Informed Consent Responsibility

Nurses Relations

Published

An OR nurse wanted to write up a unit nurse because the informed consent, signed by the MD and the patient had abbreviations that were written by the MD. Is it the witnessing RN's responsibility to inform the MD what and what he cannot write on his surgical informed consent? And the witnessing RN, the PM nurse witnessed and signed the consent, passed the chart over to the day shift RN who sent the patient to OR and now OR nurse wants to write up an incident on the day shift RN. What is the RN's responsibility in regards to informed consent?

Specializes in OR, Nursing Professional Development.
One RN suggested, if pre-op meds are not given then just tell them in report the patient has questions, document the consent has not been witnessed, tell them in report the consent has not been witnessed b/c the patient has questions, and put the responsibility on the Pre-OP RN each and every time....... let the MD and Pre-OP RN take responsibility for the consent and leave the unit RN out of the situation altogether.

This would work if all preop units were staffed 24/7. Most aren't, and the OR nurse is expected to get the patient ready for surgery. Having the consent completed before arriving in the OR, especially since the doc would have seen the patient on the floor, makes more sense.

Except the floor RN is the scapegoat for the MD's mistake of using abbreviations!

In 2010 I had a total hip replacement. I REFUSED to sign the paper that gave permission to allow students to participate and observe the surgery. AFTER I was given midazolam and several other drugs a nurse asked me to sign that form and my first response was to say no...she then told me to sign it again and I did; my boyfriend was present and witnessed this fact. In my opinion I did NOT give "INFORMED CONSENT" since I was drugged and then, IMO I was FORCED to sign this paper. I also was getting a general so I don't understand {nor was I informed} that I would get an amnesia drug--I would have refused the surgery had I known. I have lupus, MS and several other major medical problems. I had aphasia after the surgery and it took me months to find out what happened to me; I have lost a lot of my memories since before and after the surgery, early alzheimers {midazolam eats the hippocampus} and when I confronted the surgeon for giving me alz with the use of midazolam he laughed and said, Yes, we gave you alz with the use of versed but it is chemically caused so it's different--I also have a witness to that statement.

I am a childhood sexual abuse survivor and I think I have the right to limit my body exposure, I have a RIGHT to some modesty. It has been 4 years since my surgery and I STILL experience amnesia bouts and still have some aphasia. I have been in terrific pain with my hip implant and the insurance refuses to do an MRI or CT scan to see what the problem is but they have no problem keeping me on pain meds 24/7; I have NO LIFE at all due to all this and can't find an attorney since Good Sam OWNS the state of Oregon or as the attorney's tell me, we all depend on G S for our income and most of us are on retainer with them so they are unwilling to even listen to my story. I have all my medical records and some of this crap would make you scream. Giving me insulin w/o taking blood sugars even tho I never had insulin before & no one was waking me up to eat for 3 days, allergy to Tylenol {noted on chart, due to liver damage from lupus} but nurse writes that since I refused to take the pills they just gave it to me in a suppository {in b & w on the chart notes}, the use of a polar ice machine even tho I have reynaud's & nurses note that I was screaming the ice was burning me {she did not take it off, just noted I was screaming about the burning} no checking skin for burns, a pillow case for insulation on the polar, u/a hat in toilet was being used by 3 people and was overflowing how can anyone check my output,{I also have kidney damage} after removal of the catheter??

The list goes on forever and most of it is in my chart, all but who the student was that put me in this hell on earth of a body. With all of my medical probs I would never have guessed that they would turn a student loose on me. Now all I do is sit and wait to die, I have no brain left, my bilateral AVN will go untreated since I can never trust the medical community again and my second hip is almost gone, the pain of the implant after 4 years makes me pray for death at least once a day, I can't die fast enough. Informed Consent? No, you can't drug a person and then have them sign a legal paper but you CAN get away with it if they can't find an attorney.

Specializes in OR, Nursing Professional Development.
In 2010 I had a total hip replacement. I REFUSED to sign the paper that gave permission to allow students to participate and observe the surgery. AFTER I was given midazolam and several other drugs a nurse asked me to sign that form and my first response was to say no...she then told me to sign it again and I did; my boyfriend was present and witnessed this fact. In my opinion I did NOT give "INFORMED CONSENT" since I was drugged and then, IMO I was FORCED to sign this paper. I also was getting a general so I don't understand {nor was I informed} that I would get an amnesia drug--I would have refused the surgery had I known. I have lupus, MS and several other major medical problems. I had aphasia after the surgery and it took me months to find out what happened to me; I have lost a lot of my memories since before and after the surgery, early alzheimers {midazolam eats the hippocampus} and when I confronted the surgeon for giving me alz with the use of midazolam he laughed and said, Yes, we gave you alz with the use of versed but it is chemically caused so it's different--I also have a witness to that statement.

