I had a surgeon ask me to witness a consent for a potential surgery patient that was confused agitated and unsure if they wanted a hip pinning. In the docs defense one couldn’t tell the patient was confused all the time only after spending some time talking to the patient, and reading my assessment or nurses notes. The patient thought it was 1980 and knew his hip hurt but was unsure why. He had ambulated with this fracture for five days and came to us from a nursing home after complaining his hip hurt and a Cna noticed his hip swollen. The doc calls me in the room and insists I co-sign for this surgery and I had to say no because I did not feel the patient who was 87 and had dementia could not consent. The dr was angry with me but I felt getting phone consent from the patients POA was a much better option although it might take some time, which it did. The dr has never forgiven me but I still feel I did the right thing. The patient received his surgery the next day and family was present when he came out. I really believe in patients rights to choose.