ILMRN

Thanks for the feedback. Normally as the patient’s primary nurse, I would’ve checked this before moving to the OR. However, it was a rush type of thing since it was unscheduled and the only time slot the surgeon had. Since there were no parents or surgeon present and they were already calling for me to bring the patient, I had to pack up and go anyway. Had the patient not become unstable after we arrived, I would’ve likely been able to address the fact the consent had no witnesses. I know everyone should be double-checking these things, but my priority had to shift being that me and the RT were the only people available who knew NRP well enough to stabilize the baby.

Thank you all for your answers. I don’t want to make trouble, but I’d never want to put my integrity or license on the line.

If you didn’t actually see a consent happen, do you feel comfortable signing as a witness? Say it’s assumed the parents consented based on how they acted after the procedure, but you had no contact with them prior to the (non-emergent) surgery. The surgeon has the consent filled out, but is missing a witness. I wasn’t present when he got consent from the parents, but because it was technically my patient my charge RN says I need to sign. Shouldn’t they have caught this during a time-out in the OR?

This may be more details than necessary, but I’m just frustrated after a crazy day and am wondering if anyone has gone through a similar experience. A baby I was caring for unexpectedly needed to have a Broviac placed as the UVC needed to be removed (low lying) and multiple PICC attempts had failed. The parents live 2.5 hrs away and weren’t present at the time. The OR called and wanted the baby right then, so I packed the baby up and headed to preop with my RT. As soon as I got there, the baby crumped and needed intubating (28 weeker on CPAP that was exhausted from the move and PICC attempts-not shocking). Mom and dad were on their way but didn’t make it there before we had to move to the OR and intubate. The UVC was still functioning so the surgery itself was not an emergency, but had to be done right away because of the surgeon’s availability. Apparently the parents knew this would be a possibility, but the surgeon and anesthesiologist hadn’t gotten consent yet as they were waiting to see if the PICC attempts would be successful. All this to say, I was not present when the surgeon or anesthesiologist actually called to get phone consent. They called after we had to move from preop to the OR so we could actually go ahead and intubate. I assumed that when the time out was done in the OR, someone should have caught that no one witnessed the consent. In my hospital, policy is that phone consent requires two witnesses. Although the parents showed up after the surgery and acted understanding, I never saw or heard from them prior to the surgery as I was in the OR stabilizing the baby. Now my charge nurse wants me to sign (and back-time the date/time) as a witness so the consent is complete in the chart. Am I wrong for refusing to sign this? I feel that signing as a witness to something I did not actually witness questions my integrity and puts my license in jeopardy. I did not witness any consent and I did not even perform the time out, so why am I having to deal with this now? Why is it my problem and not the surgeon’s? If you made it this far, thanks for reading! Any input is helpful!