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Difficulty: MediumClient Rights and Advocacy

An attending surgeon hands a surgical consent form to the practical nurse (PN) and states, "I am needed in the emergency department right now. Please explain the risks of the bowel resection to the client and get their signature." A friend is currently visiting in the client's room. Which of the following actions should the PN take to protect the client's rights and maintain safe practice? Select all that apply.

  1. Inform the surgeon that the provider who performs the procedure must be the one to explain the surgical risks.Answer
  2. Ask the visiting friend to step out of the room before initiating any clinical discussions with the client.Answer
  3. C
    Read the surgical risks directly from the provider's preoperative notes to the client and then obtain the signature.
  4. D
    Discuss the client's medical diagnosis and the need for surgery while the friend is present to ensure the client has emotional support.
  5. E
    Accept the surgeon's directive to expedite care because the situation involves a provider emergency in another department.

Answer

The correct actions are to inform the surgeon that explaining surgical risks is the provider's responsibility, and to ask the visiting friend to step out of the room before having any clinical discussions.
The correct actions uphold the practical nurse's scope of practice and protect the client's right to privacy. The healthcare provider performing the procedure is legally responsible for explaining the risks, benefits, and alternatives. The nurse's role is strictly to witness the signature. Additionally, asking the visitor to step out ensures the client's medical information is kept confidential, upholding HIPAA regulations.

Step-by-Step Solution

1
Analyze the provider's request against the practical nurse's scope of practice.
The PN identifies that explaining surgical risks is solely the provider's responsibility.
The nurse's role in informed consent is limited to witnessing the client's signature only after the provider has fully educated the client.
2
Evaluate the environment for potential privacy violations.
The presence of a friend in the room poses a risk to client confidentiality.
HIPAA and client rights regulations require medical information to be discussed in private unless the client explicitly consents to others hearing it.
3
Select the interventions that uphold both scope of practice and confidentiality.
The PN declines the out-of-scope task and secures the room's privacy.
Client advocacy requires protecting both the client's legal right to proper informed consent and their right to privacy.

Key Concept

Informed Consent and Confidentiality
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Topics

Client Rights and Advocacy

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