OK, I don't do this very often, but there we were, in Report, and day shift nurse started harping on me and browbeating me over having a patient sign consent for surgery.
"We don't do that," I corrected her. "The doc has to do that."
"Night shift does that, now why wasn't it done?"
"Because the doc hasn't spoken to the patient about the risks and benefits of the surgery. The DOC has to get consent, not us."
"No he doesn't. WE do it. You were supposed to do that. Why didn't you do that?"
"Because the patient's procedure isn't scheduled until this afternoon. The doc has plenty of time to come in and see her about it."
"But NIGHT SHIFT is supposed to do that!"
...she would not get off it.....
I didn't even want to get into what the Nurse Practice Act says about the surgeon getting the informed consent with the nurse only witnessing the patient's signature, but I wasn't giving a lesson on Nursing Law; I was trying to give Report.
"But you were supposed to get the consent signed!"
Finally my temper blew. I stood up and said, "You need to stop arguing with me and just TAKE REPORT. I am trying to give you REPORT so that I can GET OUT OF HERE and go home. I am giving you THE INFORMATION THAT I WAS GIVEN. I DO NOT KNOW if the doctor has spoken to this patient about this procedure. Therefore, CONSENT WAS NOT OBTAINED. Do you understand."
Very loudly. Heads turned.
On the one hand, I've NEVER stood up for myself like that before. OTOH, if she'd just have shut up, I would've stayed and helped her. OTOH, I feel terrible for losing my cool.
I'm probably in a whole lot of trouble.
Did this ever happen to you? Wanna tell me about it?
Specializes in LTC, assisted living, med-surg, psych.
Ya know, the older I get, the more difficult it is for me to tolerate stupidity.
I don't blame you one bit for losing your cool. You're HUMAN. Let yourself off the hook, and if some manager wants to give you grief for it, take it in stride and then move on........a lot of nurses would have done the very same thing, or worse!
I dont know about other places, but where i work the doctor cant even write for consent and to schedule until he has talked to the patient and done his part of explaining the procedure. If he has written the order for consent and scheduling, then we can obtain the consent and sign as a witness to the signature. It doesnt matter day or night as long as its done prior to surgery and anesthesia.
If on the other hand the patient conveys to the nurse that the doctor hasnt spoken to him about the procedure or they have more questions (which the nurse should be asking anyway BEFORE the patient has been given the paper to sign),, we call the doctor andhe has to return to the floor and speak with the patient again before the consent is signed.
OK, I don't do this very often, but there we were, in Report, and day shift nurse started harping on me and browbeating me over having a patient sign consent for surgery.
"We don't do that," I corrected her. "The doc has to do that."
"Night shift does that, now why wasn't it done?"
"Because the doc hasn't spoken to the patient about the risks and benefits of the surgery. The DOC has to get consent, not us."
"No he doesn't. WE do it. You were supposed to do that. Why didn't you do that?"
"Because the patient's procedure isn't scheduled until this afternoon. The doc has plenty of time to come in and see her about it."
"But NIGHT SHIFT is supposed to do that!"
...she would not get off it.....
I didn't even want to get into what the Nurse Practice Act says about the surgeon getting the informed consent with the nurse only witnessing the patient's signature, but I wasn't giving a lesson on Nursing Law; I was trying to give Report.
"But you were supposed to get the consent signed!"
Finally my temper blew. I stood up and said, "You need to stop arguing with me and just TAKE REPORT. I am trying to give you REPORT so that I can GET OUT OF HERE and go home. I am giving you THE INFORMATION THAT I WAS GIVEN. I DO NOT KNOW if the doctor has spoken to this patient about this procedure. Therefore, CONSENT WAS NOT OBTAINED. Do you understand."
Very loudly. Heads turned.
On the one hand, I've NEVER stood up for myself like that before. OTOH, if she'd just have shut up, I would've stayed and helped her. OTOH, I feel terrible for losing my cool.
I'm probably in a whole lot of trouble.
Did this ever happen to you? Wanna tell me about it?
I feel your frustration Angie O'Plasty, you can only say the same thing so many times before you go crazy. I work with a co-worker like this and it drives me crazy. You did the right thing, if she is having the patient sign consents before the doctor has spoken with them, it is her but* on the line. Keep up the good work:)
hi I work in out pt surgery and we get the consents signed for all the pts and the pts come in from docters office with procedure explained ,but there are so many pts that have no clue about what the docter is going to do for them? Some open heart pts do not know what is open heart surgery and they just say that the doc is going to fix their heart ,but still we try to explain them and try to get the docter pre op if they are available.
