A nurse is teaching a newly licensed nurse about client confidentiality. The nurse should include which of the following examples represents a violation of client confidentiality?

a. Including the time the medication error occurred is important for accurately documenting the sequence of events and providing context for further investigation or review.
b. Making a copy of the incident report for personal record-keeping may not be necessary as the incident report is typically filed in the institution's records system.
c. Identifying the medication name and dosage administered to the client is essential for understanding the nature and severity of the medication error and guiding subsequent actions or interventions.
d. Placing a copy of the completed report in the client's medical record, which is inappropriate because incident reports are internal documents and not part of the client's health record.
e. Obtaining an order from the client's provider to complete the report may not be necessary as incident reporting is typically a standard practice and does not require provider authorization.

A: The autonomy of the patient is paramount in medical ethics. If the client understands the risks and still refuses the procedure, their choice must be respected. It is a fundamental right for patients to make informed decisions about their own healthcare.

B: While a durable power of attorney for health care is crucial when a patient is incapacitated, it does not override the wishes of a competent patient. As long as the client is capable of making decisions, their consent is required for any procedure.

C: Although religious beliefs are respected, they do not serve as the primary deciding factor if the client is competent. The client's understanding and decision-making capacity are the key determinants in whether to proceed with the surgery.

D: The ethics committee can provide guidance on complex cases, but it cannot make decisions for a competent patient. The committee's role is advisory, and the final decision rests with the patient.