📋 Management of Care · Lesson 1 of 7 · 6 min
Whose Job Is Informed Consent? (Not Yours)
🖊️ A surgeon asks you to 'get the consent signed.' The client asks you what the surgery involves. Say the wrong thing here and you have just practiced medicine without a license, on the exam and in real life.
💡 Key idea
The provider informs; the nurse witnesses and advocates. If understanding is in doubt, stop and call the provider before the client signs.
🧠 Why it matters
INFORMED CONSENT requires three things: the client is COMPETENT and over the age of majority (or an emancipated minor), the decision is VOLUNTARY, and the client has been INFORMED of the procedure, its risks, benefits and alternatives, including refusal. Explaining the procedure, risks and alternatives is the PROVIDER'S responsibility, the person performing the procedure. The NURSE'S role is to WITNESS the signature, confirm the client is competent and signing voluntarily, and verify the client understands. If the client has questions the nurse cannot answer within the nursing scope, or seems confused about what was explained, the nurse stops the process and notifies the provider. Sedated clients cannot consent, so consent is obtained before pre-medication. In a true emergency with no decision-maker available, implied consent allows life-saving treatment. Clients may withdraw consent at any time, even after signing.
🏥 In the real world
💤 A pre-op nurse gives the ordered midazolam, then realizes the consent is unsigned. The surgeon arrives and asks the drowsy client to sign. The nurse refuses to witness, correctly: a sedated client cannot give valid consent. The case is delayed. Annoying for the schedule, but the alternative is battery.
📌 Takeaways
- Competent, voluntary, informed: all three or no valid consent
- The provider explains; the nurse witnesses and checks understanding
- No consent after sedation; clients can withdraw consent any time
📖 Terms in this lesson
Informed consent: A competent client's voluntary agreement to a procedure after the provider explains its risks, benefits and alternatives.
✅ Test yourself
A client scheduled for a colonoscopy asks the nurse, 'What are the risks of this procedure?' The consent is not yet signed. What should the nurse do?
- Tell the client not to worry
- Notify the provider before the client signs
- Have the client sign and then ask the provider to visit
- Explain the risks using the hospital brochure
Answer: B · Notify the provider before the client signs
Explaining risks is the provider's duty. The nurse ensures the client is informed before signing by involving the provider.
Which client can legally provide informed consent?
- A 17-year-old who is married and lives independently
- A client with an active court-appointed guardian
- A 16-year-old living with parents
- A client who received IV lorazepam 20 minutes ago
Answer: A · A 17-year-old who is married and lives independently
Marriage, military service or living independently can emancipate a minor. Sedated clients and clients with guardians cannot consent for themselves.
In the operating room holding area, a client says, 'I've changed my mind. I don't want the surgery.' What is the nurse's responsibility?
- Explain that cancelling would be a waste of resources
- Stop the process and notify the surgeon
- Ask the family to convince the client to go ahead
- Proceed, because the consent was already signed
Answer: B · Stop the process and notify the surgeon
Consent is revocable. The nurse advocates for the client's decision and informs the surgical team.
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More in Management of Care
- 1Whose Job Is Informed Consent? (Not Yours)
- 2HIPAA in the Elevator, the Hallway and the Group Chat
- 3Living Wills, Proxies and the DNR That Is Not 'Do Not Treat'
- 4Six Ethical Principles the Exam Names by Name
- 5Negligence, Malpractice, Assault, Battery, False Imprisonment
- 6SBAR, Handoffs and When to Climb the Chain of Command
- 7Incident Reports, Root Causes and Who to Refer To