Communication, Professionalism, and Legal-Ethical Responsibilities
Therapeutic communication
Use open-ended questions, active listening, silence, reflection, and clarification. Avoid false reassurance ('you will be fine'), unsolicited advice, accusatory 'why' questions, and changing the subject. When a patient is angry, acknowledge the feeling before problem-solving. Use a qualified interpreter rather than a family member for consent and clinical information.
Legal framework
Informed consent is the provider's responsibility; your role is to verify the form is signed and to refer questions beyond your scope. HIPAA governs protected health information: discuss only with those involved in care, avoid hallway and elevator conversations, and secure screens and paperwork. Never document care you did not provide, never chart in advance, and never alter a record; correct errors with a single line, the word error, your initials, and the date. Incident reports are factual and objective and are not part of the medical record; chart the objective facts of the event without blame or opinion. Report suspected abuse or neglect under state mandatory reporting laws.
Ethics and professionalism
Core principles are autonomy, beneficence, nonmaleficence, justice, veracity, and fidelity. Advance directives and DNR orders must be honored, and the nurse informed if status changes. Accept only tasks within your training; delegation flows from the licensed nurse, and you may clarify or decline a task outside your scope. Use the chain of command when you disagree. Professional behavior means punctuality, appropriate appearance, confidentiality, teamwork, and owning mistakes promptly.
Worked example
A patient's daughter asks what her father's test results mean. Rule of thumb: empathize, then redirect, for example by saying you will let his nurse know the family would like to speak with the team. Never interpret results yourself.