A 45-year-old client is in the preoperative staging area prior to an elective cervical laminectomy. When the registered nurse (RN) provides the consent form for signature, the client hesitates and states, "I do not think I am ready to sign this. I still have a lot of questions about what my mobility will be like after the surgery." Arrange the following nursing actions in the correct priority order.
- 1Stop the consent signing process.
- 2Ask the client to explain their specific concerns about postoperative mobility.
- 3Reassure the client that they have the right to delay the surgery until their questions are answered.
- 4Notify the surgeon that the client requires further clarification about the procedure.
- 5Document the client's exact statements and the notification of the surgeon in the medical record.
Answer
The correct sequence is to first stop the signing process, then assess the client's specific concerns, reassure them of their right to delay the procedure, notify the surgeon to provide clarification, and finally document the event.
The correct sequence follows the nursing process and legal principles of informed consent. First, the RN must immediately halt the process to prevent an invalid consent from being signed. Second, the RN assesses the client's specific concerns to understand the knowledge deficit. Third, the RN advocates for the client by reassuring them of their right to delay the procedure. Fourth, the RN notifies the surgeon, as it is the provider's legal duty to explain procedural risks and outcomes. Finally, the RN documents the entire interaction and the notification of the provider.
Step-by-Step Solution
Key Concept
The RN's role in informed consent is to act as a witness and advocate. When a client expresses a lack of understanding, the RN must halt the process, assess concerns, and notify the primary healthcare provider to provide clarification.