一位 55 歲男性因心衰竭急性發作入住一般病房。在心導管檢查同意書討論期間,他英語能力有限且明顯對程序感到困惑,卻仍點頭表示同意。下列何項行動最能體現護理師的倫理倡導職責?
A 55-year-old male client is admitted to the medical unit with an acute exacerbation of heart failure. He speaks limited English and nods during the angiogram informed consent discussion, despite showing visible confusion about the procedure. Which action best represents the registered nurse's ethical advocacy responsibility?
- AEncourage the client to sign quickly because the cardiovascular condition requires prompt intervention.鼓勵病人盡快簽署，因為心血管狀況需要迅速介入
- BAsk any bilingual staff member on the unit to provide informal translation for the consent.請病房內任何會雙語的工作人員提供非正式的翻譯以協助簽署同意書
- CPause the consent process, hold the signature, and arrange a certified medical interpreter before continuing.✓ 正解暫停簽署程序，暫緩簽名，並在繼續之前安排合格的醫療通譯員
- DProceed with obtaining the informed consent signature because the client nodded affirmatively.繼續取得知情同意書的簽署，因為病人已點頭表示同意
知情同意必須建立在病人實質理解的基礎上。當病人語言能力有限且明顯困惑時,單純點頭並不構成有效同意,法律上同意書無效。護理師身為病人倡導者(advocate)應暫停流程,要求醫院聘請的合格醫療通譯員進行專業翻譯,不可由未經訓練的雙語員工或家屬代替,以避免醫療資訊誤譯與後續法律與安全風險。即使病情有時效壓力,維護病人自主權與正確的知情同意流程仍是優先。
Informed consent requires that the client fully understands the procedure, which is compromised by language barriers and visible confusion. The nurse must act as an advocate by pausing the process and arranging for a certified medical interpreter rather than relying on untrained staff or family members. This ensures accurate communication of risks and benefits, protecting the client's autonomy and legal rights regardless of clinical urgency.
只要是不懂英文的病患，無論情況怎樣，只要沒牽扯到『無意識且即將死掉的心肺停止急救』，就一定要叫官方 Certified Interpreter。