MDs should obtain & have patients sign consent

Hi,

I have a problem with our hospital asking us to get a patient to sign a consent for a proceddure . We are constantly having to clarify or call an MD because we are never sure what the patient has been told or if the patient understands. Many patients are Hispanic and need interpreters. We are being told that the forms are not filled out right. Why do we have to do the MDs job? Does anyone feel the same way? Is there anyone who works in a hospital where the MDs obtain consent and have the patient sign the consent. I would appreciate feedback

I have never seen a doc obtain a consent unless the consent was signed in the doc's office, but I do insist that the doc talk with the pt before I go in with the consent. I ask what the pt understands is going to be the procedure and if they have any questions. If what they think the procedure is, is different than what is on the consent, I stop and call the doc. If they have any questions I stop and call the doc.

the physician, and only the physician is to obtain consent. the one doing the mentioned procedure is liable in a court of law for that.

never, ever, ever, ever, ever,ever, ever, ever, obtain consent.

ever.

did i say never too.

NEVER!

you may be the witness ONLY.

[marilynmom, LPN, NP]

All our docs in the PICU do the consenting.

[Jennerizer, ASN, RN]

I have never seen a doctor at my hospital get the consent signed on the floor.

Before getting consent, I will ask the patient if the doctor explained the procedure - risks & benefits. If they have any questions that I am unable to answer or if they have the slightest bit of hesitation - I will tell them to wait to sign the consent until they speak with the doctor again.

[ebear, BSN, RN]

Riley,

N.O. There should be a place for the doc to sign and for you to sign ONLY AS A WITNESS!! The provider performing the procedure is responsible for this. I strongly suggest that administration at your hospital address this policy ASAP. This practice leaves the nurse wide open for legal issues.

ebear

[not now, RN]

Gah, I get so many verbal orders for "Please get consent for XYZ procedure..." Dude, you haven't even been in the room. You weren't even in house when the patient got admitted from the ED, you just looked at the x-ray and called me. Frustrating.

All of our MD's get their own consents. Every once in a blue moon, we might have a situation where we need to get consent (usually for a blood transfusion) but otherwise it's all them. Besides, it's THEIR job to obtain consent. YOUR job is to make sure the consent is signed!

[nyapa, RN]

Docs should have the consent signed. You aren't doing the procedure, you won't be there when its being done, you therefore can't gain informed consent. Its illegal here.

[jmgrn65, RN]

I have never seen a doctor at my hospital get the consent signed on the floor.

Before getting consent, I will ask the patient if the doctor explained the procedure - risks & benefits. If they have any questions that I am unable to answer or if they have the slightest bit of hesitation - I will tell them to wait to sign the consent until they speak with the doctor again.

THis what occurs at my hospital. I don't have them sign unless the Doctor has spoken to them first. Usually if a doctor is asking for the consent to be signed he has spoken to them, note i said usually.

[BittyBabyGrower, MSN, RN]

That is a huge no no. You all that are getting consent need to go to your risk management and address this. Only the doc or service doing the procedure is to get permits! In some institutions advanced practice nurses can get permits and have the attending co sign, but staff nurses should never, ever get informed consent.

I have never seen docs get their own consents at any job I have had all over the country. The nurses take the consent in, tell the pt "here is the consent for your procedure, read it over and I'll back when you are ready to sign it". Pt reads, pt signs, nurse witnesses. If pt says he doesn't have a clue what is going on, doc is called and told pt won't be signing consent until doc comes back in to speak with him. And like I said, this has been everywhere I've ever been over many years.

[BrnEyedGirl, BSN, MSN, RN, APRN]

I've never seen a doc get his own consent. He writes the order for the consent, exactly what he wants the consent to say,.the RN fills out the paper work,..takes the consent to the pt, makes sure the pt has spoken with the doc and has no further questions,.pt signs and dates the RN signs as witness,.there's not even a place for the doc to sign! I do not however have the consent signed before the doc has spoken with the pt, as our consent plainly states that "Dr Whomever has reviewed the details of the procedure, risks and benefits....etc". I agree that sometimes this is a real pain,.especially in ER where the procedures vary and things happen very quickly,.often times pt's have questions that I shouldn't be answering. When that happens I call the doc or leave the consent unsigned and have the doc speak with the pt again in OR holding.

[leslymill]

Back in the 1980's it was the nurses job to read and get consent forms signed. There was a sudden and abrupt halt to this for legal reasons. If nurses are still getting consents signed they are behind the times and only witnessing the signature not an informed consent which is the doctors job and scope of practice.

[ebear, BSN, RN]

..."especially in E.R. where procedures vary, and things happen very quickly"

That is exactly the problem; however, in life threatening emergencies, the consent can be waived to save to pt's. life. The physician takes FULL responsibility in this situation.

Back in the 1980's it was the nurses job to read and get consent forms signed. There was a sudden and abrupt halt to this for legal reasons. If nurses are still getting consents signed they are behind the times and only witnessing the signature not an informed consent which is the doctors job and scope of practice.

I agree. Our city has two hospitals (well, besides a VA); I've worked in both. In one, ONLY the docs get consents signed, always. In the other hospital, it is the nurse's responsibility to do so, and often the doc will write "get consent for surgery" without even specifying the procedure to be consented. The nurses are expected to look up the the surgery schedule and copy down whatever is listed as the procedure. Only one surgeon there does his own consents.

I agree. Our city has two hospitals (well, besides a VA); I've worked in both. In one, ONLY the docs get consents signed, always. In the other hospital, it is the nurse's responsibility to do so, and often the doc will write "get consent for surgery" without even specifying the procedure to be consented. The nurses are expected to look up the the surgery schedule and copy down whatever is listed as the procedure. Only one surgeon there does his own consents.

There are two different conversations going on here:

(1) Physicians must always obtain informed consent, in all cases, without exception. However, this does not mean that they have to get the piece of paper signed. They simply must explain the risks, benefits, and possible alternatives to the procedure, and ensure that the patient understands and agrees.

(2) Getting the piece of paper signed can be done by anyone: MD, nurse, tech, janitor, whoever. It really makes no difference, as long as the patient's signature, physician's signature, and witness signature are on it.

At my institution, physicians fill out the paper (when anyone can find one). Nurses typically go into the room at their convenience, ensure that the physician has fully explained the procedure and that the patient doesn't have any other questions, then gets the paper signed.

[ebear, BSN, RN]

TiredMD,:welcome: to allnurses

Your title is surprising. Explain????

ebear