Communication, Ethics, and Patient Rights
Communicate with patients and the care team effectively, and understand the rights that govern how patients are treated.
By the end of this lesson you can
- Report observations to a nurse clearly and completely
- Describe fundamental patient rights
- Recognize and report abuse or neglect
- Maintain dignity in personal care
Lesson Notes
Read through the key concepts before you try the challenge.
Reporting is the job
You are working a medical unit at Lakeside Regional.
You notice a patient's breathing seems faster than this morning and they are quieter than usual. You mention at handoff that they 'seemed a bit off.' The oncoming nurse has nothing actionable, and a deterioration that was visible at two o'clock is found at six.
Your task: Report observations specifically enough that a nurse can act on them.
A PCT's most valuable contribution is often an observation nobody else was present to make. That value is realized only when the observation is reported in a form a nurse can use — which means specific, measured, and compared to a baseline.
| Vague | Actionable |
|---|---|
| Seems a bit off | Respirations 26, up from 16 this morning; quieter than usual; declined lunch |
| Didn't eat much | Ate about 25% of lunch; no breakfast |
| Seems confused | Did not know where she was at 1400; oriented at 0800 |
| Complained of pain | Reported 7/10 pain in right hip on repositioning at 1330 |
| Skin looks bad | New 2 cm reddened area over sacrum, does not blanch |
| Right | In practice |
|---|---|
| To be treated with dignity and respect | Knock, introduce yourself, explain before you touch |
| To privacy and confidentiality | Curtains and doors closed; no discussion in corridors |
| To refuse care | A patient may decline anything; report the refusal, do not override it |
| To be informed | Explain what you are about to do, every time |
| To be free from abuse and neglect | Recognize it and report it; you are likely a mandated reporter |
| To be free from unnecessary restraint | Restraints require an order and close monitoring |
Abuse and neglect must be recognized and reported. Physical signs include unexplained bruising, particularly in patterns or at various stages of healing. Behavioral signs include fear of specific staff or visitors, withdrawal, or a change in demeanour when someone is present. Neglect shows as poor hygiene, dehydration, untreated pressure injuries, or unmet basic needs. Healthcare workers are mandated reporters in most jurisdictions — report through your facility's process, and reporting is required whether or not you are certain.
A competent patient refuses their scheduled bath. What should you do?
Challenge
Apply what you've learned in this lesson.
Precision in reporting is learnable and immediately useful.
- Rewrite each as an actionable report: 'She's not herself today.' 'He didn't sleep well.' 'The wound looks worse.' 'He's in a lot of pain.'
- Research the SBAR communication format. Write an SBAR report for the patient in the opening scenario.
- Find your state's mandated reporter requirements for healthcare workers. Note who must report, what, and within what timeframe.
- List four signs of possible abuse and four of neglect, and describe how you would report a concern through a facility process.
Finished this lesson?
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