OSCE Test

A client who wants to leave and refuse treatment
IENCAP OSCE practice station

Ethics, consent & capacity · 2 min to read · 13 min to perform

Try a real conversation · IENCAP OSCEAI practice

George Papadakis, aged 77, was admitted last night with a serious skin infection of the lower leg and is due to continue intravenous antibiotics.

George PapadakisI am going home. Take this needle out of my arm.

Free · no sign-up · uses your one free station

The task

You are the nurse on a medical unit in Ontario. George Papadakis, aged 77, was admitted last night with a serious skin infection of the lower leg and is due to continue intravenous antibiotics. He has told a colleague he wants to go home now and does not want the IV. A colleague is nearby. Introduce yourself and talk with him. Explore his decision, including whether he understands the information. Decide what you need to do and who to tell. Record the conversation and your actions in the note provided.

What this station tests

  • Capacity is presumed. It is specific to the decision and not decided by age or an unwise-looking choice.
  • Ontario's test: can the person understand the relevant information and appreciate the foreseeable consequences? Also check the choice is voluntary.
  • Find the real reason behind a refusal and offer ways to solve it.
  • Never restrain or coerce. Involve the physician for formal assessment and review.
  • Record the client's own words and the options you offered.

Sources for the clinical content

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

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