I am a childhood sexual abuse survivor and I think I have the right to limit my body exposure, I have a RIGHT to some modesty. It has been 4 years since my surgery and I STILL experience amnesia bouts and still have some aphasia. I have been in terrific pain with my hip implant and the insurance refuses to do an MRI or CT scan to see what the problem is but they have no problem keeping me on pain meds 24/7; I have NO LIFE at all due to all this and can't find an attorney since Good Sam OWNS the state of Oregon or as the attorney's tell me, we all depend on G S for our income and most of us are on retainer with them so they are unwilling to even listen to my story. I have all my medical records and some of this crap would make you scream. Giving me insulin w/o taking blood sugars even tho I never had insulin before & no one was waking me up to eat for 3 days, allergy to Tylenol {noted on chart, due to liver damage from lupus} but nurse writes that since I refused to take the pills they just gave it to me in a suppository {in b & w on the chart notes}, the use of a polar ice machine even tho I have reynaud's & nurses note that I was screaming the ice was burning me {she did not take it off, just noted I was screaming about the burning} no checking skin for burns, a pillow case for insulation on the polar, u/a hat in toilet was being used by 3 people and was overflowing how can anyone check my output,{I also have kidney damage} after removal of the catheter??

The list goes on forever and most of it is in my chart, all but who the student was that put me in this hell on earth of a body. With all of my medical probs I would never have guessed that they would turn a student loose on me. Now all I do is sit and wait to die, I have no brain left, my bilateral AVN will go untreated since I can never trust the medical community again and my second hip is almost gone, the pain of the implant after 4 years makes me pray for death at least once a day, I can't die fast enough. Informed Consent? No, you can't drug a person and then have them sign a legal paper but you CAN get away with it if they can't find an attorney.

I really debated whether to respond to this or not. My two key points are these:

1. The student likely bears little to no responsibility for your current condition. Students are not turned loose to wreak havoc with patients; they are supervised either by the nurse who has been assigned the patient or their instructor. In the OR, they are limited to merely observing. They do not participate in any patient care activities within the OR in the vast majority of facilities.

2. You really need to seek counseling to help you work through your experience. You obviously continue to need medical care, and need assistance in being able to access the necessary care to improve your quality of life. Please, take care of yourself in any means necessary, including counseling.

Specializes in NICU, PICU, PACU.

No abbreviations here either. If they write them and I am witnessing, they have to redo the consent or I don't sign.

Specializes in Complex pedi to LTC/SA & now a manager.

Nothing like reanimating a nearly 5 year old thread...

Specializes in NICU, PICU, PACU.

I never look at the original dates lol

Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.
In 2010 I had a total hip replacement. I REFUSED to sign the paper that gave permission to allow students to participate and observe the surgery. AFTER I was given midazolam and several other drugs a nurse asked me to sign that form and my first response was to say no...she then told me to sign it again and I did; my boyfriend was present and witnessed this fact. In my opinion I did NOT give "INFORMED CONSENT" since I was drugged and then, IMO I was FORCED to sign this paper. I also was getting a general so I don't understand {nor was I informed} that I would get an amnesia drug--I would have refused the surgery had I known. I have lupus, MS and several other major medical problems. I had aphasia after the surgery and it took me months to find out what happened to me; I have lost a lot of my memories since before and after the surgery, early alzheimers {midazolam eats the hippocampus} and when I confronted the surgeon for giving me alz with the use of midazolam he laughed and said, Yes, we gave you alz with the use of versed but it is chemically caused so it's different--I also have a witness to that statement.

I am a childhood sexual abuse survivor and I think I have the right to limit my body exposure, I have a RIGHT to some modesty. It has been 4 years since my surgery and I STILL experience amnesia bouts and still have some aphasia. I have been in terrific pain with my hip implant and the insurance refuses to do an MRI or CT scan to see what the problem is but they have no problem keeping me on pain meds 24/7; I have NO LIFE at all due to all this and can't find an attorney since Good Sam OWNS the state of Oregon or as the attorney's tell me, we all depend on G S for our income and most of us are on retainer with them so they are unwilling to even listen to my story. I have all my medical records and some of this crap would make you scream. Giving me insulin w/o taking blood sugars even tho I never had insulin before & no one was waking me up to eat for 3 days, allergy to Tylenol {noted on chart, due to liver damage from lupus} but nurse writes that since I refused to take the pills they just gave it to me in a suppository {in b & w on the chart notes}, the use of a polar ice machine even tho I have reynaud's & nurses note that I was screaming the ice was burning me {she did not take it off, just noted I was screaming about the burning} no checking skin for burns, a pillow case for insulation on the polar, u/a hat in toilet was being used by 3 people and was overflowing how can anyone check my output,{I also have kidney damage} after removal of the catheter??

The list goes on forever and most of it is in my chart, all but who the student was that put me in this hell on earth of a body. With all of my medical probs I would never have guessed that they would turn a student loose on me. Now all I do is sit and wait to die, I have no brain left, my bilateral AVN will go untreated since I can never trust the medical community again and my second hip is almost gone, the pain of the implant after 4 years makes me pray for death at least once a day, I can't die fast enough. Informed Consent? No, you can't drug a person and then have them sign a legal paper but you CAN get away with it if they can't find an attorney.

I am so sorry you have had such a difficult time. I pray that you find some resolution. I think you might need to speak with someone t help you move past this horrible experience.
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