Patient Education

• Nurses are empowered to assess and understand their patient’s cognitive abilities, knowledge of their condition, and learning styles, allowing for appropriate interactions and successful nurse-patient education.
• Nurses spend more time educating patients than most other healthcare disciplines. Nurses fill trusted roles as patient caregiver, advocate, educator, and steward.
• During bedside care, nurses may be asked by both the patient and family to answer questions related to upcoming procedures and surgeries, providing key information about upcoming procedures and tests.
• Consideration must be made to factors such as pain, anxiety, the disease in question, and therapeutic interventions, as these may hinder the meaningful participation of patients in the decision-making process.

Informed Consent

• At its core, informed consent requires patients be aware of the risks, benefits, and alternatives of the proposed surgery, intervention, or treatment and be given an opportunity to ask questions.
• The process of informed consent is complex, may require the participation of multiple parties, and usually begins well in advance of the point of obtaining a signature on a form.
• The signed and witnessed informed consent form is the legal obligation of the physician or advanced practice provider performing the procedure in question.
• Nurses are usually charged with verifying the informed consent paperwork has been obtained just prior to surgery or procedures.
• Consent should never be considered a waiver of liability.
• Patients have the right to know who is performing their procedure, as well as how many times the person has successfully completed this procedure.
• If the nurse believes the patient has not been fully informed or has less than a full understanding of the proposed treatment, the nurse must act as a patient advocate to ensure that the patient receives the necessary information.

• Informed decision-making: Can only be completed by a patient with the mental capabilities to understand the decision to accept or reject the medical treatment being offered.
• Decisional capacity: A patient who is unconscious, disoriented, or delusional may have a surrogate decision-maker assume authority for providing informed consent on their behalf.
• Healthcare surrogate: A person designated by the patient to make healthcare decisions should the patient become incapacitated.
• Substituted judgement: In the event that a patient lacks the capacity to make decisions on their own, statutes in many states allow for the assignment of a proxy to make decisions, who must consider any and all known wishes of the patient.

Refusal of consent

• It is within the rights of the autonomous patient to refuse a recommended treatment.
• A competent patient may verbally withdraw consent at any time, and refuse to continue a treatment pathway, even in the presence of a signed consent form.