A nurse is assisting with teaching a class about the roles and responsibilities of a case manager. Which of the following responsibilities should the nurse include?

Choice A reason:A nurse explaining the details or steps of a surgical procedure goes beyond their professional scope. Providing detailed procedural explanations is the role of the surgeon or primary provider, as they possess the medical expertise and legal responsibility to ensure informed consent. When a nurse provides such explanations, it can cause misinformation, legal liability, and confusion for the patient, making this behavior unprofessional.
Choice B reason: This is incorrect. Witnessing a client consent for a surgical procedure is not unprofessional, but a professional responsibility of a nurse. A nurse should act as a witness to the client's signature on the consent form, and ensure that the consent process was conducted properly, ethically, and legally².
Choice C reason:A nurse confirming client competency to provide consent is also within professional practice. This involves assessing whether the client is alert, oriented, and able to make decisions. Ensuring competency helps protect the client’s rights and supports ethical nursing practice.
Choice D reason: This is incorrect. Verifying that a client voluntarily gave consent to a surgical procedure is not unprofessional, but a professional obligation of a nurse. A nurse should ensure that the client's consent was given freely, without any coercion, manipulation, or undue influence from others². A nurse should also respect the client's right to withdraw or change their consent at any time².

The correct answer is: c. Less time for direct client care

Choice A: Decreased amount of paperwork

Reason: One of the advantages of electronic charting is that it significantly reduces the amount of paperwork. Traditional paper records require extensive manual documentation, which can be time-consuming and prone to errors. Electronic systems streamline this process, making it easier to input and retrieve patient information. Therefore, decreased paperwork is a benefit, not a challenge.

Choice B: Increased number of medication errors

Reason: Electronic charting systems are designed to reduce medication errors by providing features such as electronic prescribing, automated alerts for potential drug interactions, and barcode scanning for medication administration. These systems help ensure that the right medication is given to the right patient at the right time, thereby decreasing the likelihood of errors. Hence, increased medication errors are not typically associated with electronic charting.

Choice C: Less time for direct client care

Reason: One of the significant challenges of electronic charting is that it can be time-consuming, requiring nurses to spend a considerable amount of time on documentation. This can reduce the time available for direct patient care. Nurses often report that the demands of electronic documentation can detract from their ability to engage with patients, perform assessments, and provide hands-on care.

Choice D: Provides evidence of care provided

Reason: Providing evidence of care is a benefit of electronic charting, not a challenge. Electronic health records (EHRs) create a detailed and accurate record of the care provided, which can be easily accessed and reviewed. This documentation is crucial for legal, regulatory, and quality improvement purposes. Therefore, this option does not represent a challenge.