Help understanding legal implications fundamentals question

[swansonplace]

The client that speaks Swahili has come to the hospital to have her baby. There are no health care providers on the obstetrics unit that speak this language. How does the nurse obtain consent to give the

Client an injection?

__ Ask the client's five-year son speaks the same language as the nurse explain the procedure

__Have the hospital provided interpreter who speaks Swahili explain the procedure

__Have the client's husband who speaks the same language as the nurse explain the procedure

__Give the injection without explaining the procedure since there is no one that speaks Swahili

__Use gestures to explain the procedure and observe the client's nonverbal response that indicates an understanding of what is about to occur

I selected the "Have the hospital provided interpreter who speaks Swahili explain the procedure"

The correct answers are use the hospital provided interpreter, the husband, and use gestures. I am confused as I thought nonmedical personnel are not suppose to be used to translate, and the use of gestures for a concent form makes me think that the signing of the form is truly not valid as the patient may not understand what is being signed.

Thanks for explaination of where I am wrong.

[dura_mater]

I think you are spot on with your answer and rationale, I was taught the same as you, that unlicensed personel and gestures are not an appropriate way to obtain consent/explain procedures.

I would disregard what your book says, and stick with what you have learned is correct. I know when I was studying for NCLEX I found a few errors in some of the review book answer sections. Don't fret too much over this one question, you have sound rationale behind your answer.

HTH

[BellsRNBSN]

I agree with the PP. We've been asked similar questions in my classes and what we were taught is that you ALWAYS get the hospital interpreter and you NEVER use a family member to translate.

Is there a professor you can talk to about that particular question and ask for the rationale behind the answer(s)?

[swansonplace]

Thanks. I emailed my professor, and I am awaiting a response. Thank You so much.

[Asystole RN]

Ask the client’s five-year son speaks the same language as the nurse explain the procedure

Unable to accept, transfer, or relay information reliably or consent personally or by proxy.

Have the hospital provided interpreter who speaks Swahili explain the procedure

Best answer.

Have the client’s husband who speaks the same language as the nurse explain the procedure

NOK, able to understand both languages, of age to accept, transfer, and relay consent. The legal bar that you must hurdle is, "What a reasonable nurse would do in a similar situation in a similar community." Is asking the husband reasonable and is it reasonable that no one on the floor speaks Swahili in that particular community? Can that husband relay the information to that patient and relay consent back to you in a reasonable fashion?

Use gestures to explain the procedure and observe the client’s nonverbal response that indicates an understanding of what is about to occur

Nonverbal methods of communication are seen as acceptable as long as the recipient is able to understand the communication, verfied through demonstration. (Written consent falls into this category)

What you have to realize is that consent must be provided through a means of communication...that means of communication is not something specified. It can be visual, auditory, smell, taste whatever.

If you have to use smoke signals and that patient understands your communication and is able to communicate back to you that they consent then you are legally covered.

The legal requirement is (as stated previously), "What would a reasonable nurse do in a similar situation in a similar community."

[Jolie, BSN]

The hospital interpreter is the best answer.

The husband may have to be utilized in a pinch, such as the patient is in urgent need of a procedure and no formal interpreter is available within a reasonable time frame.

The use of gestures is a very distant third and should only be considered if there is absolutely no other option. While you may be able to convey to the patient that you are about to give an injection and she may be able to convey to you that she understands this, there is no possible way to ascertain allergies, identify the medication and its purpose or relay risks/benefits/possible negative reactions, all of which are vital to informed consent.

[Meriwhen, ASN, BSN, MSN, RN]

In the perfect textbook world of nursing, using a hospital interpreter is the correct answer.

In the real world of nursing...until you get hold of that interpreter (and in most hospitals you can probably get one for Swahili, if not in person then at least via telephone), you could use the husband or family member--NOT the 5 year old, though. Even with the hubby interpreting, you run the risk of your message not being properly communicated as well as interpreter bias.

The risk with pantomine is that it may be impossible to tell if the patient truly understands what you are saying--for example, she may get that idea that you want to give her a shot...but how will you know if she consents to the drug inside the syringe?

[swansonplace]

Thank you so much for the help.