In North Carolina, nurses are now liable for patient harm from a physician order

https://www.beckershospitalreview.com/legal-regulatory-issues/nurses-liable-for-patient-harm-carried-out-under-physicians-orders-north-carolina-court-rules.html

This is really huge news.  I am waffling between if this is good news or bad news…..I will say it is mixed.

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. 

I have a few thoughts on this.  First off, nurses practice autonomously under their own licensure.  Albeit through a different scope of practice.  Will this start to be the end of nurses working solely as the “order executors of physicians”?  Will this law finally end the hierarchy of “do what the physician tells you to do”?  I hope so.

How will this apply to vaccination injury?  If the physician told the nurse to give the vaccine, the nurse is acting under physician order, and in North Carolina if that patient is harmed, the nurse can be held liable not just the physician.  This is going to lead to RN’s obtaining their own malpractice insurance (which I always believed they should anyways, never trust an employer to protect you).

The long standing argument for APRN’s not having autonomous practice is physicians wanted to control what they did and how they did it.  20+ states have abolished collaborative agreements, and APRN’s can practice autonomously.  Missouri has very harsh restrictions on APRN practice.  The most stringent in the United States.  If the North Carolina law were to take effect in all 50 states, then the collaborative agreement in Missouri would be on very shaky ground. Which would be good. EVERY single healthcare provider whether they are a MD, DO, PA, APRN, or RN should be held liable to their scope of practice within their license. We all have our own state license to practice, we all carry our own malpractice insurance (and if you are employed and do not carry your own med mal GO GET YOUR OWN ASAP). This hierarchy pissing contest of “do what I say” needs to end, if they are going to hold everyone not an MD to the same level of culpability.

Nurses are well educated, critical thinkers, and should be held to the same standards as a physician.  The defense of “they told me to do it” should not hold water.