Informed consent is a very big safety issue.
It came up recently when two doctors, a surgeon and an anesthesiologist consented a family member over the phone for surgery on a patient, who could not consent for himself.
It is a good thing that I was listening in to the call, unbeknownst to the doctors.
Because telephone consent cannot be obtained by the surgeon of record.
BECAUSE of potential bias on the surgeon’s part.
After I reamed them out, the anesthesiologist had more questions.
Can two doctor’s ever sign consent for surgery?
Yes, in a truly dire emergency where if the family was consulted/asked/found it would lead to the patient’s death from waiting. The signer cannot be the surgeon of record.
Why does not have to be a nurse who consents over the phone?
Um, because the bias issue.
What exactly is the nurse co-signing?
The nurse, that would be me, is signing acknowledgement the patient’s signature, of the fact that the surgeon and the patient have discussed the surgical procedure, all risks and benefits and alternatives. There is a lot of other language in a consent, such as who is allowed in the room, whether or not to give blood products, whether there can be photography. Not the actual informing part of the consent, just the acknowledgement of it.
He had further questions. I wonder if he was testing my own knowledge.
I referred him to the state statute that explains the consent laws in our state, such as who can sign consent.
Prat.
Dispatches from the Evening Shift 