Arm bruising before going home with a nephew
RCSI OSCE practice station
Ethics, consent & capacity · 1 min to read · 10 min to perform
Mr Francis Hogan, aged 78, is waiting for discharge after a fall.
Mr Francis HoganI'm going home today with Conor. I'm grand.
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Open the full station (charts, voice, result letter) →The task
You are the nurse on a medical ward. Mr Francis Hogan, aged 78, is waiting for discharge after a fall. While helping him dress, you notice bruising on both upper arms. His nephew has come to take him home today and Mr Hogan says he wants to go. Speak with Mr Hogan privately. Introduce yourself and confirm his identity. Explore the bruising and what he wants, check that he understands his decision and decide how to respond. The nurse in charge is available. Record your conversation and actions.
What this station tests
- See and speak to the person alone; do not confront the alleged abuser.
- Do not promise confidentiality when someone may be at risk.
- Presume capacity; assess it for the specific decision and support the person to decide.
- An unwise decision is not evidence of lack of capacity.
- Report concerns under the national safeguarding policy and record facts in the person's own words.
Sources for the clinical content
- HSE: recognising and supporting adult safeguarding
- Irish Statute Book: Assisted Decision-Making (Capacity) Act 2015
- Decision Support Service
- HSE: National Consent Policy
- NMBI: Code of Professional Conduct and Ethics
- RCSI: overseas aptitude test preparation (public topic list)
An original practice scenario with invented patients. Not an exam question.