Patient accussed me of not seeking consent

[hcsw4912]

So, I am a male Healthcate Support Worker for the NHS in Scotland.

Today, we had a patient that had come in with an overdose. I noticed that her skin hadn't been checked for pressure sores, and I asked the staff nurse about what should be done. She said to attempt to check her skin.

I woke the patient up (which took a few moments) and asked her if it was OK to check her skin. She nodded and then turned onto her side when asked. She was wearing jeans, and I told her I would have to undo her jeans to check her skin. As I attempted this, she suddenly turned around and demanded to know what I was doing. I explained that I had to check for pressure sores on her backside, to which she said "youre not doing that because I don't have any." I accepted that, and walked away.

About 5 minutes later, I came back and apologised to her, explaining that it was standard protocol for all patients. She said she understood that, but that I should have told hwr what was happening first. I said that I had asked her, but I apologised again.

A few hours later, the staff nurse spoke to me privately. She said that the patient had told her that I told her I was checking her skin, but that I didn't wait for consent. I explained that she did consent, but that I could accept that as she had just woken up, she may not have been fully aware of what she was consenting to, and that I accepted responsibility if that was the case.

The nurse said that from her perspective, she did not think this would go any further at the present moment, but mentioned the fact that patients can choose to report things at a later date. I offered to write a statement, but she said it wasn't necessary and that she wasn't going to note the incident.

I don't work on the ward full time (I am an agency worker), so I a  aware that there's probably not much I can do at the moment as I guess the matter's closed, but the situation has shaken me up a bit.

I'm just posting the story here for any advice anyone may have.

 

[Majie RN, CNA, LPN, RN]

Notify the charge nurse, supervisor, or manager of that hospital or facility and your agency about what happened. Patients accuse us HCWs here and there because their brains aren't functioning the way they should be.

I'm not an expert on this, but the patient gave you verbal consent to perform the skin assessment. If your workplace requires two people performing skin at all times and you didn't follow this policy, then you are in trouble.

Where I live, I always go to my manager or supervisor when this happens. Assessing the skin of our patients is part of our responsibility. We can get into legal trouble if we don't follow through unless the patient refuses. They always have the right to refuse. Always document everything! 

From my experience, if a patient is capable of using their arms, I ask them to remove their own clothing after getting their consent. I would only remove their clothes if they're unconscious or immobile. I stopped doing things for patients who have functional limbs to avoid ending up in situations like yours

[HiddenAngels]

Your situation is a little difficult because of her admitting diagnosis.  It's easy for us to say what we would or should have done with someone coming in this way.  If you asked her and she turned on her side, you could have again gone over to the side where she was facing and asked her again.  If she turns away from you, that's a refusal and you can document that.  If her arms were working, yes, I would have asked her to remove her own clothing, and always have a 2nd nurse, especially with the opposite sex.

Don't stress about too much.  Thank you for posting this.  It is a very good lesson for all of us to learn going forward.

[MarkMyWords]

Did the patient nod her head at all?  That is consent. Implied.

 I,  a man,was in a hospital post surgery, when a nurse walked in , and asked to see my back side butt, I nodded, as I was barely awake. I didn't care. She didn't say the reason. Something odd about her smile.