House Bill 746 creates a new statutory limited-immunity rule for nurses in North Carolina. The bill adds a section to Chapter 90 providing that a nurse is not liable for damages in a malpractice action when the nurse acts within the nurse’s scope of practice and follows directions from a supervising health care provider. It also protects a nurse who, acting in good faith, raises a patient-safety concern about another provider’s order that may be inconsistent with patient safety.
The bill is framed as a legislative response to North Carolina case law. Its findings cite Byrd v. Marion General Hospital (1932), which had long recognized protection for nurses acting under physician orders, and Connette ex rel. Gullatte v. Charlotte Mecklenburg Hospital Authority (2022), which the bill says overturned that rule and left the issue for the General Assembly to address. The bill restores a form of immunity, but it does not shield conduct involving gross negligence, recklessness, or intentional misconduct. It applies only to acts or omissions on or after October 1, 2025.
HB746 amends Article 1B of Chapter 90 of the North Carolina General Statutes by adding G.S. 90-21.14A, creating a new malpractice defense for nurses. The term "nurse" is defined broadly to include individuals licensed under Articles 9A, 9G, or 10A of Chapter 90, and the protection applies only when the nurse is acting within scope and consistent with a supervising provider’s directions, or when the nurse in good faith questions a potentially unsafe order. The bill preserves liability for more serious misconduct and does not affect claims based on gross negligence, recklessness, or intentional wrongdoing. It is prospective only and takes effect October 1, 2025.
The available context suggests generally favorable sentiment toward the bill, as reflected by the committee substitute favorable reports on April 29 and May 6, 2025. The bill’s findings indicate it was intended to restore a prior legal protection for nurses that supporters believed had been removed by recent case law. No committee transcript or recorded vote details are provided, so the broader debate cannot be measured directly, but the procedural history indicates the measure advanced through committee without documented opposition in the materials provided.
The main point of contention appears to be the scope of nurse liability when following orders from supervising health care providers. Supporters of the bill appear to favor restoring immunity consistent with the older Byrd rule and limiting malpractice exposure for nurses acting under direction. The bill itself acknowledges the countervailing concern that nurses have an independent duty of care, which is why it preserves liability when a nurse acts in bad faith or engages in gross negligence, recklessness, or intentional misconduct. The underlying legal dispute referenced in the findings—whether the General Assembly or the courts should define this immunity—also appears to be the central policy issue.