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Discussion

didnt get consent signed?

I am a surgical nurse, working in a very fast paced hospital. I had a patient who was getting a surgery done, doctor brought consents filled out. I swear I looked at the consent and saw a signature from the patient. Come to find out--the patient did not sign. No harm done to the patient, I did my interview and procedure was correct.

I am so scared of the repercussions of my actions. I have never had a slip up like this EVER. Is this ground for my manager to fire me? I can't lose my job but I am freaking out! HELP!

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  • Admin

At my facility, the doc is responsible for obtaining consent. However, the pre-procedure nurse and procedure nurse are responsible for making sure the consent is completed prior to the patient entering the actual procedure area. Honestly, there is no reason with the multiple people working with a patient prior to a procedure that a patient actually reaches the point of starting a procedure without a consent. We had a nurse take a patient to the OR without a surgical consent or an anesthesia consent. The patient was anesthetized, but when they realized that the patient had no consent completed, they were woken up and the procedure canceled until the following day. When they woke up and realized that the procedure was not completed, they were very much not happy. That nurse was terminated over the lack of signed consents.

Bottom line, always always always double check that your patient's consent is completed, whether they tell you or another nurse tells you it is complete. You are the final check; don't blow it off.

Ugh, one thing that has happened on my unit was that I was ordered in writing to get a signed consent for a patient who was A&O x zero/1. So I had to spend a lot of time trying to find a responsible contact, leaving a VM for that contact, receiving a phone call from that contact, and asking that contact to drive to the hospital to sign a form. It would have been SO much easier if the MD had gotten the signature at the time she or he had explained the risks and benefits, especially since I was under all this pressure to get the consent signed before transport came to pick up the patient. But it's SO hard to get changes made on my unit.

I am am a circulating nurse. Consents are a responsibility of everyone. The circulator must ensure the consents have been signed and witnessed appropriately . The patient does NOT sign surgical consent until the surgeon has explained the risks and benefits and you are only signing as a witness to their signatures. You must ensure patient understands consent as well. The second consent is for anesthesia and the same rules apply. The timeout in the OR is done off the signed consent and that is your last chance to ensure the correct procedure, on the correct patient and laterality are addressed as well as signatures etc.

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