Question

Question: A 19-year-old male presents to the emergency department via ambulance in critical condition (sign...

A 19-year-old male presents to the emergency department via ambulance in critical condition (significantly hypotensive, hemorrhaging, and Glasgow coma scale of 6). The patient was involved in a high-speed motor vehicle collision. His identity is unknown. The trauma surgeon makes the decision to take the patient directly to the operating room.

A 45-year-old female is admitted after a fall while horseback riding. She sustained a femur fracture and requires surgical correction of an open reduction internal fixation. The orthopedic surgeon has a lengthy conversation with the patient explaining the purpose, benefits, risks, and complications. The surgeon asks the nurse to have the patient sign the consent and witness the signature. The patient states to the nurse she fully understands and has no questions.

A 27-year-old female is admitted for cholecystitis and requires a minimally invasive cholecystectomy. The patient recently immigrated from Bangladesh and only speaks Bengali. She is accompanied by her husband who also speaks Bengali but has a limited understanding of English. The surgeon explains the purpose, benefits, risks, and complications of the surgery to the husband and has him sign the consent.

identify which scenario requires further nursing intervention pertaining to informed consent. Identify the appropriate nursing intervention and what members of the healthcare team need to be involved to resolve the situation.

Answer 1

This 19 year old patient in critical condition .A GCS of 6 means the client will not be in a state to understand or give consent. This scenario requires further nursing intervention to handle this case morally ,ethically and legally .The following healthcare professionals has to be involved to resolve the situation like ethical committee of the hospital to make a decision on behalf of the patient from the point of principle of beneficence and non maleficence.The nurse has to ensure the parents or the guardians of the client is informed regarding the status and informing them to arrive to the ED for further proceedings .If they are not available it has to be moved legally to get consent through judiciary . This scenario requires more nurse intervention.

The 45 year old patient have been explained about the surgery  and she has understood and provided consent which requires no further interventions.

In 27 year old client there is language barrier yet with minimal English knowledge of patient and husband the surgery has been explained by the surgeon and consent is done. The need of nursing intervention is reduced here.

Therefore the 19 yr old patient has to be considered .