Is it legal for the operating room circulator to sign as a witness on the surgical consent for the patient for whom he or she will be the circulating nurse?
Dear Nancy replies:
As you know, when one witnesses a signature on a consent form, that is all the nurse or other individual is doing: watching the patient sign his or her name to the document. The nurse is not obtaining the informed consent of the patient for the procedure in question unless, of course, the nurse is performing a nursing procedure and consent is needed.
There really is no excuse for a patient to come to the OR without the consent form being signed and witnessed. This should be done prior to the patient being released from the floor to the OR. Indeed, it should be policy if the consent form is not signed and witnessed, the patient cannot be transferred to the OR.
When a patient comes to the OR with an incomplete document, it places the OR nursing staff in a difficult position. Because a witness is needed, the circulating or another nurse may witness the signature so there is not a delay in the surgery. This is not the best solution, though. Better to have a policy everyone adheres to so there are never questions about what transpired prior to surgery.
Questions that could arise include: Did the patient feel pressure to sign the form because he was already in the OR? Did the patient obtain the necessary information he needed from the person doing the procedure so his consent was fully informed, but he just didn’t sign the form? Was the patient assessed for any questions he had about the procedure before signing it and the signature being witnessed?