RN obtaining Consent for Blood Transfusion & PICC lines

[bhanna02]

Can anyone tell me an exception to the rule that would allow the RN to obtain consent for a Blood Transfusion and insertion of Mid or Picc line. The facility in Michigan that I work at not only allows this , but it is expected of the RN to obtain Consent from families via telephone or bedside of these procedures. Personally , I find it very challenging and confusing , and have spent many evenings after work trying to research the procedures and correct terminology on how to describe the procedures that physicians are suppose to obtain. I have been trained through the nursing program that "A RN IS TO WITNESS, NOT TO OBTAIN CONSENT" . I have challenged the practice of the RN obtaining consent and would love feedback.

[KelRN215, BSN, RN]

At my facility, if PICC lines are placed by the IV RN, he/she is the one who obtains the consent. We require the resident/NP to obtain consent for blood transfusions.

[MunoRN, RN]

Although not always written consent, Nurses are expected to get consent for many things we do, including starting peripheral IV's and giving medications. Our PICC Nurses are the ones who obtain written consent for PICC's at my facility, including explaining the purpose of the procedure, risks, and alternatives. RN's also get consent for blood transfusions, which also includes an explanation of the purpose, alternatives, and risks (TRALI, overload, antibody reaction, etc). I don't know of any rule that says only MD's get consent for everything, the person performing the procedure or administering the treatment are usually the ones who are supposed to get consent, if that person is unable to properly explain the procedure or treatment, then they may need to have someone (such as an MD) help them explain it, but it's not automatically their responsibility.

[platon20]

MunoRN is correct. The person getting consent should be the one doing the procedure.

For blood transfusions, nurses are more qualified to get consent than the MDs are; since giving blood is a nursing, not a physician role. In fact, I've never seen a doctor administer a transfusion except in an emergency situation in a trauma ER or OR.

[NicuGal, MSN, RN]

Where I work, the fellows and NNP's are responsible to get consent for PICCs and blood transfusions.

[MomRN0913]

In my old facility, RN's can obtain consent for Blood transfusions. If there is something they don't understand upon reading a consent, or if they want to speak with a MD first, they most certainly can. PICC line consents are obtained by the MD, usually, as it is done in IR.

[wooh, BSN, RN]

Agree with Muno. Our PICC team nurses get PICC consent. Nurses or MD will get blood consent.

For surgical procedures, I won't do more than witness because that needs to be explained by the surgeon (or someone on their team.)

[psu_213, BSN, RN]

For blood transfusions, nurses are more qualified to get consent than the MDs are;

I totally disagree with that. I recently saw an MD get truly informed consent on a pt getting blood. The pt had many questions and he was able to give statistics and talk about the rates of complications and how they are handled. It was much less comprehensive that what I would have been able to give the pt.

Now if someone had to explain the Alaris pump...