Consent and Elder Abuse in Nursing Scenario

This scenario discusses the importance of obtaining valid consent in healthcare procedures and the issue of elder abuse. It highlights the responsibilities of nurses and the potential legal implications. The case also emphasizes the need for proper documentation and open disclosure of incidents. References are provided for further reading.

ASSESSMENT TASK 2 – SCENARIO
Instructions
for
completion
 You are required to go through the scenarios mentioned below
and answer the questions that follow
 all questions must be answered correctly
 Assessment requirements may be hand written or typed
 Answers should be on average 100 words per question unless
otherwise indicated
 If hand written, the writing must be legible
 Use of APA referencing must be used where original sources other
than your own have been used – to avoid plagiarism
 Write your name, student ID, the assessment task and the name
of the unit of competency on each piece of paper you attach to
this assessment document
 Submit to your trainer/assessor by the due date.
Due Date  The trainer/assessor inform you of the due date
The due date for this task is _____________________________
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Your shift handover from AM nurse Mark, a fellow EN, was rushed – he was
finishing early so he could get home in time to watch an AFL game, and seemed
distracted. One of the patients he’s handing over is Mrs. Lee, a frail 75-year-old
woman who recently emigrated to Australia with her family from China. Neither
she nor her accompanying daughter speak English.
Mark tells you that she has verbally agreed to a renal biopsy. As directed by the
nephrologist, she has been fasting for the procedure, and would be called down
to radiology soon. Because it’s a weekend, you’ll have to accompany Mrs Lee,
and stay throughout the procedure.
As soon as Mark leaves, you get a phone call from the Ultrasonography room.
The nephrologist and the radiologist are ready for you to bring Mrs Lee down for
an ultrasound-guided biopsy; as you hang up the phone, an orderly appears to
take her down on the bed. You pick up her files, and accompany Mrs Lee and her
daughter, Ji-yeon, to ultrasound.
You demonstrate to Mrs Lee that she needs to lie prone, and undo her gown so
the nephrologist and radiographer can access her kidney. Before you cover her
exposed buttocks, you notice several longitudinal bruise-like marks on her
buttocks, as if she was hit with a belt. Mrs Lee winces when you gently touch
them. The Nephrologist exclaims,” It looks like elderly abuse to me. Please ask
the intern to make note of this in the patient history.”
The nephrologist then asks you if there’s a consent, and you absent-mindedly
reply yes because you’re thinking about the marks, and because Mark said Mrs
Lee had finally agreed to the procedure.
The nephrologist shows the biopsy needle to Mrs Lee, who starts shouting and
banging her fists to the bed. It takes you and Ji-yeon half an hour to calm her
down, after which the biopsy is successfully performed.
Q1. Identify a key concern regarding consent in the above scenario?
The validity of the consent for the procedure.
Q2. You know that elder abuse is wrong. You took a picture of Mrs Lee’s buttocks
on your phone after the procedure. You want to report this to the highest
authority and think posting it on twitter will raise awareness regarding abuse. By
doing this, you will be:
Statement A: Breaching the patient’s privacy and confidentiality. This
statement is true according to Palacios-González, (2015).
Statement B: Breaching the legislative requirements and the organisational
policies and procedures
Pick the correct answer:
a.Statement A is correct and Statement B is incorrect.
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b.Statement B is correct and Statement A is incorrect.
c.Both Statements are correct.
d. Both statements are incorrect.
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Student Assessment
Q3. Would it be a good idea to restrain Mrs. Lee’s fists to the biopsy table?
No.
Scenario continues:
The next day you learn that Mrs Lee had bleeding from her biopsy site
overnight, and has been transferred to ICU for monitoring. You are told
she will probably recover, but that is not certain; though the biopsy was
performed appropriately, but there was not a valid consent for the
procedure.
Q4. Whose responsibility was it to obtain signed consent from Mrs Lee? What
were your obligations here?
It was my responsibility as the nurse in session. According to Cook, (2014),
and Menendez, (2013), it is nurses’ responsibility to obtain and witness
written consent for healthcare treatment.
My obligations were to confirm the validity of the consent with the patient
and her daughter and explaining the whole procedure what the entire
procedure entails to Mrs. Lee the patient
Q5. What is duty of care?
It is a moral or legal obligation to ensure safety or well-being of others (Jones
et al., 2014).
Q6. The hospital might be sued in a court of law. State at least (2) legal terms
is applicable to a civil suit in this situation?
The duty of care
Harm; if the plaintiff does not suffer harm, he cannot sue for negligence.
Q7. If Mrs Lee dies, this case will also be referred to the coroner, because it
will be the direct result of medical intervention. One of the things the coroner
will scrutinize is all the documentation associated with the lead up to,
process, and subsequent events of the biopsy and death.
Statement A: It is essential that all the nursing notes and other charting are
written according to legal requirements in line with organizational policies
when the patient is not a native English speaker.
Statement B: When negligence was identified, all the incidents that resulted
in the harm to the patient should have been openly disclosed to the patient,
their family, carers and other support persons. This statement is true
according to Okuyama, Wagner, & Bijnen, (2014).
Pick the correct answer:
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Student Assessment
a. Statement A is correct and Statement B is incorrect.
b. Statement B is correct and Statement A is incorrect.
c. Both Statements are correct.
d. Both statements are incorrect.
Q8. Mrs Lee’s son in law asks you to send the photographs you took,
however, as this is an outsider’s request you are in dilemma. Whom do you
consult?
I will seek Mrs. Lee’s consent.
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Student Assessment
References.
Cook, W. E. (2014). “Sign here:" Nursing value and the process of informed
consent
Plastic Surgical Nursing, 34(1), 29-33.
Jones, B. L., Contro, N., & Koch, K. D. (2014). The duty of the physician to care
for the family in pediatric palliative care: context, communication, and
caring. Pediatrics, 133(Suppl 1), S8-S15.
Menendez, J. B. (2013). Informed consent: Essential legal and ethical principles
for nurses. JONA's Healthcare Law, Ethics, and Regulation, 15(4), 140-144.
Okuyama, A., Wagner, C., & Bijnen, B. (2014). Speaking up for patient safety by
hospital-based health care professionals: a literature review. BMC health
services research, 14(1), 61.
Palacios-González, C. (2015). The ethics of clinical photography and social
media. Medicine, Health Care and Philosophy, 18(1), 63-70.
HLT54115 Diploma of Nursing
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