Nurses obtaining blood consent

[Zee_RN, BSN, RN]

In the Commonwealth of Pennsylvania, I have always been told that registered nurses are not to obtain informed consent for blood transfusions; it is out of their scope of practice. Only physicians can obtain blood consents.

Does anyone know where I can find documentation of this fact? The internet is NOT being my friend today. :)

Thank you!

[signaturedoc]

http://courts.phila.gov/pdf/opinions/civiltrial/feldman.pdf

on page 3 says : Furthermore, in Pennsylvania, the duty to obtain informed consent runs only

from the physician to the patient, and not from the facility itself"

[Zee_RN, BSN, RN]

Thank you for that link and the document. Unfortunately, I need documentation specifically about blood transfusions; that is speaking of surgical informed consent. There is mention of a complication the plaintiff claimed came from the administration of blood but the consent for the blood was not an issue itself.

So if anyone knows where I can support the claim that registered nurses cannot obtain informed consent for the blood transfusion, I would be grateful. Physicians are maintaining that nurses can get the consent because they are the ones administering the blood -- as opposed to surgery where it is the physician performing the surgery. This runs counter to what I've always held as true and have seen at other facilities. But I can't find the documentation that supports it.

Thank you.

[cebuana_nurse]

As a new nurse in the Commonwealth of Pennsylvania, thank you so much for pointing this out! I have no idea that RN's are not allowed to obtain informed consent regarding BT's. I hope someone out there could help you. Will try to research on this when I get home from work tonight.

[Batman25]

Call your state BON. They will be able to answer the question and provide documentation as needed.

We don't obtain the consent in my facility and I've never been asked to do so. The doctors do it.

[bunsterj]

If you don't obtain a consent for transfusion of blood products, how do you handle when a patient has a substantial drop in H & H in the middle of the night and needs a transfusion?

[Zee_RN, BSN, RN]

In emergency situations, blood can be given without a consent. In nonemergent but middle of the night situations, I've worked in places were (a) the resident -- in a teaching hospital -- was called to obtain consent or (b) the house doctor got consent or © the ER doc got consent (they REALLY hate that). Nurses did NOT get consent, period.

[GM2RN]

I get consent for blood in the ED all the time, but I don't live in PA either. Honestly, it has never occurred to me that nurses anywhwere couldn't get consent for blood.

[MERRYWIDOW46]

I am licensed in 5 jurisdictions, one being the Commonwealth of Pennsylvania. I have NEVER gotten consent for blood, chemo, or surgery. Informed consent is ALWAYS obtained by the MD.

Check with the BON, they know what the RN's scope of practice is. Good Luck.

[GM2RN]

I don't get consent for surgery and we don't do chemo in the ED. But all of the nurses where I work get consent for blood, so it's not just me. I live in Michigan were a nurses scope of practice is not well defined.

[Zee_RN, BSN, RN]

I'll have to call the BON. They've just never been helpful in the very few calls I've made in the past -- downright rude, actually, so I was hoping to avoid that.

Thanks for the replies!

[apocatastasis]

In Texas, we not only do blood consents but also surgery consents on behalf of the physician. If physician writes for blood, you have to get the consent. If the physician orders "consent for surgery," you have to get the consent.

Not how it should be, not comfortable with it, but that's how it is.