In one case it is observed that the patient who is scheduled for a surgery didn't properly understand the physician's explanation. The patient is now worried and asking many queries. Which among the following would be the right action to be taken?

Appeared in: AIIMS Raipur - 2017 (Shift-3)

Explanation

The primary responsibility for explaining a surgical procedure, including its risks, benefits, and alternatives, lies with the physician or surgeon performing it.
This process is known as obtaining informed consent, which is a legal and ethical requirement before any invasive procedure.
When a nurse assesses that a patient does not understand the information provided, their role as a patient advocate is to immediately notify the physician.
The physician must then revisit the patient to provide further explanation and answer questions to ensure the consent is truly informed.
Proceeding without the patient's full understanding would invalidate the consent and violate their rights.

Option A: This action is outside the nurse's legal scope of practice. While a nurse can reinforce teaching, providing the primary explanation of surgical risks and procedures is the sole responsibility of the surgeon.
Option B: This is a premature and drastic action. The immediate problem is a lack of understanding, which can be resolved by proper communication. Canceling the surgery is not the first or most appropriate step.
Option C: A supervisor RN, like any other registered nurse, is also bound by the same scope of practice. They cannot substitute for the physician in obtaining informed consent.

Visual 1: Flowchart - A flowchart illustrating the correct workflow for a nurse when a patient expresses a lack of understanding about a procedure. It would show: 1. Patient expresses confusion -> 2. Nurse assesses understanding -> 3. Nurse notifies physician -> 4. Physician re-explains to patient -> 5. Nurse verifies understanding and witnesses consent.

Clinical Relevance

Nursing practice connection: Use the key finding related to Nurse's role in the informed consent process before surgery to guide bedside assessment, documentation, and the next nursing action.
Ensuring informed consent is a cornerstone of patient safety and ethical nursing practice. A failure to do so can lead to legal action against the nurse, physician, and hospital for battery.
A nurse who proceeds to have a patient sign a consent form, knowing the patient does not understand, is ethically and legally culpable.
What if? If the patient's question was about a routine post-operative nursing activity, like how to use the incentive spirometer, the nurse could and should explain it. The key distinction is whether the explanation relates to the surgical procedure itself (physician's duty) or routine nursing care (nurse's duty).

How to Approach the Question

First, identify the core issue of the question: a problem with informed consent.
Second, recall the legal and ethical principles governing a nurse's scope of practice. The primary responsibility for explaining a procedure and its risks belongs to the provider performing it.
Third, evaluate each option based on this scope of practice. Option A (nurse explains) and C (supervisor explains) are outside the nursing scope.
Fourth, consider the remaining options. Option B (cancel surgery) is too extreme as a first step. Option D (notify physician) directly addresses the communication gap and aligns with the nurse's role as a patient advocate.
Therefore, notifying the physician is the only correct and safe action.

Concept Tested & Keywords

Concept Tested: Nurse's role in the informed consent process before surgery.
Stem keywords: scheduled for a surgery, didn't properly understand, patient is now worried, right action
Lead-in keywords: right action
Clinical cues: [object Object]

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Attempt every question from this paper in a timed mock, then review the full solution for each one.