Informed Consent and Ongoing Care

Informed Consent

• Informed consent is an agreement from a client to accept specific treatment or a procedure after receiving complete information from a health provider.
• Nurses are responsible for obtaining informed consent for nursing procedures.
• Witnessing the exchange between a client and a physician, ensuring the client understands provided information, and witnessing the client's signature are responsibilities for nurses in relation to medical procedures.

Ongoing Consent to Care

• Ongoing consent to care involves five stages: giving information, consulting with the client, encouraging active client participation, obtaining consent to care, and facilitating the development of advance statements and/or directives from the client.
• The concept of ongoing consent to care is applicable to long-term care clients to ensure their continuous agreement to treatment and care.
• Active participation in care planning and review is crucial for clients receiving long-term care.

Problems Obtaining Consent

• Obtaining consent can present challenges, such as clients refusing treatment, parents refusing permission for their child's treatment, dealing with mentally ill or intoxicated clients, or clients withdrawing previously given consent.
• Dealing with these situations raises conflicts regarding values, rights, and responsibilities, e.g., the right to life versus the right to die.

Strategies for Resolving Consent Problems

• Assess and address any psychosocial or physical difficulties influencing the client's decision.
• Engage in every reasonable and lawful effort to persuade the client to accept the recommended treatment.
• If a conscious and rational adult client or parent refuses consent, treatment cannot be administered without risking civil and criminal liability.
• Document and witness the client's refusal.
• Seek legal advice if the client's condition is serious.

Competent Nursing Care

• Providing competent nursing care within legal boundaries and established agency policies and procedures is fundamental to legal protection for nurses.
• Nurses must be familiar with job descriptions and ensure their education and experience meet the outlined responsibilities.
• Safeguarding clients from harm through anticipating potential injury sources, educating clients about hazards, and implementing preventive measures is essential.
• Employing the nursing process to accurately assess clients' needs and implement appropriate interventions is critical.
• All assessments and care must be documented accurately.
• Engage clients in discussions about their care and acknowledge when unable to answer their questions, promising to find the answer and ensuring it is provided.

Ethical Dilemma

• Ethical dilemmas arise when two or more mutually exclusive morally correct courses of action exist, creating conflict over philosophies, values, and professional duties.
• In an ethical dilemma, each alternative course of action can be justified based on individual value systems.
• Different perspectives (patient, healthcare agency, legal system, nurse) may lead to variations in the perceived best course of action.
• According to the nursing code of ethics, the primary loyalty is to the client. However, determining the action that best serves the client's needs can be challenging.

Sources of Ethical Dilemmas

• Social and technological changes, such as the right to healthcare, increasing healthcare costs, and conflicting institutional policies, can contribute to ethical dilemmas.
• Conflicts between nurses' loyalties and obligations can also create ethical challenges.

Categories of Ethical Dilemmas:

• The text does not provide specific categories of ethical dilemmas.

This quiz covers the concepts of informed consent and ongoing consent to care in nursing practice. It discusses the responsibilities of nurses in obtaining informed consent and the stages of ongoing consent in long-term care settings. Understand the importance of client participation and clarity in communication during medical procedures.