nurses getting consents signed?

  1. Hi,
    I just started working on a med-surg floor a few months ago, and this is my first nursing job.

    I have a lot of patients that go for procedures, surgery, etc., with consents to be signed.

    The doctors write orders to have the consents signed, but I thought that the nurses could be a witness to the signing, but that it was the dr's responsibility to get the consent signed. I mean...as a nurse...I don't even know WHAT the Dr. has told the pt.....complications, etc.

    I have gotten a couple of consents signed, but am now questioning this, so what's the correct way? getting physician to consent? Thanks!
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  2. 33 Comments

  3. by   lovemyjob
    That is a huge no-no. I think some places do it b/c "that is how it has always been done." But, the docs can just as easily take the form in and have the pt sign it after discussing the surgery. Honestly, unless I heard the doc explaining the procedure/risk/benefit, I would refuse. Take it up with your manager and if they dont back you talk to risk management. I can imagine a pt not being consented correctly could be a problem, especially if you witnessed it.
  4. by   MS._Jen_RN
    I would NEVER "witness" something that I didn't witness. And it is not OK for you to get the consent signed, at least not where I've worked. That's the MD's job.
    ~Jen
  5. by   ncriverrat
    Ok, thanks for the info! I have never 'witnessed' without seeing the consent(prob cause I was the one getting the consent signed........)

    Once, when I first started, day shift and secretary both asked me if I got the consent signed during my shift, which I said "no", and from the way they reacted, I thought that i was supposed to, although something in my head remembered learning to NOT to get consents signed, that that is the physicians job.

    The next time this comes up, should I just refuse, and talk to my charge nurse about it? I have a feeling that if I did this, she would just go do it, but it has me wondering about patient safety- on the consent I was supposed to get signed but didn't, the pt. didn't know hardly anything about the procedure, and said no one had explained the risks/complications.
  6. by   lovemyjob
    If she wants to put her license on the line, then so be it. However, like I said, talk to your NM and if they are not going to take action, head over to risk management....I am sure they would be interested in knowing the staff RNs are getting consents signed.
  7. by   Lacie
    Only time I have ever had the pt sign a consent form is when the doctor was present and I myself heard him/her ensuring the pt is well informed of complications, etc. If not I wouldnt touch a consent form. Simple as that as its my license at stake in this instance. Thats the docs job not yours.
  8. by   SCRN1
    I was taught in school that the nurse can get a consent signed AFTER asking the patient if the doctor explained the procedure and risks and asking the patient if they understand or have any questions. If the nurse has the patient sign, the nurse is signing as a witness only to the patient signing the consent. The nurse is not signing that she/he explained anything. That part is the physician's responsibility. If the patient states that the doctor has not explained, if the patient doesn't understand, or if the patient has any more questions for the doctor, then the signing of the consent is held off until the physician talks to the patient and the patient then fully understands.

    This is also protocol in each hospital I've worked and we witness the signing of consents all the time. Again, we are only witnessing that the patient signed it.
  9. by   mamason
    Quote from SCRN1
    I was taught in school that the nurse can get a consent signed AFTER asking the patient if the doctor explained the procedure and risks and asking the patient if they understand or have any questions. If the nurse has the patient sign, the nurse is signing as a witness only to the patient signing the consent. The nurse is not signing that she/he explained anything. That part is the physician's responsibility. If the patient states that the doctor has not explained, if the patient doesn't understand, or if the patient has any more questions for the doctor, then the signing of the consent is held off until the physician talks to the patient and the patient then fully understands.

    This is also protocol in each hospital I've worked and we witness the signing of consents all the time. Again, we are only witnessing that the patient signed it.
    I have to agree. This is how I was taught to do this also.
  10. by   KIAN
    I agree with SCRN1. That is how we do it in clinic.
  11. by   Daytonite
    ncriverrat. . .the whole issue of getting consents signed should have been discussed with you when you were in orientation as a new employee at this facility. Every facility has a policy and protocol for this and you need to review what it is. Go to your manager or the nursing educator and have them go over the procedure you are to follow--again. You need to get this clarified since it is going to come up over and over. A public forum like this is not the appropriate place to get specific advice about what your employer will want you to be doing.
  12. by   meownsmile
    We sign as witnesses all the time. By signing im just witnessing the patients verification by signature that they have informed consent and the doctor has explained everything to their satisfaction. In fact i think most consents actually say that. That is why the patient should read or have read to them the consent again before they sign it.
    If the patient has questions then the doctor needs to be called to come and answer any more questions the patient has BEFORE they sign.
  13. by   mediatix8
    I sign these all the time also. If I didn't, I would not be liked very much. I don't think I've ever seen an MD have a patient sign the consent. If you refuse to do this then you might have a lot of angry doctors and patients after you as nothing is going to happen without the consent signed. As many others are saying, you're just witnessing that the patient signed it and at least that the patient states they are satisfied with the MD's explaination and don't have any further questions. Go ahead and talk to your NM about this and I'm sure they will tell you that it is OK. There might be other things you thought were supposed to be the MD's job but come to find out it's your job. Like when I was a student I thought that the doctor was the one who informed family of a patient's death/worsening condition and so forth but oh no it's you!
  14. by   banditrn
    Quote from SCRN1
    I was taught in school that the nurse can get a consent signed AFTER asking the patient if the doctor explained the procedure and risks and asking the patient if they understand or have any questions. If the nurse has the patient sign, the nurse is signing as a witness only to the patient signing the consent. The nurse is not signing that she/he explained anything. That part is the physician's responsibility. If the patient states that the doctor has not explained, if the patient doesn't understand, or if the patient has any more questions for the doctor, then the signing of the consent is held off until the physician talks to the patient and the patient then fully understands.

    This is also protocol in each hospital I've worked and we witness the signing of consents all the time. Again, we are only witnessing that the patient signed it.
    This sounds right to me.

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