A nurse is caring for a client who has a chest tube with a closed drainage system. Which of the following actions should the nurse take?

Rationale

A. The provider obtains verbal consent for the procedure without witnessing the client's signature: While verbal consent may be appropriate for some low-risk procedures, most invasive or high-risk procedures require written consent. Obtaining consent without documentation does not meet legal or ethical standards for informed consent and may place both the client and provider at risk.

B. The provider performing the procedure is responsible for obtaining informed consent: The provider who will perform the procedure must ensure the client understands the risks, benefits, alternatives, and potential outcomes. This responsibility ensures the client receives accurate, procedure-specific information from the person most qualified to answer questions and address concerns.

C. The nurse's role is to provide the client with initial information about the procedure prior to obtaining informed consent: The nurse’s role is to reinforce teaching, clarify information, and ensure the client comprehends the procedure. Nurses can answer questions and verify understanding but do not obtain legal consent for invasive procedures.

D. Clients are unable to change their mind once a consent form is signed: Clients have the right to withdraw consent at any time, even after signing the consent form. Respecting autonomy means that the client can refuse or discontinue a procedure without penalty, and this right must be communicated as part of the informed consent process.

Rationale

A. Encourage the oncoming shift nurse to contact the provider with any questions: While the oncoming nurse may need to contact the provider, relying on this step alone does not ensure a comprehensive or standardized handoff. Important information may be missed if the report is informal or incomplete.

B. Record a verbal report on a recorder for the oncoming nurse to listen to: Using a recording is not ideal because it prevents real-time clarification and questions. Direct communication is necessary to address immediate concerns and confirm understanding for safe continuity of care.

C. Use a standardized approach to giving the handoff report: Utilizing a standardized method, such as SBAR (Situation, Background, Assessment, Recommendation), ensures that essential information is communicated clearly, consistently, and completely. This approach reduces errors and promotes continuity of care between shifts.

D. Provide the handoff report at the nurses' station: Providing a report at the nurses’ station may compromise privacy and lead to distractions. Bedside handoff or a private setting allows for a more thorough and interactive exchange of information, supporting safety and continuity.