Nurses and Consent

In Utah, we followed the case of a nurse who refused to draw blood on a patient who was unable to give consent to the procedure. This, of course, was the right ethical action.

Not only are there risks associated with a blood draw, but that patient should be protected from illegal search and seizure of what could potentially be evidence against him.

However, the bigger question for nurses is “ What is consent?” We are all taught about it in school, but do we really know what the specifics are?

Here is a brief look at some of the details regarding consent that may help refresh your memory.

Implied consent

Implied consent is the most difficult to nail down, but it is probably the consent used most often. If a patient is in the hospital, some of the consent for non-invasive nursing procedures is implied.

This consent centers around the patient’s actions. Have they performed an action that makes them reasonably willing to submit to a simple procedure such as having a pulse taken?

This consent is very slippery and should not be relied on in most cases. You should not take it for granted that any patient wants you to perform any procedure no matter how minor.

Yet it does happen. You walk into a room and take vitals without asking. That’s implied consent.

Verbal consent

Verbal consent is where most nursing consent lives. It is better to ask if you can take those vitals than to just do it.

In Utah, a conscious patient could have given verbal consent, but there was neither verbal nor implied consent because the patient was unable. It is important that a patient says it is okay to perform any nursing procedure.

If they can’t, then you can’t. If they don’t say it’s okay, then you can’t. Simple as that.

Written consent

Written consent is the most formal of them, and it is usually left for larger procedures. This means surgeries, invasive diagnostic tests, and the like.

Doctors come in at this point, but it is essential that nurses witness and verify written consent of any procedure. This is an essential function of any nurse to protect the safety and the rights of the patient.

In Utah, none of this occurred, and a diligent nurse was punished for it. Consent is a huge issue in what a nurse does day to day, and this event brings out just how important a concept it is.

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