A client who is scheduled for a cholecystectomy later today tells the practical nurse (PN), 'I am still confused about what they are actually removing.' The PN has the consent documentation in hand for the client to sign. Arrange the following nursing actions in the correct sequence from first to last.
- 1Withhold the consent documentation to prevent the client from signing it prematurely.
- 2Contact the operating surgeon to report the client's knowledge deficit.
- 3Wait while the surgeon provides further education about the cholecystectomy.
- 4Act as a witness to the client's voluntary signature on the document.
Answer
The correct sequence is to first withhold the consent document, then contact the surgeon regarding the knowledge deficit, allow the surgeon to educate the client, and finally witness the signature.
The correct sequence ensures the client's legal rights and safety are protected. When a client expresses a lack of understanding, the immediate priority is to stop them from signing a legally binding document. Because explaining a surgical procedure is outside the PN's scope of practice, the nurse must then notify the healthcare provider. The provider must return to explain the procedure and answer the client's questions. Only after the client's understanding is confirmed can the PN ethically and legally witness the voluntary signature on the informed consent form.
Step-by-Step Solution
Key Concept
Informed Consent and the Practical Nurse Scope of Practice