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Difficulty: MediumInformed Consent

A client on an acute oncology unit is scheduled for a bedside bone marrow aspiration and biopsy. The healthcare provider discussed the procedure and obtained the client's signature on the informed consent document earlier in the shift. As the nurse assists the client into the appropriate physical position, the client suddenly pulls away, begins crying, and states, 'I changed my mind. I cannot go through with this. Please stop.' The provider is in the room and is currently opening the sterile tray. Which of the following is the priority nursing action?

  1. A
    Reassure the client that the provider is highly skilled and the procedure will be over very quickly.
  2. B
    Administer the prescribed as-needed intravenous anxiolytic to calm the client so the procedure can continue.
  3. C
    Record the client's verbal apprehension in the electronic health record while the provider finishes setting up.
  4. Halt all procedural preparation immediately and notify the healthcare provider that the client is revoking consent.Answer

Answer

Halt all procedural preparation immediately and notify the healthcare provider that the client is revoking consent.
The correct action directly addresses the legal and ethical requirement of informed consent. A client's signature on a consent form is not a binding contract; they retain the right to refuse or halt the intervention at any moment. By stopping the preparation and notifying the provider, the nurse fulfills the role of client advocate and prevents potential medical battery.

Step-by-Step Solution

1
Analyze the clinical scenario to determine the client's legal status regarding consent.
The client has explicitly verbalized a desire to stop the procedure, effectively revoking their previously given consent.
Recognizing a revocation of consent is critical because proceeding without valid consent constitutes battery.
2
Identify the primary role of the registered nurse in this context.
The nurse must act as a client advocate, ensuring the client's autonomy and right to refuse treatment are respected.
Patient advocacy is a core competency and legal obligation for nurses, especially when patient rights are actively being exercised.
3
Select the intervention that immediately protects the client's rights.
The nurse must intervene to stop the procedure from moving forward and communicate the client's decision to the healthcare provider.
Direct communication halts the workflow and forces a reassessment of the situation by the medical team, ensuring no unwanted physical contact occurs.

Key Concept

A competent client has the ethical and legal right to revoke informed consent at any time, including right before or during a procedure. The nurse's duty is to advocate for the client by immediately halting the procedure and notifying the provider.
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Informed Consent

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