Question:
Dear Nancy,
I am employed as an adjunct faculty, and I had a question about students administering medication. Is it legal for nursing students to administer medication with only the staff RN present, or does the staff nurse have to watch, too? Who is liable in case of a med error? All the students had passed a med competency exam and were observed giving medications.
Helen
Nancy replies:
Dear Helen,
During their clinical rotations, nursing students are able to provide nursing care that an RN provides so long as certain conditions are met. Obviously, the first is that the clinical rotation conforms with the state nurse practice act in terms of, for examples, student to faculty ratios and the definition of nursing practice in the act and/or rules. Additionally, the importance of conformity with the nursing education program?s requirements concerning clinicals must occur.
One requirement of utmost importance would be the nursing student?s competency and experience in administering the medication required for the patients for whom he or she is assigned. This competency would include not only a knowledge of the medication administered but also how it is to be administered. Again, as an example, the student nurse may know the drug?s side effects, its contraindications, and how the dose is calculated. The student must also be competent in administering the medication (e.g., IM injection).
Most clinical nursing education rotations use preceptors from the nursing staff to make the most of the clinical rotation and also provide oversight (as defined by the nursing program?s policies) when the students are providing care to the patients in the facility. This is also necessary due to the fact that students are on different units/floors in the facility and the faculty member cannot be in all places at the same time when students provide care.
Generally, however, it is best that a student not administer a medication or provide other care the first time the medication is administered or the particular care done (e.g., wound dressing change) without the faculty member present. The clinical rotation syllabus and other guidelines can help spell out this requirement so that students and staff preceptors know that when there is a ?new? procedure or patient care responsibility to be carried out, the faculty member must be contacted so he or she can be present to instruct the student, observe the student, and provide an evaluation of the student?s care.
Consulting with the educational facility?s legal counsel would be a wise move to ensure that the nursing program?s policies are fashioned to protect the patient and all those working with the student in the clinical area.
Cordially,
Nancy
Nancy J. Brent, RN, MS, JD, is an attorney in private practice in Wilmette, Ill. This information is for educational purposes only and is not intended as legal or any other advice. The reader is encouraged to seek the advice of an attorney or other professional when an opinion is needed.
