i asked this question a while back and got this response.
it is never
a nurse's responsibility to obtain consent.
"obtaining consent" implies informed consent. "informed consent" means that the patient has been educated regarding risks/beneifits of the procedure.
only a physician can give risks/benefits conseling. this is not something that can be delegated.
this is not only a state regulation in most states -- including the one i practice in -- but it is also a cms regulation.
where consents are concerned, the nurse's responsibility is to witness the consent, and to check with the patient if there is any other info they need before signing.
it doesn't matter that the picc is being placed by a nurse. it it still ordered by the physician, and it is the physician's responsibility to do the risk/benefit education.
the facility i worked at got "around" this (since we all know that a doc isn't going to come in and give that risk/benefit education, even if they knew what the risks/benefits of a picc were
), by having one of the interventional radiologists create a "risk/benefit" education hand-out. hospital legal decided that this was good enough to stand in for the physician-provided risks/benefits counseling. so, once the patient/family reads this, they are able to sign the consent and the nurse can wittness it. (by the way, we [the picc nurses] were not allowed to wittness the consents; it had to be the bedside nurse).
the regulations do not
say that only
a physician can educate about the procedure, only that the risks/benefits counseling must come from a physician. so it is fine for the nurse to answer additional quesitons. however, there were times that i had to refer some patients that had very specific quesitons they wanted answered prior to picc placement, back to their physician before i placed the picc.