MDs should obtain & have patients sign consent

[riley50]

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

[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.

[EmmaG, RN]

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.

[TiredMD]

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

[EmmaG, RN]

TiredMD,:welcome: to allnurses

Your title is surprising. Explain????

ebear

He's a sleepy doc?

I understand what he's saying. I guess the surgery consent wasn't the best of examples, because (hopefully) most patients realize what they're having surgery for and the risks, etc. However, it was common practice in that hospital to have a doc come in for a procedure that was to be done on the floor (placement of central line, I&D, chest tube, even to have ports removed at bedside--- what a damned mess, but I digress...) and for them to tell us to get a consent signed before they (the doc) had even seen the patient. Those I found a bit disconcerting, to say the least.

[All4Seasons]

Only the physician or surgeon gets written consent from a patient in our health care centre. I do remember though,years ago,that we RNs got consent all the time.Now,it seems so ridiculous that we ever did. It's the MD's job to explain all the risks.

[TiredMD]

TiredMD,:welcome: to allnurses

Your title is surprising. Explain????

ebear

I drifted over from SDN. Thought I'd see what all the fuss is about.

[ebear, BSN, RN]

We also have had surgeons post surgeries before seeing the patient to reserve an O.R. space! The O.R. would often be set up, then the doc would say "never mind" after seeing the patient. aarrrgghhhh!! I personally feel that the doc should be charged for these unusable sterile supplies! It also screwed the O.R. schedule royally. The "Honchos" patted the docs on the head, though, which is a whole other story...

[EmmaG, RN]

I drifted over from SDN. Thought I'd see what all the fuss is about.

Welcome. Grab a coffee, put your feet up and stay a while.

[ebear, BSN, RN]

TiredMD,

Hahahahaha!!! Well, stick around! I'm sure you'll find out. You may also get a whole new perspective about nursing and the issues we face. I personally wish more docs would get on this site. I think it would foster more respect and understanding on both parts.