2) is able to sign for themselves (no slew of morphine or Versed on board, 3) is actually willing for it to be done (not being pressured), 4) has had time to read the consent for themselves or has me read it to them. All of that is my job as the patient advocate. If they are incapacitated, then next of kin or POA signs. If there are narcs on board, I ask family to also sign sometimes. I work in a busy ER, but there is always time for those steps unless it is an immediately life or death situation, in which case we don't do paperwork first! :rotfl: (Verbal consent if possible.)

PamUK · Dec 11, 2005

In the UK, and I think in the States also, a Consent Form is NOT a legal requirment (thee are rare circumstances) What is a legal requirement is that the patient understands the procedure & the impact on their life-style, and that they are not coerced in any way AND gives their consent. This can be verbal. We would obtain a written consent form if the procedure is risky or lengthy or unusual. A consent form is NOT a contract and the patient can change their mind at any time.

So, you could have a situation where the patient signs a consent form, BUT, if at a later date the patient can prove they did not understand all the consequences of the procedure, then any law-suit is likely to have a successful outcome.

A consent form is only evidence that you discussed the procedure fully with the patient

In the UK, the doctor is ultimately responsible for obtaining consent (verbal or written), however, he can delegate that responsibility to another person. That person MUST be fully conversant with the procedure and be able to asnwer any questions the patient may have. The doctor is still responsible for that persons actions (although if that person is negligent, they stand on their own)

yankeesrule · Dec 11, 2005

Working in a state facility for the handicapped/mental retardation typically its whooever has power of attorney. In some cases with no family the procedure anything from dental for an extraction to DNR goes to the special decision making committe made up of attorneys, individuals with a medical background. For consent for mammo, bloodwork we as nurses can sign for the patient.

JaneyW · Dec 11, 2005

I am at a teaching facility and it is the resident's job to get informed consent. As already stated, we are just witnessing the signature. We still have some problems. The residents will often go in and get the consent signed and then come out to us and expect us to witness. They seem confused when I take the consent back in to the patient and we both have to sign again. Also, our first year and some second year residents aren't licensed yet and cannot legally get informed consent. So we have to be aware of who is signing everything.