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Zorluk: ZorAdvance Directives and Informed Consent

A practical nurse (PN) and a registered nurse (RN) are co-assigned to an individual awaiting a lumbar laminectomy. The attending surgeon completed the preoperative discussion earlier. The RN is currently occupied with a critical admission and directs the PN, "Please obtain the signature for the surgical paperwork, and if the client asks what happens if they cancel the procedure, just explain the risks of spinal nerve damage." When the PN presents the document, the individual states, "My mind went blank. What did the doctor say would happen if I refuse this operation?" Which action is the most appropriate legal response by the PN?

  1. A
    Follow the registered nurse's directive and explain the physiological consequences of refusing the procedure before securing the signature.
  2. B
    Locate the surgeon's consultation notes in the health record and read the documented risks of refusal aloud to the individual.
  3. Delay the signing of the document and contact the attending surgeon to return and directly answer the individual's inquiry.Cevap
  4. D
    Instruct the individual to sign the document to maintain the operating room schedule, and note the inquiry in the nursing record.

Cevap

The correct action is to delay the signing of the document and contact the attending surgeon to return and directly answer the individual's inquiry.
The correct action is to delay the signing and contact the attending surgeon. In the informed consent process, the practical nurse acts solely as a witness and an advocate to verify that the individual understands the procedure. If the individual expresses confusion or asks questions regarding the risks, benefits, or alternatives (including the consequences of refusal), the practical nurse must not provide this education. The nurse must halt the signing process and notify the healthcare provider, as it is the provider's legal duty to directly explain these elements. Furthermore, the practical nurse must recognize that the registered nurse's delegation to explain these risks was inappropriate and outside the scope of practice.

Adım Adım Çözüm

1
Analyze the legal scope of practice for the practical nurse regarding informed consent.
The PN's role is strictly limited to witnessing the client's signature and ensuring the client voluntarily understands the provider's explanation.
Informed consent is a provider responsibility. Nurses do not educate on primary surgical risks, benefits, or alternatives.
2
Evaluate the registered nurse's delegation to the practical nurse.
The RN inappropriately delegated the task of explaining surgical risks and consequences of refusal to the PN.
Explaining the medical consequences of refusing a surgery is strictly the responsibility of the healthcare provider, not the RN or the PN.
3
Determine the appropriate intervention when a client expresses confusion or forgotten information prior to signing consent.
The PN must withhold the consent form and escalate the situation back to the primary provider.
A signature obtained while the client lacks understanding is not legally valid.

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