Students make mistakes, C.Is are liable

sunnysideup09 · Nov 16, 2008

First, no student should do a procedure unless the CI can verify the student knows what they are doing. Yes, the CI would be liable if she did instruct the student, but was not there when it was done and the student had an error. Most CI don't let students do anything on their own for this reason.

classicdame, MSN, EdD · Nov 19, 2008

Check with your Board of Nursing. You may not be liable for certain acts, as you cannot prevent malice or other acts if you are not physically present.

island40 · Jan 2, 2009

Depends on the state practice act. In IA the student bears responsibility for their own actions. Depending on the instruction and evaluation of competence given by the instructor- the CI could share in that responsibility, so can the assigned nurse in the facility, the facility pharmacy/tech/CNA/MD.. you name it. Depends on what happened and who was responsibile for making sure that it was done right. There is NO WAY one instructor can be present for ALL student activities- I've taught 10 students at a time. The other 9 are not sitting around staring at the walls. My AAS in paralegal studies comes in handy sometimes.

cholli · Jan 15, 2009

Even though the instructor demonstrated and instucted, they were still responsible to assess the student learning. That would be my question. Of course there is an entire spectrum of possibilities here. Each person is ultimately responsible for his or her own actions.

VickyRN, MSN, DNP, RN · Jan 16, 2009

In North Carolina, it's a gray area. Our BON states:

Does a nursing student “work under the faculty or preceptor’s license”?
A nursing student who is in a clinical area as part of an approved nursing education program is working as an “unlicensed provider”. The authority to practice or “student status” is granted in The Nursing Practice Act Article 90-171.43 License required (2).
Note: A student is held to the same standard of care as any licensed nurse.
Only the person named on the nursing license has the authority to practice nursing.
The faculty member and /or preceptor is responsible for “appropriate supervision and delegation.” The law allows a licensed nurse to delegate certain nursing responsibilities to individuals who are competent to perform the assignment. Persons caring for the patient are responsible for knowing the boundaries of their job and for knowing if they have the knowledge/skills/abilities to provide for the client’s needs. It is up to each nurse to decide what activities can safely be assigned to another individual based upon the agency policies/procedures, the education/training of the individual, and the validated competency of the individual. When the nurse has delegated appropriately he/she is not accountable for the actions/errors of the individual assigned the task.

http://www.ncbon.com/content.aspx?id...ursing_License

I think the key phrase here is "The faculty member and /or preceptor is responsible" - but it's still very murky.

Also, according to the NCBON (in reference to delegation):

“The licensed nurse maintains accountability and responsibility for the delivery of safe and competent care”

http://www.ncbon.com/content.aspx?id=826

WHICH licensed provider – the nursing instructor, the primary nurse in charge of the patient – or BOTH – is unclear.

When questioned about this, one of the education consultants from the NCBON shrugged and confirmed that this is a gray area.

One of our primary clinical sites, a very large teaching hospital, has included the following in their policy and procedure concerning student nurses in their facility and ultimate accountability for any patient harm:

“The responsibility for nursing care and related duties is retained by the hospital nursing unit when nursing students are providing care within a patient care unit.” And “The RN delegates patient care assignments to licensed personnel, and aspects of care to unlicensed personnel, based on the qualifications of the staff members for meeting the needs of the patient. Patient care is supervised throughout the shift by an RN.” And yet another policy (can’t quote the exact words) states that the ultimate responsibility for the patient and patient care (when students are involved) is retained by the primary nurse.

So, I echo previous advice - check with your BON, check the policies and procedures in the clinical site facility, and also confer with your nursing program director.