Consent forms

At my facility we send the patient down with the unsigned (but filled out, if possible) consent on the front of the chart. We know the surgeon isn't coming to the floor to explain anything so....

I have a question for nurses who work in operating rooms. I may be looking at cardio-thoracic surgery in my near future and have read about all that goes on while the patient is unconscious such as no consent exams, unnecessary visitors/vendors/spectators, as well as patient video and photography. If I do need surgery I plan on protecting my privacy and modifying my consent form to prevent this, which according to my local hospital's patient bill of rights, is my right. My question is will the surgical staff honor my requests or will the attitude be that once I'm under anesthesia it's game-on and what I don't know about doesn't matter?

You'll need to discuss your specific concerns with your surgeon or surgical staff. Facility patient bill of rights follow the template of the CMS bill of rights, which allows patients to make changes to their consents so long as the are practical and don't affect the quality of your care or others. Some requests are reasonable and could be accommodated, but for the most part everything that happens in the OR isn't really optional. I've had patients ask that they be allowed to remain fully clothed during OHS, and another ask that the surgeon be the only person in the room throughout the case.

I am all for doing what's necessary to make my surgery as safe and successful as possible and I will talk to the surgeon well before surgery but what I am trying to find out is will they honor the agreed to restrictions on the consent agreement after I'm under or just humor me while I am awake? I have read many times it's after you're unconscious that all the unnecessary people enter the OR.

I know a coworker who recently had CABG at my local hospital which is also a teaching hospital and I have been asking her about her experience. When she signed the "standard" consent form allowing visitors, students, etc., she really had no idea how far that would go. She told me when she was wheeled into surgery that the operating room was huge and said there were about 25 people in there already. From what I have learned this operation should take about eight people max. Is that a fair estimate? At 25 people it seems way over the top. She should have charged admission.