I have been a long time follower of the forums, but I come to you now for some advice regarding a mistake that was made during my shift 2 days ago. I did not even realize it at the time (I am a new nurse) I only became aware of it last night while I was in bed.
I brought back 2 patients (mother and daughter - who was a minor) who were scheduled for the same procedure that requires a few injections. This was not their first treatment and while very safe, obviously has risks. Anyway, there is a consent that I did not need to sign, but the pt's mother did have to sign for herself and daughter and the physician was to sign after them. I am supposed to give it to the pt's while waiting for the MD but I totally forgot and I know the MD did not sign or remember it either. The injections were performed and everyone was fine as they left. I had never forgotten before this point.
I have been riddled with anxiety, remorse, disbelief that I forgot, all the crummy and terrible feelings that go along with making a huge mistake.
So I don't know what to do now, tell the doctor who runs the clinic on monday and hope to God he won't fire me (though I believe he will, this is huge) or not say anything and hope it goes unnoticed.
Thank you, nursemarion, for your advice. I was and still am afraid to admit to the doc's what happened, but now I feel like there is no other option but to admit what was missed. I feel very at fault for this and I do not want it to be viewed as me pointing the finger at the doctor who did the procedure. Ultimately, if I were to be fired, I would feel better for doing so with the truth than to hope I won't be caught and live with the 'what-ifs' until that time comes or does not come. I can handle being hawk-eyed.
I value and love this job and would do anything to protect it and the institution because it's run by good people and staff. I know I am not alone in making this mistake but I can't help but feel like the biggest dummy on earth. Thank you all for the encouragement to do the right thing.
For some reason I don't think this is as big a deal as you are making it. At my work if I need to get a consent for something that means there probably needs to be a timeout prior to the procedure which means the people involved shoud be looking at the consent. Therefore, if I sent the pt without a consent, they would then catch it at that time and get a consent. If I were you I would talk to the Dr. Who did the procedure. I'd say something along the lines of "hey remember pt so and so from last week, I realized a couple days later that I never got the consent for the procedure, Did you happen to notice and get it yourself?" if he says no, then I would say "so what steps should I take from here". I doubt it will be that big of a deal (I could be wrong). Seems like they would be like well don't let it happen again and maybe everyone would be a little more cautious about it, I'm sure you are not the first one to do so.
My fear of you going to the "head" doctor is everything looks worse to outsiders (people not involved) so he might blow it out of proportion unless he heard it from the other doctor (who in this case is also to blame).
Your anxiety shows that you are conscientious and I agree so much with the other post stating you will never forget consent again! I have managed a medical practice and been a hospital nurse for 12 years. You are only human, and no harm came to the patient, which is THE most important thing. I seriously doubt you would be fired over this incident. Reprimanded, perhaps.
Don't be so hard on yourself! I would personally respect the fact that you recognized your error and were honest about it.
I have been a long time follower of the forums, but I come to you now for some advice regarding a mistake that was made during my shift 2 days ago. I did not even realize it at the time (I am a new nurse) I only became aware of it last night while I was in bed.
I brought back 2 patients (mother and daughter - who was a minor) who were scheduled for the same procedure that requires a few injections. This was not their first treatment and while very safe, obviously has risks. Anyway, there is a consent that I did not need to sign, but the pt's mother did have to sign for herself and daughter and the physician was to sign after them. I am supposed to give it to the pt's while waiting for the MD but I totally forgot and I know the MD did not sign or remember it either. The injections were performed and everyone was fine as they left. I had never forgotten before this point.
I have been riddled with anxiety, remorse, disbelief that I forgot, all the crummy and terrible feelings that go along with making a huge mistake.
So I don't know what to do now, tell the doctor who runs the clinic on monday and hope to God he won't fire me (though I believe he will, this is huge) or not say anything and hope it goes unnoticed.
Thanks everyone
Report what you did to your immediate supervisor. It's the right thing to do, and if you don't, it'll always be hanging over your head and you'll feel guilty.
Getting a consent signed may have been in your job description, but my understanding has always been that the physician performing the procedure/operation is the one ultimately responsible for making sure the consents are signed for that procedure. So.....you were in the wrong as far as your job goes, but the physician is the one that performed a procedure without obtaining consent.
1) although you might witness a signature, it is the physician's responsibility to obtain consent. your signature is only to indicate that the physician has done so and the patient understands and has signed the paper.
2) the physician has the responsibility to be sure a consent is signed before he does anything.
3) if there is no damage done to anyone, i.e., the procedure went fine and there were no complications, then there can be no lawsuit against anyone.
the four components of rationale for a malpractice suit are: there was a duty to care (e.g., doctor-pt relationship or nurse-pt relationship); there was a standard of care which was breached; there was some sort of damage; and the damage was as a result of the breach. if even one of those things is missing, there is no case.
i'll bet you'll never make that mistake again! and i agree that honesty is the best policy here; let him know so he can take steps to prevent it happening again. to make it right the physician ought to have the mother sign as an addendum (real-time, not back-dated), to cover his butt in case complications result. but if they do, it was not your responsibility to see that consent was obtained, it's his.
I certainly don't believe that there is any way I could forget the consent again! I'm sorry to have learned it the hard way, but at least I've learned.
Thanks for the insight, GrnTea. I'm curious to see what we will do to right this situation, I believe the pt's set to come back in 3 or 4 months for a follow up but by that time the doc who did the procedure will be working elsewhere. I wonder if they will have to come back in before then or what will happen.
I have definitely decided to tell the first doc I see just so someone knows ASAP. I am in no way trying to throw the other doc under the bus by any means but I feel like someone in charge needs to know as soon as my shift is about to start Monday morning. Whatever consequences come my way will I will have to deal with and I accept that as my part in all this. I appreciate all the feed back from everyone and I agree fully go with integrity. I guess I just needed some encouragement that this is not the 'end of the world' especially since no patients have been harmed and no complications occurred which is ultimately the most important thing. Thank you
Why are you making this into a big deal and why is it not the doctor's fault as well? He would have responibility to ensure consents are signed.So you forgot.Crap happens.
I talked to he head doc his morning about the situation, he was not concerned, emailed the other doc who said it was his mistake to not catch and he was not worried about it because it wasn't the first time. Thank you for the support!
I'm glad it's over and no one was upset about the situation.
I do want to add as others said though that getting informed consent is not supposed to be a nurses job. The MD is responsible for that. So really every time you are getting the consent you are in the wrong. I know a lot of places have nurses do it out of laziness of the doctor but it's not right.
Clearly the patient was okay with the procedure happening and luckily it went well. Most patients would just happily sign the next time they were in and wouldn't think twice about it. You do have to be careful for the occasional ******* that will use it against you though!
holdyourheadhigh
7 Posts
Thank you, nursemarion, for your advice. I was and still am afraid to admit to the doc's what happened, but now I feel like there is no other option but to admit what was missed. I feel very at fault for this and I do not want it to be viewed as me pointing the finger at the doctor who did the procedure. Ultimately, if I were to be fired, I would feel better for doing so with the truth than to hope I won't be caught and live with the 'what-ifs' until that time comes or does not come. I can handle being hawk-eyed.
I value and love this job and would do anything to protect it and the institution because it's run by good people and staff. I know I am not alone in making this mistake but I can't help but feel like the biggest dummy on earth. Thank you all for the encouragement to do the right thing.