Obtaining consent

Nurses General Nursing

Published

I had a patient recently with a climbing troponin, and the doc called me to say he was going to cath the pt that evening and he would be up to talk to the pt. His extender called shortly after to give orders and told me the cath lab would be up to get the pt within minutes. I told her I did not feel comfortable obtaining consent without the doctor talking to the pt, and she said she would be up shortly to explain the procedure to the pt.

The cath lab tech arrived for the pt before the extender got there, and when she did arrive I overheard her huffing and puffing to the tech that, basically, I was putting them behind and should have just gotten the consent.

Would you have handled this differently?

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Specializes in Hospital Education Coordinator.

Nope. Tell them next time that informed consent requires the MD to discuss with the patient and for you to do it would mean you are acting outside your scope of practice. You might want to go to your Nurse Practice Act and cite chapter and verse. This is usually an education issue as the MD's may not be aware of your scope of practice - but you should be! Not only are they to provide the information they need to DOCUMENT. Also, you may serve as a witness to the signature (s). You did the right thing.

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Specializes in RN, BSN, CHDN.

No way I wont do the consent form with the pt unless the Doc has actually talked to the pt. It is their job and they know it. I let the consent be signed down in the cath lab with the Dr. i had the same problem yesterday and i demanded the doctors to come to the floor and explain as I was dealing with an angry family, who wanted explaination.

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Specializes in Cardiac, ER.

Nope,..read your consent. I'm sure it says right there in black and white that the physician has explained the procedure and the risks and benefits. If the doc hasn't seen the pt cath lab can have the consent signed.

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Specializes in Acute Care Cardiac, Education, Prof Practice.

I would have done the same thing. No doc, no signature from me! I know how fast they can push people in and around, but I still want my license. It won't break the arm of the RN in the cath lab to get the consent if the doc hasn't had time to get to the floor.

Tait

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Not in a million years. You were 100% right and they all know it. Stick your ground here and protect yourself and your license. Shame on them because they know better.

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Anyone know why Dr.'s can't fill out the consent forms. I mean if they are the ones explaining it, it would make sense that they would sign the form along with the patient. I know there have been many times that patients don't even know what procedure they are going for even after the Dr. has "explained" it. So I know that we serve as a check system...but still, wouldn't it be nice.

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Specializes in Med/Surg, Ortho, Oncology, Rehab, LTAC.

I had a patient while working as a traveling nurse that needed abdominal surgery. The patient had dementia so the spouse was to sign the consent. The doctor had spoken to the family and had them sign the consent, but when I went in to confirm their signature and sign the form myself they still had questions. I called down to preop and explained that I didn't feel comfortable signing the consent and I told them exactly why. Well the surgeon (who had a particularly bad reputation) called up to the floor and demanded that I come down in person to sign the consent. I went and told the nurse manager what was happening and asked her to come down with me. I wasn't walking into the warzone alone. We walked through the doors and with the surgeon standing within ear shot I went to the family and asked if he had answered all their questions. I'm sorry, but I'm not losing my license for a doctor that can no longer fit his head through the door.:no:

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Thank you all for the replies. I feel a lot better now.

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