RN signing consent for OR procedures

[IngyRN]

Hi all,

Several things are bothering me about my new job but right now I will only mention 2.

1st- It is expected that the RN gets consent from pt/family members for OR or other procedures-stating that the physician explained all the risks/benefits. Shouldnt it be the provider who will be performing the procedure to get consent. Is this within our scope of practice?? My biggest problem is that many MD's dont even explain the procedure to the the pt & yet my name is expected to go on this LEGAL document.

2nd- I was always taught that it is not within our scope to give diagnostic results to pt or family. RN's give this information to the pt before the MD has d/w pt.

So am I being too old school or is this the norm??

[suzanne4, RN]

Your signature on the consent means only that you have witnessed the signature. And you can write that as well if it makes you feel more comfortable.

It is the responsibility of the surgeon or provider to have provided information to the patient and discuss everything with them beforehand. If they have not, then the patient has every right not to sign it until they have had their questions answered.

Results are normally given the patient by the physician or the provider. It is not something that you are required of obligated to do or should be doing.

Hope that this helps clear up things for you.

[Christen, ANP]

When getting a patient to sign consent say something like, "This consent form states that your doctor, ______, has discussed this procedure with you name the procedure and gone over any risks or potential complications and outcomes. Please sign here in order to give us permission to perform this procedure."

In terms of diagnostics, when I was a new grad I didn't feel comfortable giving out any sort of diagnostic information. Now it's more of a case-by-case situation. If a patient asks about labs, I tell them. If they ask what the cxr showed that morning, if a report is available I will say, well, the report says this, but you should discuss this with your MD when he comes in if you want further information. Again, this is case-by-case and is a nursing judgement sort of thing.

[Dolce, RN]

It is the physicians duty to obtain consent, we as nurses simply witness that. I carefully read the consent to the patient and explain any "medicalize" and then ask them if that was what their physician explained to them. If they agree you may have them sign the consent. Your signature on this document simply means that you witnessed their signature. It is also important that you are ensuring they are able to sign consent. Obviously a 12-year-old cannot sign their own consent, neither can some people suffering from dementia or severe mental retardation.

Your second question is a somewhat gray area. There are many things that we explain to patients before the physicians. For example, many patients after a colonoscopy will ask the results. If there were no biopsies/polyps/diverticuli, etc and the endoscopy nurse informed me that it was a normal colon I will relay that to the patient. Often patients don't see their physician right after the procedure and are curious if their colon was normal. There are many other examples like this where patients receive information from their nurse. In fact, sometimes if the surgeon is unable to find the family members after surgery he will tell us, "Tell the family blah, blah, blah." We are not diagnosing--just simply relaying information from the physician. There is a big difference between saying, "Your BNP is elevated" and "You have CHF."

[Elvish, BSN, DNP, RN, NP]

At my job I witness parents sign consents for circumcision of their baby boys. Our consent clearly states that I am witnessing their signature, not that I have discussed anything about the procedure with them. If they have any questions or are in any way uncomfortable with having the procedure done, I stop right there and do not have them sign anything until the doc has answered their questions. Funny thing - after a few of these phone calls, the docs have starting being more thorough the first time around.

[Dolce, RN]

If they have any questions or are in any way uncomfortable with having the procedure done, I stop right there and do not have them sign anything until the doc has answered their questions. Funny thing - after a few of these phone calls, the docs have starting being more thorough the first time around.

Thats for sure. I had a doc get steamed at me once because a mom had more questions before she signed consent and he had to actually physically walk over to the unit and talk to her.

[RazorbackRN, BSN, RN]

Whenever we need consent, it is our physicians who obtain it. We hand the doc the consent form, they discuss it with the parents in the presence of an RN. The physician then tells the parent where they need to sign and what they are signing. As the witnessing RN, we verify that they understood what was being said and that all questions have been answered, then we sign the witness blank. The same procedure applies if it is a telephone consent (we get on the phone after listening to the doctor explain).

We never take the form in the room after the doc has left and get the parents signature. It is always done in the presence of a physician.