Consents Part 1- signatures

Oops, here I go again with the series. This time will be discussing consents.

A patient’s signature on a surgical consent indicates that they agree with the surgery that is going to be performed. That they agree that Surgeon X is going to perform the surgery.

A nurse’s co-signature on a surgical consent indicates that the patient was witnessed signing the consent.

That’s it.

The conversation about what all the words in the procedure mean should have happened between the patient and the surgeon. That is what makes it informed consent.

The surgeon INFORMS the patient about the risks, benefits, and alternatives to the surgical procedure. The surgeon also has to note this in the history and physical of the patient.

Yes, sometimes the PA or NP fills out the H&P, or their partner if they have one. But someone has to have a conversation, detailed in the notes or the H&P, with the patient.

And the ONLY time there is no informed consent is the true life or death emergency.

For example, the patient will die without treatment.

To recap, the patient who is named at the top of the surgical consent form agrees with the procedure listed on the surgical consent form to be performed by the surgeon listed on the surgical consent form (or their practice partner). The nurse who watched as the patient signed the consent also signed as the witnessing nurse.

In the hospital where I work, all three signatures must be present for the consent to be considered complete. If one of the signatures is missing, the surgery cannot be started until all three signatures are present.

Consents are a big deal and we in the operating room spend a lot of time making sure they are correct. These are the three absolute signatures on the consent for surgery to proceed.

But, but, but…

What if the patient is not able to sign their own consent?

What if the patient is not alert and oriented enough to sign their own consent?

What if the patient is under 18 and not emancipated?

Those questions will be answered as the series continues.