Specialist Nurses Trained to Obtain Informed Consent

Nurse reaction
The specialized nurses had two distinct reactions to the discussion about informed consent. The first was concern—if they were not allowed to obtain informed consent now, had they erred in the past when they were actively doing so? The other, however, was just the opposite—some nurses were vocal about their professional pride and were frustrated that, despite their additional training, they might have this responsibility taken
from them. 

“They didn't want to be disrespectful to their physician colleagues, but these nurses were the ones actually doing the PICC lines,” says Randazzo. “I was a little frustrated myself because I'd been a part of the program before and had my own concerns.” 

Next steps
Since the decision on PICC lines, St. Mary's has added one more procedure for which nurses are allowed to obtain informed consent.

Small-bore feeding tubes are now inserted by nurses without the use of thoroscopy (in the past, this procedure was traditionally done by a radiologist). 

“If we were going to allow nurses to do this for PICC lines, it made sense they could also do this for small-bore feeding tubes,” says Randazzo. “We applied the same logic to the decision.” 

Overall, it has been an eye-opening experience, says Randazzo. “I really appreciated the opportunity to further explore,” she says. “It would have been very easy to say, 'Legal says we can't, so we're done.' I also really appreciated the chance to talk further with someone directly from SIG. We had a really nice conversation. It was great to really be able to talk to someone in real time and bounce ideas off him. His advice was really sound.”

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This article was adapted from one that originally appeared in the September 2010 issue of HCPro's Advisor to the ANCC Magnet Recognition Program®,  [http://www.hcmarketplace.com/prod-7406/HCPros-Resource-Center-for-the-ANCC-Magnet-Recognition-Program.html], an HCPro publication.