A practical nurse is caring for an alert and oriented older adult client whose discharge is scheduled for later in the day. The client's adult child, who is the designated healthcare proxy, arrives and states, "I am taking my parent to a memory care facility right now." The client privately tells the nurse, "I do not want to go there. I live independently and I want to go back to my own house." Which of the following is the most appropriate action for the practical nurse to take?
- Notify the charge nurse and the facility social worker immediately about the client's stated wishes.Answer
- BExplain to the client that the designated healthcare proxy has the legal authority to make the final discharge decision.
- CCoordinate the cancellation of the memory care transfer and independently arrange for home health services.
- DAsk the client's roommate if the client had previously expressed a desire to return home instead of the facility.
Answer
Notify the charge nurse and the facility social worker immediately about the client's stated wishes.
The correct action is to notify the interdisciplinary team (charge nurse and social worker). A designated healthcare proxy only makes medical decisions when the client is deemed legally incompetent or unable to make their own decisions. Because this client is alert and oriented, they retain the right to self-determination regarding their discharge location. The practical nurse advocates for the client by ensuring the appropriate team members are aware of this conflict so it can be legally and safely resolved.
Step-by-Step Solution
Key Concept
Client Rights, Self-Determination, and Advocacy