CACI 504 Standard of Care for Nurses

California Civil Jury Instructions CACI

504 Standard of Care for Nurses

[A/An] [insert type of nurse] is negligent if [he/she/nonbinary pronoun] fails to use the level of skill, knowledge, and care in diagnosis and treatment that other reasonably careful [insert type of nurses] would use in similar circumstances. This level of skill, knowledge, and care is sometimes referred to as “the standard of care.”

[You must determine the level of skill, knowledge, and care that other reasonably careful [insert type of nurses] would use in similar circumstances based only on the testimony of the expert witnesses [including [name of defendant]] who have testified in this case.]

Directions for Use

The appropriate level of nurse should be inserted where indicated—i.e., registered nurse, licensed vocational nurse, nurse practitioner.

The second paragraph should be included unless the court determines that expert testimony is not necessary to establish the standard of care.

Sources and Authority

“[A] nurse is negligent if he or she fails to meet the standard of care—that is, fails to use the level of skill, knowledge, and care that a reasonably careful nurse would use in similar circumstances.” (Massey v. Mercy Med. Ctr. Redding (2009) 180 Cal.App.4th 690, 694 [103 Cal.Rptr.3d 209] [citing this instruction].)

“ ‘[T]oday’s nurses are held to strict professional standards of knowledge and performance.’ But ‘[s]ome difficulties are presented [in the nursing malpractice context] by the fact that a nurse’s traditional role has involved “both routine, nontechnical tasks as well as specialized nursing tasks. If, in considering the case law in this area, the dispute is analyzed in terms of what action by the nurse is being complained about, it is possible to make some sense out of the relevant decisions.” ’ ” (Massey, supra, 180 Cal.App.4th at p. 697, internal citation omitted.)

“[A] nurse’s conduct must not be measured by the standard of care required of a physician or surgeon, but by that of other nurses in the same or similar locality and under similar circumstances.” (Lattimore v. Dickey (2015) 239 Cal.App.4th 959, 969 [191 Cal.Rptr.3d 766].)

The jury should not be instructed that the standard of care for a nurse practitioner must be measured by the standard of care for a physician or surgeon when the nurse is examining a patient or making a diagnosis. (Fein v. Permanente Medical Group (1985) 38 Cal.3d 137, 150 [211 Cal.Rptr. 368, 695 P.2d 665].) Courts have observed that nurses are trained, “but to a lesser degree than a physician, in the recognition of the symptoms of diseases and injuries.” (Cooper v. National Motor Bearing Co. (1955) 136 Cal.App.2d 229, 238 [288 P.2d 581].)

“[E]xpert opinion testimony is required to prove that a defendant nurse did not meet the standard of care and therefore was negligent, ‘except in cases where the negligence is obvious to laymen.’ ” (Massey, supra, 180 Cal.App.4th at pp. 694–695.)

Secondary Sources

6 Witkin, Summary of California Law (11th ed. 2017) Torts, §§ 1129–1130
California Tort Guide (Cont.Ed.Bar 3d ed.) § 9.52
3 Levy et al., California Torts, Ch. 31, Liability of Physicians and Other Medical Practitioners, § 31.84 (Matthew Bender)
36 California Forms of Pleading and Practice, Ch. 415, Physicians: Medical Malpractice, § 415.11 (Matthew Bender)
17 California Points and Authorities, Ch. 175, Physicians and Surgeons, § 175.20 et seq. (Matthew Bender)