NC court: Nurses liable for patient harm, even if result of doctors’ orders

The following is an excerpt from Becker’s Hospital Review.

Nurses in North Carolina can now be sued for patient harm that results from them following physicians’ orders, the state Supreme Court ruled last month. 

The Aug. 19 ruling strikes down a 90-year-old precedent set by the 1932 case Byrd v. Marion General Hospital, which protected nurses from culpability for obeying and executing orders from a physician or surgeon, unless the order was obviously negligent. 

The North Carolina Supreme Court overturned this ruling in a 3-2 opinion as part of a separate case involving a young child who experienced permanent anoxic brain damage during an ablation procedure at a North Carolina hospital in 2010.

The ruling means the certified registered nurse anesthetist involved in the ablation could be held liable for the patient’s harm. 

“Due to the evolution of the medical profession’s recognition of the increased specialization and independence of nurses in the treatment of patients over the course of the ensuing ninety years since this Court’s issuance of the Byrd opinion, we determine that it is timely and appropriate to overrule Byrd as it is applied to the facts of this case,” Justice Michael Morgan wrote in the opinion. 

Read the full opinion here.

Leave a Comment

Your email address will not be published. Required fields are marked *

15 thoughts on “NC court: Nurses liable for patient harm, even if result of doctors’ orders”

  1. Well that ruling will send more nurses out of the field into other careers. Good luck finding stoolies to take the rap for a doctor’s negligence.

    1. I pretty much agree with what you say here. I don’t know the details of the case, but if precedent already had an exception for doctor’s orders which were obviously negligent, then this puts them in a bad position.

      Having said that, I think that striking nurses do not belong in the profession and should be fired so more suitable people can take their place.

      1. Therpa…. You are a lay-person, obviously. Following a Drs orders is sacrocinst. The DR is giving the orders. Now we nurses are damned if we Do & Damned if we DO NOT !!! we NO LONGER have ANY protection from the law. RUN… FASTER !!

        1. Martin Ginsburg

          Nurses are not John Dean. Even soldiers are required by military law to refuse unlawful orders.

          Physician orders haven’t been sacrosanct since the 1940s. That’s when docs started demanding BSNs instead of the Diploma nurses who were far and away better patient advocates. The educational model made for better early career nurses able to start work with only a couple weeks orientation instead of more than 12 weeks like these days.

          Funny thing is that during the first 7 years of computer boards – remember the test to be sure you’d be safe to practice nursing, Diploma nurses outscored BSNs and ASNs more than 22 of 28 quarters. ASNs took the lead more times than BSNs.

  2. When I worked in the field (stopped in 2018) the staffing ratios were unsafe. A med surg nurse could have 7 patients ( not counting the discharges and admissions which add even more stress) and she may not have a tech to help with the baths, Vital signs, walking, feeding. And hearing from nurses still in the field, it is worse.
    So easy to make a mistake, forget something or neglect checking on a patient…all the while not taking breaks!

  3. This makes no sense. Nurses must follow doctor’s orders except in cases where they know, even at their lower level of training, it is blatantly wrong. Then they should discuss it with the doctor. Then they still could refuse to carry out the order.

  4. This case was about an “Advance Practice Nurse”. A “Nurse Anesthetist “, who essentially is providing anesthesia- and SHOULD (in theory) be supervised by the MD. I hope the general duty “Nurse” is not lumped into this. A good Nurse knows they do not know everything: and is required to frequently research diseases, drugs, etc. A State’s Nurse Practice Act defines their scope of practice. I was one for 46 years- 2+ years in NC as a Critical Care RN. I have never stopped learning.

  5. Read the article carefully. It applies specifically to nurse anesthetists. These nurses are highly trained and should know better than to follow an unsafe doctors order. Still it is a bummer if a decision.

  6. How bout COVID protocols that (remdesivir, ventilators) that killed many.
    Was it nurses that gave the clot shot without informed consent.
    Looks like Doctors, CDC and big Pharma are shifting the blame to nurses.

  7. Good start, Now Go Up to The Doctors and their superiors. Do Not Stop at the low hanging fruit. A little bit of research on the genicide jab and it would have never gone this far.

  8. The CRNA actually devised the plan and the doc agreed it was a good plan.

    Lost at trial and on appeal until it got to the Supreme Court. The ruling overturned was 80 years old and didn’t come close to describing what nursing had become by 1990.

    You might get fired or, like me, pushed out hard but there’s an important point to remember: I was looking for a job when I found that one.

    Now I’m a legal nurse consultant and have had three cases against that hospital where I got to attend depositions. Fun to look into the eyes of the DON who ordered me to admit a TIA R\O CVA patient who hadn’t been scanned with nor orders other than Lovenox 1mg\kg sq.

    I refused to admit the lady and the DON was a little miffed at 0200. I’d rather keep being a nurse than work for an idiot.


Scroll to Top