HB 746 North Carolina House · 2025-2026 Session

Limited Immunity/Nurses.

House Bill 746 provides limited immunity from medical malpractice lawsuits for registered nurses in North Carolina. It clarifies that nurses acting under the direction of a supervising health care provider do not owe a separate duty of care to the patient. This means a nurse cannot be held liable for malpractice solely based on a separate duty of care when following a supervisor's orders. However, this protection does not apply if a nurse acts independently, departs from supervision, fails to exhibit professional conduct, or engages in gross negligence or intentional wrongdoing.

Bill status in committee 1 of 4 stages cleared

Introduction

Apr 2025

Committee Review

Floor Vote

Governor

Introduced Apr 2, 2025 Last action May 6, 2025

Maddy AI version diff · 3 comparisons

What changed between versions

Edition 2 → Edition 3 · 6 edits

MODERATE

This bill revision significantly changes the legal protections for nurses in North Carolina. The new version expands who qualifies for limited immunity, clarifies when nurses can raise concerns about unsafe orders without liability, and establishes a specific effective date. The changes shift from a model where nurses primarily follow physician orders to one that recognizes nurses have independent duties while still protecting them when acting within their scope.

Scope change

The bill now applies to all individuals licensed under Articles 9A, 9G, or 10A of Chapter 90, rather than only registered nurses acting under physician direction. It also clarifies that nurses retain independent duty of care while gaining protection when raising safety concerns.

DEFINITION

Added a definition of 'nurse' to include individuals licensed under Articles 9A, 9G, or 10A of Chapter 90, broadening who can claim immunity protections.

SCOPE

Changed from requiring nurses to act at the direction of a supervising provider to allowing immunity when nurses act within their scope of practice and follow provider directions.

REQUIREMENT

Added protection for nurses who act in good faith to raise concerns about potentially unsafe health care provider orders, recognizing nurses have independent duty of care to patients.

Removed language stating nurses do not owe a separate duty of care to patients and that their primary duty is to execute physician orders.

Removed exemptions for gross negligence, wanton conduct, and intentional wrongdoing, replacing them with broader language about gross negligence, recklessness, or intentional misconduct.

TIMELINE

Changed effective date from 'when it becomes law' to a specific date of October 1, 2025, and applies to acts occurring on or after that date.

Floor votes

How they voted

No floor votes recorded yet.

Full legislative history

Actions timeline

Total actions

Key actions

Committee

May 6, 2025

Committee

Re-ref Com On Rules, Calendar, and Operations of the House

lower

May 6, 2025

Lower · Passed

Reptd Fav Com Sub 2

lower

Apr 29, 2025

Committee

Re-ref Com On Judiciary 2

lower

Apr 29, 2025

Lower · Passed

Reptd Fav Com Substitute

lower

Apr 3, 2025

Committee

Ref to the Com on Health, if favorable, Judiciary 2, if favorable, Rules, Calendar, and Operations of the House

lower

Apr 2, 2025

Introduced

Filed

lower

2 primary · 4 co-sponsors