A practical nurse (PN) at a rehabilitation center is caring for a client scheduled for a peripherally inserted central catheter (PICC) placement. The client has already signed the informed consent document but suddenly tells the PN, 'I have decided not to get the line placed.' In what order should the PN perform the following actions? Arrange the steps from first to last.
- 1Cease any ongoing preparations for the catheter insertion.
- 2Inquire about the client's reasons for deciding against the procedure.
- 3Contact the healthcare provider to report the client's change in decision.
- 4Record the client's verbal refusal and the provider notification in the chart.
Answer
The correct sequence is to first cease preparations, then inquire about the client's reasons, contact the healthcare provider, and finally record the event in the chart.
When a client revokes consent, the nurse's first legal and ethical duty is to respect their autonomy by immediately stopping the procedure or preparations. Next, the nurse should gather data by exploring the client's concerns. This information is then relayed to the healthcare provider, who is responsible for discussing the implications of refusal. Finally, the nurse must document the entire sequence of events to maintain an accurate and legal medical record.
Step-by-Step Solution
Key Concept
Clients have the right to revoke informed consent at any time; the PN must immediately stop the procedure, assess concerns, notify the provider, and document.