Avoiding Liability Bulletin – August 1, 2012

In recent years, many states have required licensed nurses, sometimes including all levels of licensure, to complete continuing education courses in order to renew their licenses.  Illinois, Iowa, Alabama, Delaware, Utah, New Mexico, and Pennsylvania are but a few states that require continuing education courses.  Each state that has mandatory continuing education sets its own hours, the types of courses that are acceptable, and which licensed nurses are required to complete the requirements.  Similarly, if a licensed nurse does not complete the requirements prior to licensure, the state sets its own ramifications (e.g., a fine, completion of required courses within a certain time, no renewal). 1

You may ask why you as a licensed nurse must continue to take courses in order to keep your license active, especially after your grueling educational preparation.  Because continued learning is life-long, and with the advances in health care constantly changing, continued competency in nursing has been a topic of much concern to the nursing profession as a whole. 2  Because each board of nursing is responsible for ensuring, as best as possible, that only competent and safe practitioners provide care to the public, requirements for meeting these characteristics in licensed nurses were identified and included in state nurse practice acts.

So, what does completing a continuing education course do for your competency and safe practice?  For one, a good CE course will introduce you to research and new practice issues in your area of nursing specialty.  “Hands on” courses, for example, where you get the opportunity to actually use new equipment or at least view a demonstration of the patient care apparatus are really helpful when having to use the equipment in your actual practice.

Keeping up with patient and family rights is another area of information essential to your role as a patient advocate, is part of the nurse-patient relationship, and is a key component in your role as a teacher and as a resource for both the patient and his or her family.  This will be particularly important as new federal and state laws are passed or amended that protect patient rights.  Some of these laws include changes in Medicare and Medicaid, the Health Insurance Portability and Accountability Act (HIPAA), and the recently passed (and upheld by the United States Supreme Court) Affordable Care Act. 3

Strengthening and renewing your ability to communicate effectively with your patient and his or her family is another area of continuing education that can help you be more in tune with your patient’s concerns.  “Active listening” is an essential element of any nurse-patient dialogue. 4

Another area ripe for CE credits is updates on the law and updates on risk management generally.  Particularly important, though not exclusively so, are courses that focus on the state nurse practice act, its rules, and the scope of your practice as an L.P.N., R. N., or advanced practice nursing (A.P.N.).

Keep in mind that it is your responsibility to select, attend, and learn from whatever CE courses you decide to take.  Most states require you to keep track of the CE credits you have earned during the applicable period, keep the documentation of the courses attended, and attest to the fact that you have met the CE requirements for your state when you renew your license.

How best to make the most of your CE experience so that the experience translates into better, safer patient care and therefore helps avoid the risk of liability?  Here are a few pointers:

  1. Select courses that have content you can apply to your area of practice;
  2. Carefully listen to the course instructor and comments from the other members of the audience;
  3. Ask pertinent questions about the content and how it applies to your area of nursing practice;
  4. When you can’t attend a course in person, choose other ways to obtain the information you need (e.g., through accredited on-line or booklet courses);
  5. Always fill out an evaluation form (required for CEs to count as CEs in most states) and do so honestly;
  6. Consider asking your nurse colleagues to attend a CE course with you.  Many times there is a discount if more than one attendee registers as a group; and
  7. Provide feed-back to your state board of nursing about how the CE requirement can be improved, if areas of improvement are identified.


  1. “State Board Information Resource”.  NursingRequirements.com. Available at http://www.nursingrequirments.com/statelist.aspx . Accessed July 28, 2012.

2. See  National Council of State Boards of Nursing (2005).  Meeting The On Going Challenge of Continued Competency in Nursing. Available at: https://www.ncsbn.org/ContinuedCompPaperTestingService.pdf . Accessed July 28, 2012; National Council of State Boards of Nursing (2011). Statement on Continuing Competency For Nursing: A Call To Action.  Available at: www.ncsbn.org/DisplayFile.aspx?ID=200Accessed July 28, 2012.

3. The Affordable Care Act (2010).  Available at: http://www.healthcare.gov/law/full .  Accessed July 28, 2012.

4. “Active listening” is a term coined by several psychotherapists in the 1950s.  It has been described as being attentive to the patient and not using learned social communication patterns that cut off, rather than sincerely explore, patient communication.


Nancy J. Brent (2001), “Professional Negligence: Prevention and Defense”, in  Nurses And The Law: A Guide To Principles And Applications by Nancy J. Brent.  Philadelphia:  W.B. Saunders, 79.


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Nancy Brent

NANCY J. BRENT, MS, JD, RN, received her Juris Doctor Degree from Loyola University Chicago School of Law. Ms. Brent has been in practice for over 40 years and concentrates her solo law practice in education and consultation for nurses, nursing organizations, and health care delivery systems. She also defends nurses before the Illinois Department of Financial and Professional Regulation. Ms. Brent has published and lectured extensively in the area of law and nursing practice.