Nurse Kim: Dr. Freeburn? Well this is Helen Kim on ward 3B. I’ve got a problem here and I don’t know who else to call. Can I tell you about it?
Dr. Freeburn: What do you want? I was just getting to sleep after 24 hours on call. Isn’t there anybody else?
Nurse Kim: I’m so sorry to wake you up. But let me explain. We have a patient here, Jack McTeer, who has a gangrenous leg and needs an amputation. The surgeons just found a slot for him, and called to get him ready. Dr. Edelman is his hospitalist, but he’s in his office, and the surgeons are in the OR with another patient.
Dr. Freeburn: So what do you need from me? A physical, check labs, or what?
Nurse Kim: He has no signed consent form. I think it was just missed between shifts. I just came on and discovered it was missing as I was getting him ready.
Dr. Freeburn: Well, that should be straightforward. I’ll just …
Nurse Kim: No, no, it’s not. He has been given pre-op sedation ordered by the surgeons, and in the past he has wavered about consent. I’m not sure he will be truly competent just now.
Dr. Freeburn: Good grief! I hate these messes. Okay, I guess I have no choice. I’ll come up and we can try to sort it out. Give me a few minutes.
Nurse Kim: Thanks, but better come as soon as you can, so he won’t be asleep.
Dr. Freeburn: Okay. I’ll hurry.