A female patient from a refugee community is in the emergency department and needs urgent surgery. The patient defers making a choice on the operation, preferring to wait for a cultural elder to arrive. What action by the nurse is most appropriate?
A.
Encourage the patient's family to talk her into having the operation.
B.
Explain kindly to the patient that her situation cannot wait.
C.
Respect the patient's choice and wait for the elder to arrive.
D.
Take the patient to surgery under the principle of implied consent.
ANS: C
This is a difficult situation, but because the patient's wishes are known, the nurse has no choice other than to wait. In the emergency department, sometimes surgery is performed under the principle of implied consent (for instance, on an unconscious patient with no known family), but in this case, the patient has been clear as to her wishes, so doing that would be an ethics violation. The nurse must be careful to not be coercive. The nurse (and physician) would ensure that the patient understands the risks of waiting.
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