Some people just like to argue, in order to hear themselves talk. :angryfire
I agree with the other posters here that you were well within your legal rights not to get that consent signed without informed consent, and the nurse who tried to bully you into getting it otherwise needs to take a refresher course in Legal Aspects of Nursing as well as Teamwork.
I work nightsw and something just are not appropriate to do at night. I want to see what kind of browbeating the nurse who calls an surgeon at 2am to ask him to come get consent signed for a procedure the next afternoon.
Specializes in Education, Acute, Med/Surg, Tele, etc.
Good JOB! I hate having to raise my voice to explain something I know to be correct, and lately I have had my doses too!
Typically all the nurses I have been working with are friendly and helpful...yesterday I had 3 smartbutts that just thought they were all that and a bag of chips!
Now I am agency, and this was a tele floor. I am not able to do tele (yet) and I think that ruffled a few feathers because I got all the non tele patients. But if I didn't show...they would have their tele and mine!
So a patient that I had come to know at my last employer (ALF) for 3 1/2 years came in and all the sudden (and I mean BOOM) he brady'ed at 34 with not a T to be seen then flat.....about 4 beats worth then a sinus...then it repeated! Oh oh!
They got his rhythm back but still brady, and I was asking some questions about bradycardia (I like asking questions!) and asked if he may be hypokalemic? (I am very rusty...haven't done cardiac in over 7 years...so just dusting cobwebs...). They looked at me like I was an idiot and that that was not a concern!
Then they said "just go to your sickies newbie...leave the important stuff to us". I ABOUT LOST IT!
Then...they started cracking jokes about this man who I cared for very much about things like "why doesn't he just follow the light"..."well if he dies he will be more compliant"..."I hope he doesn't code on my shift...oh heck...then one more room open anyway!?"...
I tried to keep my cool...but tears started welling in my eyes. That didn't help...they thought now I was a doofus and a cry baby!
I explained to them to always keep things in check...that I am very well aquainted with this patient and if they had been watching him, they would have noticed I was in there about every 15-30 minutes helping him...along with "MY SICKIES"...And you never know who is listening at the nurses desk!!!! What if I was friend/family????
Then I said "hey..heres is a funny game..who here today had to go with the doc to witness him telling a 28 year old newly married man with a new baby that he is positive for HIV and his baby may have it???? Anyone anyone....stare into the eyes of an infant knowing they may die because daddy made a boo boo??? HMMM??? Okay how about another witness to tell a man that even with dialysis he may only live another year max??? With the family in the room...Anyone???? Okay then....how many of you have to console not one, not two, but three families whos lives have changed forever towards the bad...because the resident I cared for yesterday...got bad news and YOU (pointed to one nurse) were busy and I had to hold their hands as they cried (terminal cancer patient...just found out)....SO if it is 'sickies' or 'death' you wish....then I will gladly give you my patients and never ever return to this floor!!!".
I walked off...another nurse wanted report from me who was just as nasty and I said..."we chart and record our reports...just hit play please...I NEED to go home before someone gets a piece of my mind they will regret!" and I left.
Lucky for me the charge nurse and MD's love me, and basically stood up for me as well. Guess those nurses can chew on that for a while before treating me less than a good nurse!!!!!
BTW..the nurses cracking death jokes....were actually reported to the admin before I even said anything by a physical therapist! Way to go PT!!!!!!!!
Wow, Triage. So sorry you had to be put through that. :icon_hug:
You're such a caring, wonderful nurse. :flowersfo
In the case of what happened to me, now that I've had a couple of hours of sleep and a little time to think about it, I think this poor girl was simply overwhelmed.
I think I snapped out because the most important stuff WAS done--not the pre-op checklist or the consent, but the chasing around to lab and the computer and the printer for all the paperwork and appropriate tests that need to be ordered before any patient has surgery. I found a few errors in this patient's chart that held me up for probably over half an hour, and I was feeling pretty proud of myself that despite some order entry errors, the chart was complete and all the day shift nurse needed to do was take some vitals, assess the patient (which would have to be done anyhow), and check off the checklist.
Oh, and verify that the docgotconsent.
Why the Docs can't create efficiency and find the time to do their own job is just a tad beyond my reasoning skills at this point, but what the hey....:smiley_ab it's a useless battle.
Specializes in Education, Acute, Med/Surg, Tele, etc.
You are so wonderful!!!!! Thank you so much for your kind words. Yeah, yesterday had me down very much...I cried at home because of the emotional things I had to witness and console...and being tired myself...well it took all my energy just to stay cool and not scream at those 'bitties'... Kinda proud I didn't get into their faces! LOL!
