Wrong side/omitted procedure

  1. 0 Had a question for you all. I recently had surgery and while in the preop holding room, was given a consent form to sign. This consent form had the wrong side and omitted one of the procedures. I notified the nurse of these issues who told me that she couldn't get the consent form changed nor could I speak with the surgeon until I was in the anesthesia room. She said I was required to sign the errant consent form before she could move me down to the anesthesia room. If I didn't sign, I could not have the surgery.

    I felt at a loss so I signed the consent form with the wrong side, and omitted procedure, then moved down to anesthesia where I spoke with the doc and got the consent form rewritten and signed (prior to me being given anesthesia).

    I had also figured that once I got on the table I could make sure I was positioned to ensure they were doing the correct side, but I was given anesthesia while being wheeled into the room, and my last memory is of entering the operating room, so I was out before I was transferred to the OR table.

    I had a few questions for you all. I was wondering how often consent forms have the wrong side listed on them? I was also wondering why I was required to sign an incorrect consent form before I was allowed to speak with the doctor? I was really concerned that they'd accidentally use the bad consent form in the surgery And is it usual to be knocked out before even being put on the OR table?
  2. Visit  Ayvah profile page

    About Ayvah, RN

    Ayvah has '8' year(s) of experience and specializes in 'Med Surg, Specialty'. From 'USA'; Joined Feb '05; Posts: 722; Likes: 1,070.

    25 Comments so far...

  3. Visit  Goobstress profile page
    3
    You should have NOT signed the wrong consent!!! It is your right as a patient to speak with the doctor prior to signing your consent and your experience is exactly how wrong site surgery occurs!!! Being an OR nurse I always make sure you have all your answers questioned prior to moving into the OR. As far as being medicated anesthesia gives you versed if all is a go and you usually don't remember anything even if you were awake.
    ORoxyO, LockportRN, and BuckyBadgerRN like this.
  4. Visit  xoemmylouox profile page
    1
    I don't know why they would have you sign an incorrect consent form. In the future I would ask to speak with someone first. You would hate to wake up and find out the wrong surgery was done.
    Goobstress likes this.
  5. Visit  Rose_Queen profile page
    1
    That sounds like someone who just didn't want to deal with the problem. You should never be asked to sign an incorrect consent. Where I work, if there's any discrepancy between what the patient says/what the schedule says/what the consent says, there is no moving on to the next step. The proper thing for the nurse to do would have been to page the surgeon for clarification and to correct the consent. As for being knocked out before moving to the OR table, I'd guess you were given an anxiolytic with amnesic properties (such as Versed/midazolam) rather than full out general anesthesia.
    LockportRN likes this.
  6. Visit  sapphire18 profile page
    1
    I agree- I would never have a patient sign an incorrect consent form!

    Also, with surgery, it has always been my experience that the SURGEON obtains consent, anesthesiologist anesthesia consent, etc. When I had surgery myself, it was the resident who went over and obtained consent from me. When I worked with surgical patients, it was always the MD/NP who went over the consent with the patient and had them sign it. Now, we as RNs obtain consent for blood/central line placement/etc...even that makes me nervous though, and I don't think that it is right that they force us to do that.
    Goobstress likes this.
  7. Visit  Whispera profile page
    0
    Never sign something that isn't correct. If you signed it and they did it incorrectly but you had given the ok, you would be up a creek without a legal leg to stand on. Remember the old, "if it's not written, it didn't happen"??

    I went to the doctor 2 weeks ago. I had completed my first appointment history information ahead of time but was asked each and every question anyway. Then, the doctor, using the computer that had the information entered on it, told me things I had supposedly said about my family history, allergies, and reason for being there that were nowhere near what I had said. For instance, I was there for leg pain but the reason was listed as fatigue. I have big medication allergies, but none were listed even though I had them on the paper I completed and the person who asked me was told about them. I asked the doctor if she had the right chart. She checked. Yup, it was me.

    Later that week I explored the website that was supposed to have test results for the labs, xrays, and doppler study I had done. Those were all ok, but my diagnosis had nothing to do with what I had gone to see the doctor for. I do not have confidence in this doctor's office. I doubt I'll go back...

    Sorry for the soapbox--had to get that off my chest.

    Truly, though, don't let being told you "have" to do something make you do it. You have some extreme rights.
  8. Visit  ChristineAdrianaRN profile page
    4
    Holy CRAP, really?! That is all kinds of wrong!

