An adult client is preparing for a scheduled colonoscopy at an outpatient endoscopy center. The gastroenterologist has completed the pre-procedure consultation, discussed the risks of bleeding and perforation, and returned to the procedure room. The registered nurse delegates the practical nurse to obtain the client's signature on the consent document. As the practical nurse hands the pen to the client, the client states, "I know the doctor explained everything, but I am suddenly terrified about the risk of my bowel tearing. Can you explain how often that actually happens?" Which action by the practical nurse is most appropriate?
- AOffer therapeutic reassurance that a bowel perforation is highly unlikely and encourage the client to proceed with signing.
- BRead the standardized complication rates provided in the facility's educational pamphlet to directly answer the client's question.
- Withhold the consent document and immediately notify the registered nurse or gastroenterologist about the client's inquiry.Answer
- DWitness the client's signature since the provider already completed the required education, then document the client's question in the chart.
Answer
The most appropriate action is to withhold the consent document and immediately notify the registered nurse or gastroenterologist about the client's inquiry.
The role of the practical nurse during the informed consent process is strictly limited to advocating for the client, witnessing the signature, and verifying that the client is acting voluntarily. If a client expresses hesitation or asks specific questions about procedural risks just before signing, they have not achieved informed consent. The practical nurse must not answer these questions or explain the risks, as providing medical clarification on surgical complications is outside their scope of practice. Instead, the nurse must withhold the form and immediately notify the registered nurse or provider so the provider can return and address the client's concerns directly.
Step-by-Step Solution
Key Concept
Practical Nurse Role in Informed Consent