A client is in the preoperative holding area of an ambulatory surgery center preparing for an elective procedure. The surgeon has just left the cubicle after discussing the surgery. As the practical nurse (PN) approaches to finalize the preoperative checklist and witness the informed consent, the client states, "The doctor talked to me, but I am still not entirely sure what happens if I choose not to have this done." Which of the following actions are legally and ethically appropriate for the PN to take? Select all that apply.
- Delay witnessing the client's signature on the informed consent document until their questions are fully resolved.Answer
- Contact the surgeon to return to the bedside to clarify the medical implications of refusing the surgical intervention.Answer
- CAccept a delegated task from the registered nurse (RN) to verbally review the procedural risks with the client prior to obtaining the signature.
- Document the client's expressed uncertainty and the specific interventions taken by the nursing staff to address the concern.Answer
- EExplain the potential consequences of refusing the procedure based on the preoperative notes in the client's medical record.
Answer
The appropriate actions are to delay witnessing the signature, contact the surgeon to return to the bedside, and document the client's uncertainty alongside the nursing interventions taken.
Informed consent requires the client to fully understand the procedure, its risks, benefits, and the consequences of refusal before signing the legal document. When a client expresses uncertainty, the consent is not truly informed. The practical nurse's role is to act as a client advocate by delaying the signature, notifying the provider (surgeon) to return and clarify the medical information, and documenting the client's concerns and the nursing actions taken. The nurse serves only as a witness to the signature and must verify that the client is voluntarily agreeing with a clear and complete understanding.
Step-by-Step Solution
Key Concept
The practical nurse's role in informed consent is limited to witnessing the signature, verifying voluntary agreement, and advocating for the client if they express knowledge deficits.