Consent comes in a form of implied and expressed consent. In nurses’ day-to-day dealing with patients, consent is secured from patients frequently. Implied consent refers to nonverbal acknowledgement of a health care provider’s request to provide treatment (O’Keefe, 2001). An example of implied consent would be when a nurse walks to the patient and inform the patient that she is going to administer an antiemetic injection and the patient rolls up his/her sleeve and brings his arm forward indicates the patient has given an implied consent.
Expressed consent refers to verbal and written. It should be obtained when the treatment is likely to be more than mildly painful, when it carries appreciable risk, or when it will result in ablation of a bodily function (Evans, 2006). Nurses secure verbal informed consent by the patient bedside and the consent is obtained by providing patients with detailed information regarding the procedure. For example, prior to the insertion of a cannula, the nurse would provide the patients with information to secure an informed consent.
The physician obtains written informed consent when patients require a medical or surgical procedure. The physician carrying out the procedure will provide the patient with detailed information when obtaining an informed consent. The role of the nurse is to be a witness. Dr Young (2007) indicated that 70 percent of what patients are told is forgotten immediately after the consultation. Therefore the nurse will access the patient comprehension of the information given. The nurse has an ethical responsibility, to do good and no harm by informing the physician if the patient is unclear or has unanswered questions pertaining to the procedure for the consent that has been obtained, to be considered valid.
Nurses are guided by the Singapore Nursing Board (SNB), which indicates that nurses have a duty to obtain consent for nursing interventions where necessary, and collaborate with other members of the health care team to obtain consent for medical treatment (SNB, 2006). Taking into consideration the ethical theory of deontology, nurses are duty bound and is required to adhere to their duties. The Nursing and Midwifery council (NMC) in the United Kingdom states the responsibilities for nurses in securing consent, (1) To make the care of people their first concern and ensure they gain consent before they begin any treatment or care, (2) Ensure that the process of establishing consent is rigorous, transparent and demonstrates a clear level of professional accountability and (3) Accurately record all discussions and decisions relating to obtaining consent (NMC, 2008). Legal drivers
Obtaining consent before any procedure is mandatory, as the nurse has to gain consent from the competent patient before touching him/her. In any circumstance if the nurse were to touch the patient without his/her authorization, the nurse can be liable under the civil law for battery. When an act results in actual physical contact or touching, a battery has occurred (Aiken, 1994). Therefore prior to every nursing procedure for instance transferring patient or when care is rendered to the patient it is important to seek permission to touch the patient.
Nurses must ensure patients are well versed with the risks and complications involved, as there is a possibility of being sued for negligence under the civil law if patients are left uninformed. Murphy (2008) states that a gap in the informed consent process can cause a patient to believe, incorrectly, that he or she received negligent care. Thus informed consent is a necessity as in instances when a urinary catheter is inserted there is a risk for urinary tract infection. Patients deserve the right to information especially on the risk involved that could alter the patient health condition.
There are various theories and principles involved in relation to informed...