Obtaining informed consent
Nurses in my facility are being asked to witness signatures from clients (or their substitute decision-makers) for the purpose of obtaining consent for a procedure. The physicians tell us that we are only responsible for witnessing the signature and not for getting the informed consent. Is this true or are we accountable for determining that an informed consent was obtained?
The College believes that whoever requires the informed consent should also obtain the client’s signature. Some employers, however, require nurses to obtain the client's signature on consent forms as part of their role.
The most important part of the consent process is informing the client. A client's signature is meaningless if the client is not informed. Nurses are often told that when they obtain a client signature on a consent form, they are only witnessing the signature and not verifying that informed consent was obtained. However, nurses have ethical and professional accountabilities to ensure the client is fully informed and capable of giving consent.
Nurses should ask clients if they understand what it is they are consenting to and if their questions about the proposed treatment have been answered. In any situation where the nurse believes the client has less than a full understanding of the proposed treatment, the nurse must act as a client advocate to ensure that the client receives the necessary information.
Nurses' accountabilities exist regardless of agency policies stating the role of the witness. If the witness is acting in a "clerical capacity" only, then perhaps support staff, such as a ward clerk, can carry out this function.