Key Takeaways
- All patients have fundamental rights including privacy, informed consent, and the right to refuse treatment
- HIPAA protects patient health information and limits disclosure to those with a need to know
- Advocacy means supporting patients in understanding and exercising their rights
- LPN/LVNs must report suspected abuse or neglect of vulnerable populations
- Cultural and religious preferences should be respected while providing care within legal and ethical boundaries
Client Rights and Advocacy
Every patient has fundamental rights that must be protected regardless of their age, diagnosis, or ability to communicate. The LPN/LVN serves as an advocate by ensuring these rights are respected and patients receive the care they deserve.
Fundamental Patient Rights
| Right | Description | LPN/LVN Responsibility |
|---|---|---|
| Privacy | Protection of personal information | Follow HIPAA, close curtains, speak quietly |
| Dignity | Respectful treatment | Address appropriately, maintain modesty |
| Informed consent | Understanding before treatment | Witness consent, report questions |
| Refuse treatment | Decline any intervention | Respect choice, document, report to RN |
| Information | Access to own health information | Facilitate access, answer within scope |
| Safety | Protection from harm | Follow safety protocols, report hazards |
HIPAA: Privacy Protection
The Health Insurance Portability and Accountability Act (HIPAA) protects patient health information.
Protected Health Information (PHI) includes:
- Name, address, date of birth
- Social Security number, medical record number
- Diagnosis, treatment information
- Any individually identifiable health data
HIPAA Requirements for LPN/LVNs:
| Do | Don't |
|---|---|
| Discuss patients in private areas only | Discuss patients in elevators or cafeterias |
| Access only records you need for care | Look at records of patients not in your care |
| Log off computers when stepping away | Leave screens visible to visitors |
| Dispose of papers in shredder bins | Put patient information in regular trash |
| Verify caller identity before giving information | Give information to unverified callers |
When Can You Share Information Without Consent?
| Situation | Disclosure Allowed |
|---|---|
| Treatment | To other providers involved in care |
| Payment | To insurance for billing purposes |
| Operations | For quality improvement, training |
| Legal requirement | Court order, mandatory reporting |
| Imminent danger | To prevent serious harm to patient or others |
Informed Consent
The LPN/LVN role in informed consent:
- Witness signature on consent forms
- Verify patient identity and capacity
- Report concerns if patient seems unsure or has questions
- Document the consent process
The LPN/LVN does NOT:
- Explain procedures or surgical interventions
- Provide information about risks and benefits
- Obtain the consent (this is the provider's responsibility)
If a patient has questions about a procedure while you are witnessing consent:
- Stop the signing process
- Notify the provider or supervising RN
- Document that the provider was notified
Refusal of Treatment
Competent adults have the absolute right to refuse any treatment, even if refusal may result in death.
When a patient refuses:
- Ensure understanding - Does the patient know the consequences?
- Notify the RN - Report the refusal immediately
- Document thoroughly - What was refused, who was notified
- Respect the decision - Do not coerce or manipulate
- Continue other care - Refusal of one thing doesn't mean refusal of all care
Advocacy in Action
Advocacy means:
- Speaking up when something seems wrong
- Ensuring patients understand their options
- Connecting patients with resources
- Reporting concerns to appropriate personnel
- Respecting patient wishes even when you disagree
| Situation | Advocacy Action |
|---|---|
| Patient doesn't understand medication instructions | Request RN to provide additional teaching |
| Family pressuring patient to make a decision | Support patient's right to decide for themselves |
| Patient afraid to ask doctor questions | Offer to help communicate concerns |
| Patient's pain seems undertreated | Report to RN, advocate for adequate relief |
Mandatory Reporting
LPN/LVNs are mandated reporters for:
| Situation | Report To |
|---|---|
| Child abuse/neglect | Child Protective Services |
| Elder abuse/neglect | Adult Protective Services |
| Dependent adult abuse | Adult Protective Services |
| Gunshot wounds | Law enforcement |
| Communicable diseases | Public health department |
You must report suspected abuse even if:
- You don't have proof
- The victim asks you not to report
- The alleged abuser is a family member
- You're uncertain about what happened
Cultural and Religious Considerations
Respecting diversity while providing care:
| Consideration | Approach |
|---|---|
| Language barriers | Use professional interpreters, not family |
| Dietary restrictions | Communicate needs to dietary, respect choices |
| Religious practices | Accommodate when possible, consult chaplain |
| Modesty preferences | Provide appropriate coverage, same-sex caregivers |
| Decision-making styles | Some cultures prefer family-centered decisions |
Never:
- Make assumptions based on appearance
- Force patients to accept care against beliefs
- Use children as interpreters for medical information
- Judge lifestyle choices or cultural practices
On the NCLEX-PN
Expect questions about:
- HIPAA requirements and violations
- When to report suspected abuse
- Supporting patient autonomy
- The LPN role in informed consent
A family member calls the nursing station asking about their mother's condition. The LPN should first:
While witnessing a consent form for surgery, the patient tells the LPN, "I'm not really sure what they're going to do." What should the LPN do?
An LPN suspects that an elderly patient is being financially exploited by a family member. What action should the LPN take?