Is a nurse responsible for obtaining the signature on consent if not in room when procedure was explained?

Question

If a nurse is asked to obtain signatures on an Informed Consent form for an LP (Lumbar Puncture) for example, is it the nurses responsibility to obtain the signature or the MD who explained the procedures responsibility?

Answer 1

Where I work, we need the MD sig, the patient's sig, and a witness.  The witness's job isn't to explain the procedure, but to witness that the patient did, indeed, sign the form, and has read it and had questions answered.

Sometimes, I'll see a patient and explain everything I need to explain.  If there is no nurse there, I can't get the patient to sign, because then the signature is unwitnessed.  (Nurses are very busy people)

I'll write an order in the chart for the nurse to get the patient to sign, and then s/he can witness the signature.  It is the nurse's responsibility to make sure the patient acknowledges reading and understanding the form in question, if they choose to follow the order.

If they don't, we'll get it signed before the procedure.  It's just nice when the paperwork is taken care of ahead of time.

Answer 2

why does it matter who gets it ?? if you consent then sign if you don't don't why does the nurse have to be there when your told ??

Answer 3

I don't know about every state, but where I live nurses can't get consent because they are not performing the procedure

Answer 4

The medical physician who explains the proceedure along with the associated risks to the patient, is always responsible.

From my experience however, the patients actual signature may be absent from the bottom of the form at the time that they come into the operating theatre/proceedure room despite having formally had this interaction with the MD responsible for the proceedure.

This can happen for many, many reasons and is not uncommon.

Occasionally a nurse will be delegated via a medical physician to collect the patients signature, as may an anaesthetist.

An element of trust often exists between medical staff, and I guess if you were the nurse requested to get the patients signature on the consent form, it is up to you whether you agree to do this or not.

You would have to be certain of the following-

*that the doctor/medical physician conducting the proceedure explained the proceedure and all associated risks to patient AND that the patient understood/had the capacity to comprehend what was going to happen to them.

They should ALWAYS have the opportunity to ask questions.

The reality of what occurs in busy hospitals or clinics can sometimes differ due to the education and skill level of the practising staff, nevertheless-in your circumstance, the MD conducting the LP has the responsibility to GAIN informed consent, which yes, does include obtaining the patients signature.

All too often as nurses we find ourselves in this highly conflictial position. Although it is not right, I have been in the position where a signature on a consent form is missing & have depending on whom I'm working with, gained it from the patient, once I have assured that the proceedure has been outlined to them. At the same time, I have cancelled lists because this hasn't been done.

Patient safety must always come first, so as a nurse it is up to you to assess the sitaution. Also as you will begin to understand, there often are no blanket rules which apply in these types of scenarios.

Hope this helps a little!

Answer 5

The witness is only attesting that the patient is indeed the person signing the form. The witness is not certifying the nature of the counselling, or even the patient's understanding.

Answer 6

WE are no longer allowed to witness or obtain consents. Its is the MD's responsibility.

Source: RN