Can a patient sign discharge instructions after sedation?

[NURSECDON]

Hello, I just have a general question. Does anyone let their patient sign their discharge instructions after sedation? I need data to back me up on the issue of patients signing their discharge instructions after they have been sedated. I'm trying to stop this from happening. Also, can anyone point me in the direction online that also supports the data that a nurse must educate the patient on their discharge instructions and that a non-licensed staff member cannot. Please I have searched and searched and can't find the data to back up my statements.

[caroladybelle, BSN, RN]

No!!!! Big No!!!!

[jadelpn, LPN, EMT-B]

If someone is set up for surgery, they are usually taught about general discharge instructions at that time, along with getting medical history and the like. Additionally, follow up calls the next day are also done, to ensure that things are going ok, pain is under control, and who to call if there's an issue.

If there is a responsible person who is driving the patient home, discharge instructions can also be gone over with them. (By obtaining permission from the patient when gathering information in pre-op)

If it is an emergency surgery, sometimes one can't even give consent in some circumstances--so if there is a support person, again, discharge needs to be gone over at that time. Also protects against a " I live alone, have no-one" and the discharge itself needs to have some sort of follow up plan as in VNA services.

[NURSECDON]

I agree... that is why I need data to back me up to present to the governing body to change this from happening.

[NutmeggeRN, BSN]

Nope!

[SC_RNDude]

Who cares who signs the paper? It's not a legal agreement. Where I work we don't have anyone sign DC instructions. We simply chart that we reviewed them with whoever. Don't make things harder on yourself and everyone else.

[brownbook]

The answer is.....it depends.......it seems like a perfectly simple yes no question but as you have probably found in your research no one has a yes no answer.

Personally I agree with SC_RNDude.....but I understand your point of view also. I was researching the answer and read a fascinating article about a patient whose ride never came to drive him home. The nurse kept him....he insisted on leaving....he signed AMA...made several stops before driving home and was of course in an auto accident and (I think) eventually died.

After five years of legal battling it was decided in favor of the clinic/nurse. A clinic/surgery center is not a prison, they cannot legally keep a patient there, they cannot even call the police because of HIPAA. Scary but fascinating!

A few months ago I was Googling signing consents after receiving pain medication. Even that answer was "it depends." The short version (my bad memory of what I found), was that the patient can sign a consent after receiving opoids or other pain/sedating drugs. The surgeon/anesthesiologist/nurse document that the patient was alert and oriented and understood the procedure.

It makes sense....I just imagine a patient going to the ER, receiving some pain medication, shortly there after it is realized they need surgery (non emergency surgery). The surgeon and OR are ready....so everybody has to wait some arbitrary number of hours before the patient can sign? Not necessary.