We’ve all experienced the awkwardness of clinical learning as nurse practitioner students. Mastering the skill set required to work as an NP means practicing on real, live patients even before you are considered proficient at that skill. Anxious, you stutter and sweat as you explain the procedure to the patient, the more experienced eye (hopefully!) of your preceptor looking over your shoulder.
Even under the supervision of an experienced clinical preceptor, mastering procedures, making diagnoses, and treating medical conditions inherently carries risk. If you have volunteered to precept a nurse practitioner student, can you be held liable for the NP student’s actions? In short, yes.
Ultimately, there are several parties responsible for the actions of nurse practitioner students. If a medical error occurs, all, some, or a single one of these parties may be held accountable. Individuals and entities potentially liable for the actions of a nurse practitioner student include the NP student personally, the preceptor, the clinical facility, and the NP school.
The Nurse Practitioner Student
Students are held to the same professional standards for individuals in the profession for which they are training. Students are accountable to the standard of care expected of NPs. So, nurse practitioner students can be held personally liable for actions taken in the clinical setting.
Given this liability risk, NP students must obtain medical malpractice insurance. Typically, liability insurance plans for nurse practitioner students are purchased by the school. The cost of premiums is passed on to the student by inclusion as part of tuition or as an added fee paid to the school rather than directly to the insurance company.
The Facility and The University
Nurse practitioner programs obtain agreements with clinical sites, called affiliation agreements, prior to placing students in the site. Affiliation agreements outline the responsibilities of both the university and clinical facility.
Ultimately, the student is considered an agent of the facility when engaged in patient care in the clinical environment. The facility is more likely to be held liable for actions taken by the NP student in the clinical setting than the university.
The Preceptor
Nurse practitioner students do not practice directly with the preceptor’s license. Rather, a preceptor is responsible for a nurse practitioner student’s actions based on the principles of delegation.
State delegation laws for advanced practice providers require that NPs delegate tasks only to individuals who are properly trained, and that the task is within the individual’s scope of practice. In the case of precepting an NP student, the scope of practice considered would be that of nurse practitioners in the state where the clinical site is located.
Healthcare providers precepting NP students must take care to delegate appropriately. This begins with establishing the competence of the individual student and tailoring the level of supervision and delegation of tasks appropriately. Patients should never be placed in danger by a student’s inexperience.
There are surprisingly few lawsuits involving student advanced practice providers. In those that do occur, circumstances and courts dictate which of the above parties is held accountable for the event. The American Association of Nurse Anesthetists gives several examples of legal cases involving CRNA students.
Preceptors are in high demand, and precepting a student is a great way to give back to the nursing community. Entering into a preceptor arrangement, however, should not be taken lightly.
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