consent form....

[Guest guest]

Hospital admission forms most likely do NOT allow any kind of

alterations on them at all. To alter this form is simply not an

option in most cases. However, you can get a copy of this admitting

form PRIOR to the day of admission and read it over carefully. If you

have issues with any of the content, some hospitals allow your

explanation of these issues and your wishes attached in a separate

document submitted by you. However, this separate statement cannot

negate the admitting form you sign -- it may only serve as an

expression of your concerns.

Surgical consent and anesthesiology consent are typically two

additional forms signed AFTER you are admitted and sometime just prior

to the procedure. These forms also serve as a verification that you

are the right patient submitting to the procedure the entire team

believes it is about to perform on you. Both of these forms should be

signed BEFORE an IV is started and BEFORE any medication that would

sedate you is administered. It may be possible for you to ask for and

receive copies of these forms prior to the day of procedure. It is

definitely worth asking about so there are no surprises thrown at you

the day of the procedure.

Both the surgical consent and anesthesiology consent forms are

typically quite broad and also created and/or reviewed by legal staff.

The breadth of these forms often indicate you are signing away all

rights to whatever treatment the doc deems necessary for your

appropriate medical care. These forms often have blank lines on them

and you can indeed -- and SHOULD! -- write in that statement regarding

your desire to have the procedure you've chosen and NOT a hysterectomy

unless necessary to save your life.

While you may also choose to discuss this with your doc and get it in

your medical records prior to the procedure....please understand that

that information (your entire medical chart) doesn't necessarily make

it's way to the surgical and/or anesthesiology team. It is important

to reiterate your wishes with " the team " while signing this consent

form, as well as writing it onto the form. Why? Well, what if your

doc has another emergency and gets called away? What if your doc has

a heart attack in the middle of the procedure? What if your doc has

something else in mind for you...and figures that once you're under it

won't matter because you've signed the consent form for her/him to do

whatever s/he deems necessary? What if your doc has a scheduled

tee-off time and this myo is taking too long? (Hate to say it, but

this did in fact happen to someone I know. One of the surgical nurses

was so upset about it that she actually told the patient precisely

what occurred during surgery so the patient could choose for herself

whether to attempt legal action against the doc.)

When I underwent myomectomy, the surgical time was delayed (and almost

cancelled!) due to issues I had with UCLA's admitting form. It was

NOT the form I had seen and received prior to the day of my procedure,

as the hospital had just rewritten it with new provisions added. I

was a mess that morning with trying to decide what to do and, in the

end and after speaking to my doc, I wrote out a quick letter on blank

paper expressing my disagreement with several items. I had to rewrite

it 3 times because of wording that came off as negating the content of

the admitting form.

When I finally got down to the surgical team...the anesthesiologist

had a resident attempt to put the IV line in. Only, he forgot to get

me to sign the consent form first. That would have been a major

fiasco and would have resulted in cancelling the surgery -- except for

the fact that he was unsuccessful in getting the IV in and the

anesthesiologist in charge had to be called down to do it instead. At

that point a consent form was placed in front of me and we briefly

reiterated a prior discussion we had had over the phone regarding my

history and high tolerance to narcotic pain meds.

After the IV was in...but prior to meds getting started...the surgical

consent was given to me. At that point, the anesthesiologist nearly

came a wee bit unglued. Why? Because it hadn't been signed prior to

his putting in the IV line and he ALMOST started meds without their

having this signature.

With the team present -- but sans my doctor (which upset me terribly

and still does to this day), I signed the surgical consent form only

AFTER I wrote in my wishes for myomectomy only. I wrote it in -- and

also verbalized it to the team of nurses/residents and my spouse who

were all there with me. Politely and firmly. I didn't much care for

the head surgical nurse though, or her attitude over my taking the

time to write this in. Actually, she ticked me off royally. In the

end, I knew I could trust my doc and that was the ONLY thing that

allowed me to continue with the procedure.

I don't have very many kind things to say about the UCLA Medical

Center, how it uses residents AND interns -- and how they don't always

identify themselves appropriately, the surgical nursing staff who has

apparently assisted at primarily hysterectomies, and the short-handed,

undertrained floor nurses who can't seem to listen to a single word

you say and are spread too thin to respond in an appropriate manner to

all the patients assigned to them.

Also, that medical center wouldn't know what a vegetarian was if it

hit them square in the face -- and the phrase " glucose intolerant "

apparently escapes them to no end, as they repeatedly brought me

Novartis juice drinks laden with vitamins, minerals, and a crap-load

of sugar. ~86% sugar, according to the label. Criminy. Vegetable

broth and unsweetened juice is truly not that hard of a concept, is it?

Had it not been for Beth Tiner (from Sans Uteri) and her partner

showing up to care for me after my surgery, I would not have eaten or

drank much of anything during my time in the hospital. In fact, I

highly recommend the hiring of a doula for the time one spends in the

hospital, as Beth was truly my savior in recovering from my myomectomy

and quite the gentle advocate in getting me the simplest of things --

that vegetable broth. A cup of tea. Some unsweetened juice. A wash

cloth. Leg/foot message and assistance with getting up and walking

around. She was also simply good company with a soothing influence

that helped tremendously. If you can afford a post-op doula, it is

absolutely worth considering when entering the hospital for surgery.

It's truly too bad that nurses today are spread too thin and far too

often can't do the job that would put them in the role of caring for

patients in this type of appropriate manner.

One final note...the laws on informed consent are different in every

single state (and vary around the world, as well) in regard to

" sterilization " . To truly know whether or not you are appropriately

protected with how you sign a consent form most likely requires the

oversight of an attorney from your state. Given this support group

has members from every state and all over the world -- the

responsibility for verification on how to apply this information in an

appropriate legal manner per your own situation simply must be each

member's individual responsibility. No single legal review of the

information supplied here would be appropriate for ALL surgical

situations or ALL regions of the U.S./world.

Carla Dionne

Executive Director

National Uterine Fibroids Foundation