Informed Consent Responsibility

[Bec717]

An OR nurse wanted to write up a unit nurse because the informed consent, signed by the MD and the patient had abbreviations that were written by the MD. Is it the witnessing RN's responsibility to inform the MD what and what he cannot write on his surgical informed consent? And the witnessing RN, the PM nurse witnessed and signed the consent, passed the chart over to the day shift RN who sent the patient to OR and now OR nurse wants to write up an incident on the day shift RN. What is the RN's responsibility in regards to informed consent?

[kcochrane]

The nurse is not responsible for providing the information necessary for informed consent to the patient or health care proxy agent. The nurse’s role is both as a witness and as a patient advocate. First, the nurse as witness acknowledges that the patient has been given the information and is the witness to the patient’s signature on the consent form. Second, as patient advocate, the nurse asks questions of the patient to determine whether the patient has received sufficient information to make an informed decision.

According to the NYSNA

http://www.nysna.org/practice/positions/position18_04.htm

IMO, unless the nurse felt the patient did not understand the procedure, she was not in the wrong.

[Batman25]

This reeks of making a problem where none exists. Is this a pattern by the OR nurse? Are there bad feelings between these units?

Everything seems kosher here. The doctor obtained informed consent and documented it. The RN verified the patient understood and felt confident being a witness to it. The patient also signed the document and it doesn't appear there was a problem on that end either.

[Argo]

sounds good to me. probably an insecure OR nurse... there are some out there....

[tri-rn]

Reading this makes me happy...I always ask my patients if they have any questions, do they understand everything, or something along those lines when I witness a consent. Today I got a touch of sarcasm from the MD for it...whatever.

[iluvivt, BSN, RN]

Some hospitals have as their policy that NO abbreviations are ever to be uses on any consent...this is a very typical policy..that way the patient or surrogate can NOT say..."I did not know what I was signing for" Can you see how on can use that if ever they decided to sue!!!.So this usually comes form the facilities legal department and may even be spelled out in the stat consent manual. Would I write it up?? probably not...but I would communicate with the manager of that unit so they could train both the nurse and MDs. Maybe the incident report was lss about being punative and more about solving a problem by highlighting it that way

[Rose_Queen, BSN, MSN, RN]

Our policy is that the consent cannot have abbreviations. Not sure that I would have done a write-up, but there should have been an explanation for education.

[Tait, MSN, RN]

I would write the doc up if it was policy. I am no one's secretary!

I bet that OR nurse wouldn't have the ovaries to do it though...

Tait

[ivorybunny]

We can not have any abbrevations as well. I have been written up before because a consent form was not filled out to the hospital's expectations. Depending on it hospital, it is our responsibility, as an RN to make sure that the consent is correct. It's hard to correct a doc, and I'm shocked that one would fill out his own consent- here we have to fight to get the MD to even sign the consent after the patient has.

[meandragonbrett]

Soooooooooooo sick of crazy nurses! If it were THAT big of a problem, the OR nurse could have a new consent done in holding provided anesthesia hadn't given a cocktail

[Argo]

If it was an on call type of situation the OR nurse cant redo the consent without another nurse in alot of hospitals. Alot of places have policies in place that the RNs on the OR team can not be the one to witness the consent, my hospital is like this so if I am on call and the consent is no good or not signed I have to get a house supervisor to come up and redo it. I have gotten in trouble for trying to educate some of the floor nurses cause they say I am mean, typically I just dont smile all day long and am direct and to the point when telling people the way something is done per policy. Since I recieved that complaint I just started having the RNs on the floor written up for poor nursing practice things that should have been done prior to getting them up in holding. I give the write up to their department manager and she can do what she wants with it, at least she knows and can do something.... All of my OR nurses have the ovaries(or male equivilant) to write up anyone including physicians for things they did that way at least something is documented that an effort was taken to correct the problem. I would say 90% of the time it does NOT go in their work file, it just gets addressed and we move on.

[Bec717]

One RN suggested, if pre-op meds are not given then just tell them in report the patient has questions, document the consent has not been witnessed, tell them in report the consent has not been witnessed b/c the patient has questions, and put the responsibility on the Pre-OP RN each and every time....... let the MD and Pre-OP RN take responsibility for the consent and leave the unit RN out of the situation altogether.