Nurse Is Instructed to Have Patient with Low Literacy Level to Sign Consent for Treatment

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Scenario: Nurse Gloria is instructed by the attending physician to have Mr. Isaacs sign a consent form before a scheduled colonoscopy. As Nurse Gloria goes over the form with the patient, she notices he seems confused and is unsure where or how to sign the paperwork.

Ethical Dilemma: It is common for nurses to be the ones to get signatures on consent forms, especially for procedures like the one described in this scenario. When faced with a situation like the one here when the nurse is not sure that the patient understands what he is being told or if he can read, the decision of whether to delay a busy schedule to have the doctor come back and talk to the patient or explain to the best of her knowledge and get the patient’s signature may seem difficult to make.

Now that you have read the ethical dilemma below WHAT IS THIS PERSON FOCUSING ON EMOTIONALLY? What are the ASSOCIATED ETHICAL PRINCIPLEs AT PLAY IN THIS SCENARIO? WHAT ARE THE IMPLICATIONS OF THE NURSE’S ACTIONS? explain your responses and your current actions.

Sample Solution

Emotional Focus:

The nurse in this scenario is likely experiencing a complex interplay of emotions. They may feel:

  • Frustration: Due to time constraints and a busy workload.
  • Anxiety: Concerned about the patient’s understanding and potential legal implications.
  • Empathy: Concerned for the patient’s well-being and autonomy.
  • Uncertainty: Unsure about the best course of action.

Associated Ethical Principles:

Several ethical principles are at play in this scenario:

  • Autonomy: The patient’s right to make informed decisions about their own healthcare.
  • Beneficence: The duty to do good and promote the patient’s well-being.
  • Non-maleficence: The duty to avoid harm.
  • Justice: Ensuring fair and equitable treatment for all patients.

Implications of the Nurse’s Actions

The nurse’s actions will have significant implications for the patient and the healthcare institution. If the nurse proceeds with obtaining the patient’s signature without ensuring full understanding, potential consequences include:

  • Patient Harm: The patient may not fully understand the risks and benefits of the procedure, leading to adverse outcomes.
  • Legal Liability: The healthcare institution may be held liable for negligence if the patient suffers harm due to a lack of informed consent.
  • Ethical Violations: The nurse’s actions may violate ethical principles, such as autonomy and beneficence.

Recommended Course of Action:

To address the ethical dilemma, the nurse should prioritize the patient’s well-being and autonomy. Here are some steps the nurse can take:

  1. Communicate Clearly and Patiently: Explain the procedure, risks, and benefits in clear and simple language, avoiding medical jargon.
  2. Assess Understanding: Ask open-ended questions to determine the patient’s comprehension.
  3. Seek Clarification: If the patient seems confused, consult with the physician to clarify any questions or concerns.
  4. Involve a Family Member or Guardian: If appropriate, involve a family member or guardian to assist with decision-making.
  5. Document the Process: Thoroughly document the consent process, including any concerns or questions raised by the patient.

By following these steps, the nurse can ensure that the patient’s rights are protected and that the procedure is performed ethically and safely

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