MDs should obtain & have patients sign consent

Nurses General Nursing

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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 would never get consent for procedures/blood/etc. That is a doctor's job. Our docs know this and would not dream of asking us to get consent. I :heartbeat our docs.

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Specializes in ICU, ER, Hemodialysis.

It is the doctor's job to get the consent. It is the nurse's job to ensure that it is informed consent and not just signed. I have seen docs get the consent and the nurse usually asks if the pt has any questions etc. If the pt, after the doc leaves, states "well the doctor told me that there is zero risk in this cardiac cath and no one ever refuses because the worse that could happen is a little hematoma thingy," the doc MUST be called back and the consent is invalid.

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Specializes in Med-Surg, Wound Care.
It is the nurse's job to ensure that it is informed consent and not just signed.

Nurses, or anyone for that matter, can witness that the patient that is signing the consent is the person listed on the consent.

It is the doctors responsibility to discuss the risks with the patient. Yes, we can intervene if the patients feels uninformed, but the ultimate responsibility, and liability, is the docs.

Unless you are a surgeon who has trained for a specific procedure you legally don't know all the risks, and therefore cannot sign that the "patient is informed". That is not what witnessing is about. We witness that John Doe is who signed John Doe's consent.

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Specializes in ICU, ER, Hemodialysis.
Nurses, or anyone for that matter, can witness that the patient that is signing the consent is the person listed on the consent.

It is the doctors responsibility to discuss the risks with the patient. Yes, we can intervene if the patients feels uninformed, but the ultimate responsibility, and liability, is the docs.

Unless you are a surgeon who has trained for a specific procedure you legally don't know all the risks, and therefore cannot sign that the "patient is informed". That is not what witnessing is about. We witness that John Doe is who signed John Doe's consent.

You are saying the same thing that I am. I am saying that the doctor must give the information, but the nurse is there, as a pt advocate, to ensure that the pt is informed. So if the pt says something that is not true about the procedure, the nurse has an obligation to call the doctor. This is what I mean be ensuring the consent is INFORMED. If a doctor came into the room and said to the pt "here sign this," and I was there. I would NOT sign as a "witness." I did NOT witness informed consent. I witnessed a doctor tell a pt to sign here. And thus, we are back at the idea that the nurse is there to ensure informed consent. We also are ruled by ethics. It would be unethical to let this happen.

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Those of you obtaining consents. Call your Board of Nursing. Find out if it's in your scope of practice.

Get ready to hold the phone away from your ear - they're going to FLIP!

NO ONE CAN GO IN TO OBTAIN INFORMED CONSENT EXCEPT THE PERSON WHO CAN INFORM THE PERSON OF *ALL* RISKS AND ANSWER ANY AND ALL QUESTIONS.

Once, a doc came out and asked me to sign the witness part of the consent. I said sure. I took it and said come with me and retunred to the pt. I said, MR. So & So is this your signature? Do you understand the procedure you signed for and the risks involved?

The pt said, something like - "I signed it yes because the Dr said it was permission to go ahead and do it." I asked, do you understand the procedure and the potential risks as well as benefits? He said "Well....not really."

I told the doc to INFORM the pt and I will witness INFORMED CONSENT.

Long story short - this Dr's wife was admitted about 6 months after that and he SPECIFICALLY asked that I be his wife's nurse ;)

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Our docs obtain consent and we witness. They know better.

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In the gynecology ward that I work in the conset form was already filed in every new patient file that we opened and that serves as a remindeder for the MD. Besided that, everytime I did the nursing admission I check what the patient had understood from the MD explanations and if there is an signed conset form if not I reminded the Md to sign the patient.

I never encountered a situation where the nurse had to sign the paitent on a concet form.

Have a great weekend

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Specializes in Spinal Cord injuries, Emergency+EMS.

rightpondian persepctive -

the provider who is going to do the procedure should take the consent - ideal world

reality a provider who could do the procedure takes the consent

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I temporarily (very short time) worked in Urology as a front desk receptionist and it drove me crazy to give the patients consent forms to sign for procedures. IE patients were being given consent forms to sign without the form being reviewed by a doctor or nurse. It is possible the patient knew why they were coming in for the procedure but many times patients show up for appts just because they got a letter saying they had an appt. I was believed to ask too many questions so I had to let this slide. It is one thing to be told to hand the patient the consent form to read it over and that they will then have it reviewed with them by the doctor and be asked to sign it. It is another to hand it to the patient and say sign here when they are standing at the receptionist desk.

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Specializes in Operating Room.
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

It is like that in my state too...we are to witness consents only. I wouldn't do it even if my hospital told me to. Like Ebear said, you are leaving yourself wide open for legal trouble if you do it-if something goes wrong, do you really think your hospital or the doc will back you? Nope, they'll throw you under the wheels of the bus and won't lose any sleep over it.:no:

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Specializes in NICU.
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 could lose my license for obtaining a consent signature without the MD present. Hmmmm....crabby doc v. license.......crabby doc v. license.....

Between the two of us.....one guess on whose butt I'm more worried about. My only responsibility as far as consents are concerned is witnessing that Ms. Patient is, in fact, Ms. Patient. I absolutely cannot attest to what the MD has discussed or should discuss with the patient.

I would certainly bring this issue to your professional development council, admin, or whomever.

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