I am very proud of you too...it takes so much courage now a days to stand up to others, and so much sarcasm or arguements to fend just in a conversation! We are all on the SAME TEAM...and having to deal with this kinda stuff seems like such a waste and disservice!
I don't know...I keep picturing that adorable brown eyed two week old infant smiling at me while I hugged her tear streaked father (he had just had brain surgery to remove a ca tumor...it was sucessful...now this!). They were Hispanic and I don't speak it, so it was even more frustrating and heartbreaking! (he knew some english...but not enough for me to console him other than a look of sympathy and hope, and a hug! He thought I would catch AID's from my hug!!! Poor guy...he now won't touch his infant because he is scared he will make the baby worse...I needed an interpreter, but this was not allowed due to the sensitive nature..had to be a MD or RN to translate...we didn't have one!).
I gave him the number for infection control that he needs to call...and gave him another number for a wonderful hispanic clinic in town that I know about via my hubby (paramedic). He promiced to call...I hope he does...but wow, that was more than most of the others did for him! Such a shame...I am still saddned...
Sorry for the rant...I just feel so sad and can't stop seeing those sweet little eyes smiling at me as if the world was perfect and happy...I don't want to ever take that away! But sometimes...we get to...
Good JOB! I hate having to raise my voice to explain something I know to be correct, and lately I have had my doses too!
Typically all the nurses I have been working with are friendly and helpful...yesterday I had 3 smartbutts that just thought they were all that and a bag of chips!
Now I am agency, and this was a tele floor. I am not able to do tele (yet) and I think that ruffled a few feathers because I got all the non tele patients. But if I didn't show...they would have their tele and mine!
So a patient that I had come to know at my last employer (ALF) for 3 1/2 years came in and all the sudden (and I mean BOOM) he brady'ed at 34 with not a T to be seen then flat.....about 4 beats worth then a sinus...then it repeated! Oh oh!
They got his rhythm back but still brady, and I was asking some questions about bradycardia (I like asking questions!) and asked if he may be hypokalemic? (I am very rusty...haven't done cardiac in over 7 years...so just dusting cobwebs...). They looked at me like I was an idiot and that that was not a concern!
Then they said "just go to your sickies newbie...leave the important stuff to us". I ABOUT LOST IT!
Then...they started cracking jokes about this man who I cared for very much about things like "why doesn't he just follow the light"..."well if he dies he will be more compliant"..."I hope he doesn't code on my shift...oh heck...then one more room open anyway!?"...
I tried to keep my cool...but tears started welling in my eyes. That didn't help...they thought now I was a doofus and a cry baby!
I explained to them to always keep things in check...that I am very well aquainted with this patient and if they had been watching him, they would have noticed I was in there about every 15-30 minutes helping him...along with "MY SICKIES"...And you never know who is listening at the nurses desk!!!! What if I was friend/family????
Then I said "hey..heres is a funny game..who here today had to go with the doc to witness him telling a 28 year old newly married man with a new baby that he is positive for HIV and his baby may have it???? Anyone anyone....stare into the eyes of an infant knowing they may die because daddy made a boo boo??? HMMM??? Okay how about another witness to tell a man that even with dialysis he may only live another year max??? With the family in the room...Anyone???? Okay then....how many of you have to console not one, not two, but three families whos lives have changed forever towards the bad...because the resident I cared for yesterday...got bad news and YOU (pointed to one nurse) were busy and I had to hold their hands as they cried (terminal cancer patient...just found out)....SO if it is 'sickies' or 'death' you wish....then I will gladly give you my patients and never ever return to this floor!!!".
I walked off...another nurse wanted report from me who was just as nasty and I said..."we chart and record our reports...just hit play please...I NEED to go home before someone gets a piece of my mind they will regret!" and I left.
Lucky for me the charge nurse and MD's love me, and basically stood up for me as well. Guess those nurses can chew on that for a while before treating me less than a good nurse!!!!!
BTW..the nurses cracking death jokes....were actually reported to the admin before I even said anything by a physical therapist! Way to go PT!!!!!!!!
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So sorry you had to be put through that. :icon_hug:
VivaLasViejas, ASN, RN
22 Articles; 9,996 Posts
Ya know, the older I get, the more difficult it is for me to tolerate stupidity.
I don't blame you one bit for losing your cool. You're HUMAN. Let yourself off the hook, and if some manager wants to give you grief for it, take it in stride and then move on........a lot of nurses would have done the very same thing, or worse!