Following MD orders is not always enough for RNs- Protect your License!!

Adhering to Physician directives -as a Registered Nurse -is no longer sufficient. A decision by the North Carolina Supreme Court in 2022 has profoundly affected the legal responsibilities of nurses in clinical environments. Historically, nurses were protected from legal repercussions when acting on a physician's orders. This long-standing legal principle, which has been in place for 90 years, afforded nurses a degree of security, operating under the assumption that physicians were the primary decision-makers and thus held accountable for patient outcomes. However, the North Carolina Supreme Court has now overturned this precedent.

Nurses can be held liable even when executing a physician's orders. The rationale for this change is that the scope of nursing practice has evolved over time, with nurses now being recognized as active participants in patient care who must evaluate the safety of the orders they receive. This shift brings about increased legal risks.

The case of Byrd v. Marion General Hospital had previously offered some protection to North Carolina nurses when following doctors' orders. Justice Michael Morgan contends that it is an appropriate moment to reassess the 90-year-old Byrd precedent, given the "increased, influential roles which nurses occupy in medical diagnosis and treatment." He emphasizes that the nursing profession has advanced, highlighting the "recognition of the increased specialization and independence of nurses" within the healthcare system.

The ruling establishes that nurses are held to an already established standard of care. The court determined that even when a nurse is performing tasks under a physician's orders, they may be liable for medical malpractice if it is found that they have violated the relevant professional standard of care, as noted by Miller.

My recommendation for nurses is to familiarize themselves with and adhere to policies, implement best practices, document thoroughly to convey the narrative, maintain professional liability insurance, stay informed about changes in standards of care, and voice any questions or concerns they may have.