California Civil Jury Instructions (CACI) (2017)

504. Standard of Care for Nurses

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504.Standard of Care for Nurses
[A/An] [insert type of nurse] is negligent if [he/she] 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.]
New September 2003; Revised October 2004, June 2010
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
• “ ‘[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.
Secondary Sources
6 Witkin, Summary of California Law (10th ed. 2005) Torts, §§ 995–997
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)