Accountability of Professional Nurses: Informed Consent

Informed consent is used as a safeguard to ensure the patient’s understanding of the care or procedure needed to treat a medical issue. It also ensures the patient’s understanding of any adverse effects that can occur due to the care or procedure needed. Verbal consent is usually obtained at the bedside when discussing what minor procedures or tasks need to be done, drawing blood, for example. Signed informed consents are mainly used for nonemergent invasive procedures or surgery (Smeltzer, Bare, Hinkle, & Cheever, 2008).

According to the Agency for Healthcare Research and Quality (AHRQ), various procedures used for obtaining informed consent can be insufficient. One problem that arises from obtaining informed consent is the patient’s comprehension of the informed consent. They may not truly understand what is said because of the technical terms used. Many times a frightened patient’s state of mind does not allow them to comprehend what the doctor is telling them, or truly understand the risks involved, making the patient not really informed at all (Cunningham, 1996).

Another problem is that there are over forty million illiterate adults in America (Kirsch, Jungblut, Jenkins, et al. , 1993). This heightens the problem of these patient’s increased potential of not understanding what they are giving consent for. Some patients do not read the consent at all. According to one of several different studies conducted regarding insufficiencies of obtaining the informed consent, 69% of patients admitted that they did not read a consent form before signing it.

In ddition, approximately half of the patients awaiting treatment were unhappy with the amount of information they received, with 21% stating that most of the information they obtained about their surgical treatment was obtained outside of the hospital. (Lavelle-Jones, Byrne, Rice, et al. , 1993) Although nurses do not obtain informed consent from patients, they play a major role as patient advocate and making sure the patient understands the consent. There are different methods that can be implemented so patients can become better informed. The nurse should ensure proper discussions take place between the patient and the doctor.

They should have the patient recall the procedure to be done and the risks involved. If the patient is not able to do this or has further questions, the doctor should be made aware so he can have a continued discussion with the patient. The nurse should provide pamphlets and/or media, if available to further help the patient to understand. This also gives the patient a written reference to refer back to. After reading studies involved with understanding the informed consent, I will be ensuring that when my signature goes on an informed consent as a witness, my patients will be educated properly to the procedure involved.

A patient care situation to reflect this teaching would be to ask my patient to recall and restate what they have been told during the informed consent process. As some of my patient population includes sedated ventilator patients, I would make sure their designated health care power of attorney person, or next of kin, can recall and restate the procedure to be done to their family member. If the understanding is not perceived, I would further educate my patient or family member, within my scope of practice, or arrange for the doctor to hold further discussions.

With our diverse population, I would make sure an interpreter is available during this process, if needed. If video is available, reinforcing the understanding of the procedure with this can be invaluable for the patient and/or family member. As nurses are present during the informed consent process, when they see a terrified look in their patient’s eyes while the doctor is explaining a procedure to them, the nurse has a duty to identify those patient fears, preserve their dignity, and reassure them without being dishonest before asking them to consent to treatment (Cunningham, 1996).

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