    Everyone else has pretty much covered it, but I'm going to go a step further and say take it up to management. The fact that the surgeon was not there while you signed the consent, and the BS the nurse spouted about you being "required" to sign a wrong consent, is absolutely unacceptable, and their bosses need to know about it.
    ORoxyO, LockportRN, NicuGal, and 1 other like this.
  9. Visit  canesdukegirl profile page
    4
    Quote from ayvah
    had a question for you all. i recently had surgery and while in the preop holding room, was given a consent form to sign. this consent form had the wrong side and omitted one of the procedures. i notified the nurse of these issues who told me that she couldn't get the consent form changed nor could i speak with the surgeon until i was in the anesthesia room.

    i find this very hard to believe. the nurse might have been new, or perhaps she just didn't want to page the surgeon to come fill out a new consent with the correct info. an incorrect surgical site listed on the consent is a sentinel event:

    "a sentinel event is an unexpected occurrence involving death or serious physical or psychological injury, or the risk thereof. serious injury specifically includes loss of limb or function. the phrase, "or the risk thereof" includes any process variation for which a recurrence would carry a significant chance of a serious adverse outcome. such events are called "sentinel" because they signal the need for immediate investigation and response." -the joint commission

    furthermore, you should have been marked with the surgeon's initials on the correct site. many times, this is done in the pre-op holding room.

    of course you could have spoken to the surgeon prior to going to the anesthesia room. i imagine if the surgeon heard this excuse from the nurse delivering this message to you, s/he would have been irate. it's not like you are knocking on the giant door to oz and asking to a funny looking guy with a cartoonishly large mustache to speak with the wizard. i have never heard anything so ludicrous!

    she said i was required to sign the errant consent form before she could move me down to the anesthesia room.

    wrong, wrong, wrong. you have got to report this to risk management. this is beyond wrong, and i can't believe this was allowed to happen. it sounds like plain ol' laziness to me, and this nurse needs a serious sit down convo with her nurse manager. no hospital would ever advocate this practice.

    if i didn't sign, i could not have the surgery.

    if you didn't sign the correct consent form, you couldn't have the surgery. again, this is serious and i implore you to take this up with risk management. can you imagine what a layperson would feel like in this position? many pts feel so stripped (literally and figuratively) while in pre-op holding, that they will sign anything because they trust that we as medical professionals have all of our ducks in a row. you recognized that it was the wrong site and that a procedure was omitted, but you can probably understand how a scared and nervous pt wouldn't even read over the consent.

    i felt at a loss so i signed the consent form with the wrong side, and omitted procedure, then moved down to anesthesia where i spoke with the doc and got the consent form rewritten and signed (prior to me being given anesthesia).

    thank goodness for that! but the process this hospital uses is very dangerous.

    i had also figured that once i got on the table i could make sure i was positioned to ensure they were doing the correct side, but i was given anesthesia while being wheeled into the room, and my last memory is of entering the operating room, so i was out before i was transferred to the or table.

    yep. good ol' versed will do that to you!

    i had a few questions for you all. i was wondering how often consent forms have the wrong side listed on them? i was also wondering why i was required to sign an incorrect consent form before i was allowed to speak with the doctor? i was really concerned that they'd accidentally use the bad consent form in the surgery and is it usual to be knocked out before even being put on the or table?
    it is typical to have 1-2 mg of versed prior to being rolled back to the or. since versed has a retroamnesic effect, you probably felt that you were knocked out, but in reality, you were likely talking, helping the staff by moving to the or bed yourself from the stretcher, but just don't remember doing it. i have never seen a pt so groggy from pre-op doses of versed that we had to move them over to the bed ourselves. after emergence, that would be a routine practice, but not before induction.
  10. Visit  NicuGal profile page
    4
    Oh my....I would have never signed and said, Well I guess my surgery is off, you care to go tell the surgeon why? I would be calling their head nurse and then contacting their risk managment department about this.

