A practical nurse (PN) is admitting a young adult client to an ambulatory surgery center for an elective upper endoscopy. The client has already signed the informed consent document. While the PN is taking the client's vital signs, the client suddenly becomes tearful and states, "I cannot go through with this. I want to cancel the test right now." In what order should the PN perform the following actions? Arrange the steps from first to last.
- 1Cease all preoperative physical preparations immediately.
- 2Ask open-ended questions to determine the reason for the client's change of mind.
- 3Notify the healthcare provider and the supervising registered nurse.
- 4Observe as the healthcare provider discusses the implications of refusal with the client.
- 5Document the client's verbal refusal and the provider's intervention in the health record.
Cevap
The correct sequence is to first immediately cease all physical preparations to respect the client's autonomy. Next, the practical nurse should ask open-ended questions to explore the client's concerns. Following this data collection, the nurse must notify the healthcare provider and supervising registered nurse. The practical nurse then observes while the healthcare provider discusses the implications of refusal. Finally, the nurse documents the entire event in the health record.
The nursing process and client advocacy dictate the sequence of actions when a client revokes informed consent. The most immediate priority is to ensure the client's autonomy and physical safety by halting any further preparation. Once the procedure is paused, the practical nurse (PN) must collect data by exploring the client's concerns to understand the situation fully. After gathering this information, the PN must promptly communicate the client's decision to the supervising RN and the healthcare provider, as it is the provider's legal responsibility to address the refusal. The PN then remains to support the client while the provider explains the risks and consequences of canceling the procedure. Finally, the PN must provide a comprehensive legal record of the entire event, including the client's exact words and the actions taken, in the medical chart.
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Anahtar Kavram
Client's Right to Revoke Consent and the Nursing Process