A practical nurse (PN) is preparing to administer a scheduled investigational medication to a client participating in a clinical trial. The client refuses the dose, stating, "I changed my mind. I do not want to be in this study anymore, but I am terrified the hospital will stop treating my cancer if I quit." In which order should the PN perform the following actions to advocate for this client's rights? Arrange the actions in the correct chronological sequence.
- 1Withhold the administration of the investigational medication.
- 2Reassure the client that withdrawing from the study will not compromise their standard medical care.
- 3Notify the charge nurse and the healthcare provider of the client's decision.
- 4Document the client's exact statements and the refusal in the health record.
Answer
The correct sequence is to first withhold the medication, then reassure the client, next notify the healthcare team, and finally document the event.
The nursing process and prioritization frameworks dictate that immediate physical safety (withholding unwanted treatment) comes first. This is followed by immediate psychosocial intervention (reassuring a terrified client). Once the client is stabilized physically and emotionally, the nurse communicates with the team (chain of command) to update the care plan. Finally, the nurse documents the events as a retrospective administrative task.
Step-by-Step Solution
Key Concept
Client right to refuse treatment and withdraw informed consent without penalty