A client hospitalized with pneumonia is scheduled for a thoracentesis. As the practical nurse (PN) brings in the preparatory supplies, the client states, 'I changed my mind. I do not want anyone sticking a needle in my back.' In which order should the PN perform the following actions to advocate for this client? Arrange the actions in the correct sequence from first to last.
- 1Stop the procedure preparation and acknowledge the client's right to decline.
- 2Ask the client to share their specific concerns or reasons for refusing.
- 3Notify the healthcare provider and the supervising registered nurse about the refusal.
- 4Document the client's statement, the refusal, and the notifications in the health record.
Answer
The correct sequence is to first stop the preparation, then explore the client's concerns, followed by notifying the healthcare provider and RN, and finally documenting the entire event.
When a client refuses a procedure, the PN's first action is to respect their autonomy by immediately stopping the intervention. Next, the PN should therapeutically explore the reasons for refusal to gather data. This information is then reported to the RN and healthcare provider, who are legally responsible for explaining the medical consequences of the refusal. Finally, objective documentation of the entire event provides a legal record of the client's choice and the healthcare team's actions.
Step-by-Step Solution
Key Concept
Client advocacy during treatment refusal involves immediately respecting autonomy, exploring concerns, communicating with the healthcare team, and completing accurate documentation.