A patient withdraws consent before transfusion
RN OSCE practice station

The task

You are the RN on a hospital ward. Grace Okafor, aged 58, has a red cell transfusion prescribed for stable symptomatic anaemia. The pack is not connected and she has decision-making capacity. Confirm her wishes, explain options within your role and arrange a reviewed plan. Complete the supplied practice record. A second RN is available. Son Daniel is present. You have eight minutes; describe and select physical actions in this online exercise.

What this station tests

• Grace’s current capable refusal overrides yesterday’s written consent.
• Ask privately about the change of mind and family pressure.
• Notify the treating clinician for risks and alternatives without coercion.
• Return unused blood promptly and record that it was never connected.

Sources for the clinical content

• ACSQHC: Making informed choices (informed consent)
• Australian Red Cross Lifeblood: Transfusion process
• ACSQHC: Communicating for Safety Standard

An original practice scenario with invented patients. Not an exam question.

Practise next

• Preparing to start a red cell transfusion
• Rigors and hypotension during red cells
• An identifier mismatch before outreach transfusion
• Breathlessness during a red cell transfusion
• Preparing red cells for Peter Lawson