What is the correct procedure when obtaining informed consent for a surgical procedure?

Informed consent has specific legal requirements. Elements of valid informed consent: (1) The client must be COMPETENT (legal capacity to consent — adults presumed competent unless determined otherwise; minors generally cannot consent, parent/guardian does; cognitively impaired adults may have surrogate decision-makers); (2) Disclosure of: nature of procedure, expected benefits, risks (common and serious), alternatives (including no treatment), expected outcomes with and without treatment; (3) UNDERSTANDING — client comprehends the information (use teach-back, interpreters when needed, written materials); (4) VOLUNTARY — no coercion or undue pressure; (5) WRITTEN AGREEMENT — signed consent form. Responsibilities: PHYSICIAN/SURGEON/INDEPENDENT PROVIDER is responsible for the actual explanation of the procedure, risks, benefits, alternatives. NURSE'S ROLE: (a) witness the signature (confirming the person signing is the client and is signing voluntarily); (b) confirm client understands what was explained (if not, contact the provider to re-explain — not the nurse's role to explain the procedure itself); (c) ensure consent is on chart before procedure; (d) advocate for the client; (e) document. Special situations: emergencies (implied consent for life-saving treatment of unconscious adult); minors (parental consent except for specific exceptions — emancipated minors, mature minor doctrine in some states, certain treatments like STIs, contraception, pregnancy, mental health in many states); incompetent adults (durable power of attorney for healthcare, guardian, or surrogate per state law); Jehovah's Witness blood refusals (respected for adults; courts may override for minors); blood products may require separate consent.