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How Do I Address the Practice of Co-Signing Students' Charts?

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Question:

Dear Nancy,

I have been teaching nursing for many years. The practice of co-signing students' charts, MARs, has been inconsistent. What do I tell new clinical teachers to do?

Loretta

Nancy Brent replies:

Dear Loretta:

The issue of co-signing student's charting and MARs has been the subject of an earlier response, so you may want to check the archives and review that response. However, it is interesting that questions about this are as frequent as they have been lately.

Any new clinical instructor should have a complete orientation, not only to the nursing education program, but also to the clinical site in which he or she will be working with students. It is most probable that the clinical facility has a policy about this very situation, and new instructors need to know the policy and then follow it. If the policy is not agreed to by the nursing education program (after it is reviewed, along with other policies governing students, by the school and legal counsel), then it needs to be negotiated between the school and the clinical facility and changes made that are comfortable for both the clinical facility and the school.

Co-signing of anyone's documentation means that the co-signer has observed the facts and information contained in the entry or on the MAR and attests to its accuracy/truthfulness. If clinical faculty are going to co-sign student entries, these requirements need to be met. If they can't be met, an alternative should be developed acceptable to both the school and the facility that alerts the reader of the co-signed entry or MAR that the two requirements are not being met. As an example, one might co-sign: "Reviewed entry and signed", along with the date.

Cordially,
Nancy