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Liability Issues: Potential Legal Peril for On-Line Nursing Instructors/New Horizons.

This column will address the potential legal peril faced by on-line nursing instructors who teach out of state nursing students. For purposes of this hypothetical discussion, the students, as part of their on-line RN to BSN undergraduate nursing program of study, are required to carry out various projects in a variety of healthcare environments in their home states. The on-line instructor lives and is licensed in New Mexico but also maintains a nursing license in Pennsylvania, where several of her students reside and are doing their clinical projects. The New Mexico nursing education program requires the adjunct online nursing instructor to maintain a Pennsylvania license (since the students are in Pennsylvania). For "on the ground" questions or concerns, the Pennsylvania students work on their projects in healthcare organizations where they are overseen by volunteer clinical mentors whose qualifications are vetted by the on-line nursing program.

Q: What is the defense or recourse for the New Mexico on-line nurse instructor, who, along with the nursing student, gets named in a Pennsylvania board of nursing (BON) complaint or investigation, or who is reported to the Pennsylvania BON? Who bears oversight responsibility when a Pennsylvania nursing student of the on-line faculty is involved in a medical incident, HIPAA matter or other adverse event in the healthcare organization, where the nursing student is carrying out a course project?

A: The on-line nursing instructor may have no defense or recourse to the above, given that the online instructor was not a witness to the event(s) and has no physical presence in the state. Notwithstanding, by having a nursing license in Pennsylvania, the on-line New Mexico nursing instructor could still be subject to sanction, reprimand, discipline and possible license revocation by the Pennsylvania Board of Nursing due to being the "instructor of record." Sanctions could attach even though the position is as an on-line nursing instructor.

The on-line instructor and other nursing education program constituents could also be sued over the out-of-state adverse event but the New Mexico online nursing instructor, as the license holder, will bear the legal risk to the license. Any sanctions can be permanent and reportable nationally. From a legal standpoint, this issue is new ground as on-line nursing education programs, that also include clinical components, spring up across the country.

The responsibility falls to on-line nursing instructors to determine what level of liability coverage is necessary for the on-line teaching role. Also, the online faculty would need to maintain regular contact with each student and mentor while the health care organization project or experience is underway. Ideally, the on-line instructor should be fully compensated, commensurate with assumption of the increased level of risk caused by having students engaged in healthcare organizations that are in states where the on-line faculty has neither physical presence nor contact; that is, if despite the lack of physical presence in the state or states, the (remote) on-line nurse instructor is obliged by the nursing education program to maintain nursing license(s) in those states in which he/she has students. Finally, the bright line responsibilities of the "on the ground" clinical mentors need to be spelled out and formally contracted by the online program. This would also include appropriate monetary compensation for the mentors.

Dr. Karen L. Brooks, Esq., EdD, MSN RN Graduate Nursing Faculty Lead (Remote: Santa Fe, New Mexico) College of Online and Continuing Education Southern New Hampshire University
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Author:Brooks, Karen L.
Publication:New Mexico Nurse
Date:Jan 1, 2018
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