I have been working in the OR for a little over 2 years now. From time to time we have arguments with surgeons who are hard headed about their informed consents. For example, yesterday, we had a patient who was given 2mg versed IV and 50mg Demerol IM. Then we noticed on the consent she had signed for a Right breast bx when in fact the patient was to have a left breast bx. Now, it is very rarely we let a patient back to the or before the mistake was caught. So the CRNA gave the versed and then realize the consent was wrong. So the surgeon was told we could not do the case because the consent was wrong. Well of course he had to argue and say his R was an L, when it was pretty clear it was a R. Well then he wrote Left on the consent and had her initial it. Well our policy at our hospital states it is not legal if she had mind altering drugs and of course she did and it was versed and her pre-op of demerol IM. He through such a hissy about it that we ended up calling a sister to say it was OK with the procedure. Now, my question to you is, Do you think it is legal for that sister to OK an elective surgery legally. How do you handle situations like this? Most of the doctors order Pre-ops of demerol and sometimes versed before they even come to Surgery and then when they get to surgery their consent is wrong. I would like some input or sites that issue this kind of information out.
Aug 8, '03
Angela, sounds like you are in a difficult situation. I have no idea what you state's laws are about informed consent--some have more stringent laws than others. I have frequently seen that surgeons consider informed consent more of an annoyance than anything.
A great deal hinges on your management and administration--are they more concerned about protecting the patients (and their staff), or are they more concerned about kowtowing to the surgeons? To deal with the consent issue you really need the support of administration, if you don't have this I'm afraid not much with your OR's situation will change.
Last edit by spineCNOR on Aug 9, '03