I had a pt today with a really gnarly compound dislocation/fx that I knew from the get-go would be sent to the OR. By the time I got the wording of the consent from the surgeon the pt had been medicated with two different narcotics. I've never been comfortable getting a consent from a medicated pt but was always admonished that if the pt was still able to understand the consent and the reasons for it, I could have them sign. To protect my own butt I've always had a relative co-sign, if at all possible. The ER doc saw me doing that today and made fun of me.
Another problem with consents. We transfer all of our pts that need a psych eval because we don't have mental health. I never get a psych pt on a hold to sign a consent because it's being done against their will. I figure if they're on a hold because they're a danger to themselves, they are not capable of consenting. Other nurses tell me I'm being silly, that they can still consent.
What do you guys do? Should I stick to my guns and continue my practice, or should I give in?