    Where I work, the surgeons usually come to the holding room right before going to scrub in to touch base with the patients. Guess we are lucky that way!
    pauliecee, Goobstress, LibraSunCNM, and 1 other like this.
  11. Visit  2bFNP4ME2015 profile page
    1
    Based on your previous posts and thread. I find it highly "unlikely" that the incident occurred. As a Perioperative Nurse of over nine years, I am highly offended that you would fabricate a story about your rights and safety being violated. That a nurse would refuse for you to speak to your surgeon or clarify the procedure. Besides, based on your participation with the website...why "would" you allow it? Seriously, I stand behind my fellow OR nurses. If its attention you want, I suggest adopting a puppy.
    aliciaRNBSN likes this.
  12. Visit  Ayvah profile page
    1
    I am a 7 YEAR member of allnurses and a 5 YEAR RN; I don't appreciate the insults and insinuations. I see you have been a member of allnurses for less than 1 month OrNurrse03. I don't know why you think you have an axe to grind with me and your accusations make no sense regarding my previous 5 year history of posts. I am not here bashing OR nurses, I am here for information. If I was only posting for attention I would have posted in the general section but I came to the OR section to ask the people who know how things go, if there were possibly bad policies in place or if this was just a new nurse taking care of me who didn't know what she was doing. My background is med surg and clinic, not OR nursing. I know enough to know what I don't know, which is why I posted here.

    Thank you to everyone else who has so kindly responded to me. The surgeon had come around (prior to me even seeing the nurse or seeing the consent form) and asked me 'show me the operative site' so he could sign, so the correct site was signed, but I was so surprised by what the nurse was telling me regarding the errant consent form that I wanted to come here to get more thoughts on what happened. That nurse did tell me that she notified the doc that there were issues with the consent form and assured me he'd come talk to me after I moved, but stated that I still needed to sign it before I could be moved down to talk to him about it and that her hands were tied. Looking back I should have definitely asked to speak with her manger, but at the time I knew that after I'd been moved I'd refuse to go any further before speaking with the doc, and had my husband with me, and was in pain and worn out. After I spoke with the doctor he did tell me he'd investigate why there were issues with the consent form being wrong but I had not spoken with anyone else regarding the nurse's insistence that I sign the form before being moved there.
    OnlybyHisgraceRN likes this.
  13. Visit  Ayvah profile page
    1
    In addition, to clarify this:

    Quote from OrNurrse03
    That a nurse would refuse for you to speak to your surgeon or clarify the procedure.
    the nurse didn't state I could not ever speak with the surgeon, but that I had to be moved to the next holding room/anesthesia room before I could be able to speak with him (but that before I could be moved I had to sign the form, which is the whole reason I posted here). She told me she had called him to inform him that I would need to speak with him about the consent form when I reached the anesthesia holding room.

    per OP:
    Quote from Ayvah
    I notified the nurse of these issues who told me that she couldn't get the consent form changed nor could I speak with the surgeon until I was in the anesthesia room.
    This reminds me of a recent thread about 'crazy things that have happened in your nursing career', and one person wrote about how there was a terrible accident and 2 people had the wrong arm reattached. If you think that an issue with consent forms/misunderstood policies/new nurse is a made up story (because that never ever happens ), you need to spend a lot more time talking to your fellow nurses. sigh...
    Last edit by Ayvah on Jul 10, '12
    OnlybyHisgraceRN likes this.
  14. Visit  goats'r'us profile page
    1
    i can tell you exactly why this happened. time is money.

    my hospital has a policy that before the patient can be brought up from the waiting bay to the anaesthetic room, the surgical site must be marked and initialled by the surgeon, and the consent must be signed. If this has not been done, the anaesthetic nurse cannot bring the patient up, therefore the anaesthetic reg cannot begin doing anaestheticy things like putting in lines while the consultant finishes up the previous case, which increases changeover time.

    so, technically, if there is a signed (albeit incorrect) consent, the nurse can bring the patient up to start non-sedatey anaesthetic stuff, rather than waiting for the surgeon to finish the case and make their way down to correct the situation. it's not like they're going to medicate the patient or anything, right? and the patient can talk still talk to the surgeon in the anaesthetic room, so where's the harm?

    so wrong!!

    policies are in place for a reason, and basically this nurse is bending the rules to save a bit of time wastage and reduce hassle for herself.

    one of the reasons why my hospital has this policy is that it's been decided that when the patient's already got changed, waited in the waiting bay, been checked through to the anaesthetic room and essentially had their anaesthetic started, their consent is no longer being given freely and without pressure.

    bottom line. the nurse should 1) not be consenting you in the first place, that's the doctor's responsibility, 2) the nurse should not have allowed you to progress through to the anaesthetic room with an incorrect consent (and she knows it), and 3) stand up for yourself - you shouldn't have signed the incorrect consent form (and you know it!).
    Ayvah likes this.


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