A female patient from an unfamiliar culture is in the emergency department and needs an emergency operation. She wishes to wait for a tribal elder to arrive before making a decision about the operation. The best action by the nurse is to
a. ask the patient's husband if he is willing to consent for the operation.
b. explain that only the patient may make health care decisions for herself.
c. prepare the patient for surgery under the doctrine of implied consent.
d. wait for the tribal elder to arrive and then obtain informed consent.
D
The nurse who is providing culturally competent care recognizes that the patient has the right to include whomever she wants in the decision-making process and will wait. In some cultures, the individual's desires are secondary to family or group wishes.
The culturally competent nurse would not breach a patient's trust and ask someone whom the patient has not specifically designated to make this decision.
Culturally competent nurses realize they may need to expand their definitions of autonomy and family in order to facilitate decision making.
Preparing the patient for surgery before she chooses to go through with the operation would be paternalistic and disrespectful of the patient's right to wait to make a decision.
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