1. Johnson, Carol Susan PhD, RN-BC, NE-BC
  2. Smith, Charlene M. DNS, MSEd, WHNP, RN-BC, CNE, ANEF

Article Content

Legal and ethical issues confronting nursing professional development (NPD) practitioners in the learning process can be numerous and complex. NPD practitioners in their leadership role must differentiate between civil, administrative, and criminal law and understand how each affect legal liability in the learning environment. This column is an overview of legal and ethical issue for NPD practitioners. This column is not meant to be a substitute for legal advice. Refer to your organization's policies and legal counsel for answers to specific questions or particular situations.



Civil law involves lawsuits by private individuals or organizations and often relates to contracts or torts, which are defined as liability for harm or injury to a person by an action or omission (De Pietro, 2016). As the NPD leader, you may advise your organization about contracts for new services or products. As a member of the project team, you will collaborate with human resources, finance, and legal departments to ensure that all services are explicitly defined in the contract, including requirements for evaluation of outcomes. Once agreed on in writing, contract terms cannot be changed. The NPD practitioner must keep a copy of all contracts managed by or involving the department and may be called in a breach of contract suit if a vendor cannot provide the product as stated or deliver technical support as defined in the contract (De Pietro, 2016).


Torts apply to a civil wrong or harm to a person or his or her property (De Pietro, 2016). The most common tort lawsuit is professional negligence or malpractice. Malpractice is the most common healthcare lawsuit and has four elements that apply to NPD practitioners. These include a duty owed to the plaintiff(s) by the defendant(s) or practitioner-patient relationship, a breach of this duty by an action or omission, harm or injury foreseeably caused by the defendant(s), and damages incurred due to the harm (De Pietro, 2016). The NPD practitioner owes a duty to learners and the patients for whom they provide care. A breach of duty occurs when the NPD practitioner does not follow standards of care or practice defined in organization policies and procedures, or those established by the profession or specialty. To avoid a breach of duty, the NPD practitioner must know and follow these standards in the learning environment when delivering educational programs and materials. NPD practitioners may also be cited in injury causation and damages if proper orientation or continuing education about new policies, processes, or equipment is not provided to staff. The NPD practitioner's role in orientation and ongoing staff education must meet acceptable standards and expertise in competency assessment to facilitate learning that guides staff members toward competent practice. Other actions by NPD practitioners to protect themselves and staff members from civil liability include asking permission to touch someone; not making false statements about colleagues, staff members, or education participants; not compromising patient or work information on social media; sharing information on a need to know basis only; and only using photos with permission for educational purposes (De Pietro, 2016).



These regulations are created by federal and state agencies, and penalties include fines and even license revocation (De Pietro, 2016). NPD practitioners must be knowledgeable about their state's nurse practice act and the scope of practice for interprofessional collaborators from other healthcare disciplines. The NPD practitioner is responsible or observing, assessing, documenting, and reporting behaviors that violate standards of practice and organizational expectations. These behaviors include unprofessional conduct, incompetence, or gross negligence (De Pietro, 2016). The NPD practitioner collaborates with human resources and the organization's leaders to establish a baseline for employee competence and identify the competency assessment process, including remedial or corrective actions. Arrangements are made for staff who require accommodations for disabilities in competence measurement. Students carry a legal risk for the organization, and the NPD practitioner safeguards patient safety by ensuring enforcement of the affiliation agreement between the organization and the educational facility. The NPD department orients students and clinical faculty to meet requirements of organization policies and procedures as well as monitors compliance. The NPD practitioner also follows guidelines for employee education as directed by accreditation and regulatory agencies, such as Centers for Medicare & Medicaid Services, The Joint Commission, the state's department of health, and Occupational Safety and Health Administration, as well as complies with the Equal Employment Opportunity Commission in protecting employee rights in education and training sessions (De Pietro, 2016).



Criminal law is public law based on common law or statute that prohibits behaviors offensive to the state or society. Healthcare professionals may commit crimes punishable by incarceration, loss of license and position, and disciplinary action through administrative law methods (De Pietro, 2016). The NPD practitioner must recognize potential crimes in the learning environment, such as theft of an examination, falsifying a patient entry, backdating documentation, appropriating patient medications, and fraudulent use of patient data. Such crimes must be immediately reported, and evidence must be documented, including witness statements. Although criminal law is not commonly a focus in clinical practice, swift attention to potential crimes committed by healthcare personnel requires fair and nondiscriminatory compliance with policies for reporting, suspension, probation, or termination (De Pietro, 2016).



Armed with basic legal knowledge affecting NPD practice in the learning environment, the NPD practitioner must demonstrate "compassion and respect for the inherent dignity, worth, and unique attributes of every person" (ANA, 2015, p. 1). All learners are unique and deserve respect for what they bring to the learning experience. The NPD practitioner must integrate ethical behaviors into practice by supporting the needs of diverse learners in professional development programs and required training and education. By role modeling acceptance and advocacy for learners, the NPD practitioner "protects the autonomy, dignity, confidentiality and rights of all individuals involved in the learning process" (Harper & Maloney, 2016, p. 42).


Legal and ethical practice is an expectation for all healthcare personnel. However, many NPD practitioners lack knowledge about the legal liabilities and ethical parameters frequently encountered in the healthcare setting. If you are an NPD practitioner reading this column, take the opportunity to explore these issues in greater depth and enhance your practice. You will be glad you did and so will your learners.


Join us in next month's column and learn how to develop, implement, and evaluate a successful NPD department plan that supports the organization's mission, vision, and strategic goals.




American Nurses Association. (2015). Code of ethics for nurses with interpretive statements (2nd ed.). Silver Spring, MD: Author. [Context Link]


De Pietro S. (2016). Ethical and legal issues in nursing professional development. In Smith C. M., Harper M. G. (Eds.), Leadership in nursing professional development: An organizational and system focus (pp. 78-109). Chicago, IL: Association for Nursing Professional Development. [Context Link]


Harper M. G., Maloney P. (Eds.). (2016). Nursing professional development scope and standards of practice (3rd ed.). Chicago, IL: Association for Nursing Professional Development. [Context Link]