LNCs Bring Valuable Perspective and Expertise to a Litigation Team

As I looked at the followers I have thus far on my blog, I noticed that I have quite a few nurses following my musings. I got to thinking that I have a unique perspective on the value of nurses to a litigation team. In my prior job in New Orleans, my firm did not have any legal nurse consultants ("LNC"s) on staff. I was left to my own devices to decipher medical records and learn what all of the terminology meant. I can tell you that it took a lot of my time summarizing medical records and checking out WebMD in order for me to get a good grasp on what I was dealing with, and even then I couldn't be sure I was right.

At my current firm, Eckenrode-Maupin in Clayton, MO, I am blessed to be on a staff that includes two LNCs. They are an invaluable resource to me and my fellow attorneys in getting a case ready. I wanted to share with others some of the things I find most helpful about the work that they do.

1) They are more knowledgeable about the medical terminology.

This may be the most obvious statement I will make in this post, but it has to be said. The fact of the matter is that I was not smart enough to get into medical school, that's why I went to law school.  (Well, that and I hate blood, but that is better left for another post, or maybe another blog entirely.) LNCs have been trained in the medicine reflected in the records. They know what all the words, and perhaps more importantly, what all the abbreviations mean. They may have even worked with doctors who write illegibly, and can decipher scribbles in records that I could stare at for days and never figure out. This knowledge gives me greater comfort that I know exactly what is contained in those records than if I was simply reviewing them on my own.

2) They have real-life experience with treatment.

We all learn better by actually doing something rather than by just reading about it. That type of real world experience gives LNCs a much better understanding of a course of treatment for a plaintiff than I could ever learn by reading the recommendations of the American Medical Association. They can fallback on their experiences to give the lawyer an insight into what should or could have been done differently for a particular patient. This is especially helpful to us here as a good percentage of our cases are medical malpractice cases that turn exactly on that question.

3) Excellent resource for deposition preparation and expert selection.

When you add number 1 and number 2 together, you end up with someone that can be extremely useful in the selection of expert witnesses, and in the preparation for deposition testimony. They know the questions to ask to get to the heart of the matter from a medical standpoint, so while the ultimate decision of what to ask falls to the lawyer, the lawyer can come at those questions from a more educated position if they have an LNC to help them prepare.

4) Always good for a lawyer to get a non-legal opinion on things.

This last point would not just apply to LNCs, but to any non-lawyer. It is always good for a lawyer to get the thoughts of people without legal training when preparing a case. This is because the jury box is going to be filled, in most cases, with 12 ladies and gentlemen with no legal training. These are the people you need to sway to your side, so it is good to make sure that what you will be telling them makes sense to them. There is no better way to do that than to run your arguments and ideas past other non-legally trained folks. Specifically, the LNCs can help you in crafting your presentation of the medical evidence so that it is palatable to a person without medical training, as they had to do this all the time with their own patients.

I hope that you will share this post with lawyers who may not realize what they are missing by not bringing an LNC in to assist them. I know first-hand what it is like to try to go into battle without their help, and it can be done, but you will sustain a lot more scars along the way. Your clients will be better served having the training and expertise of an LNC working for them.

What Lawyers Can Take Away from a Trip to Sesame Street

It was 41 years ago today (November 10) that the iconic children's television program, Sesame Street, premiered on American television. Ever since then, toddlers across the country have become friends with Big Bird, Bert and Ernie, Elmo, and countless other loveable figures. The anniversary of the premiere got me thinking that there are things that lawyers can take away from the show that can help us be better at our chosen profession, even if we are a little old to plop down in front of the tube and count along with The Count.

TODAY IS BROUGHT TO YOU BY THE LETTER "B"

I am not suggeting that you dedicate your day to a particular number or letter of the alphabet. What I am suggesting is that you look at every day as an opportuntity to learn something to help you in your practice. All states require their attorneys to maintain a certain number of continuing legal education credits in order to renew their licenses. While this is important, I am suggesting a more regimented dedication to learning can help you become an even better lawyer than cramming in all 12 CLE hours just before the deadline. I make an effort to read the updates to the West reporter series, scanning them for cases pertinent to my practice areas. I also review local legal newspapers for case reports and rulings. These efforts give me insight into what judges are thinking about cases. They also give me insight into the types of arguments and cases my colleagues are having success in pursuing. Keeping up with developments in the law in this way can give you ideas that you can apply to your current cases that keep you ahead of the curve.

GROUCHES END UP IN THE TRASH CAN

I think everyone has a soft spot for Oscar the Grouch, Sesame Street's resident trash can dweller. Why does Oscar live in the trash? I would suggest that the way he treats others gives him no choice, who would want to share a house or apartment with someone like that. Attorneys should consider this in connection with their professional reputation. I still remember at my swearing-in ceremony in Louisiana the featured speaker talking about an attorney's professional reputation as being his or her currency. A good professional reputation is something that is earned over years of practicing in a particular legal community and exhibiting qualities of trustworthiness, candor, and professionalism. As long as it takes to build up a good reputation, it can be lost with one poor decision, one moment of trying to cut a corner. As lawyers we do our clients no service by acting unprofessionally to our colleagues. We need to always keep in mind that the legal communities in most cities are small, and word gets around pretty quickly. If we do not treat our colleagues with professional courtesy, we might find ourselves operating our practices from a dumpster.

I invite you all to share your thoughts on what lessons for life and career we can all take away from Sesame Street.

Good Ol' Common Sense Holds the Answer to Many Ethical Quandaries

State and National bar associations have all promulgated Rules of Professional Conduct that are meant to guide attorneys through the practice of law in an ethical manner. As litigators, we are often confronted with ethical questions during the life of our cases. They can occur at any step in the process: from case selection, through pleadings and discovery, all the way to trial and appeal. Some can be dealt with easily, and others require more thought and careful consideration. While the Rules are there to guide us as to how to deal with ethical quandaries, one thing to never leave out of the process is something we all possess, whether we went to law school or not, and that is common sense.

One ethical consideration that can arise very early in the process is determining whether you, as the attorney, have a conflict of interest that would preclude your representation of a particular client. Some conflicts are easy to spot (i.e. trying to represent both the husband and wife in a divorce, or taking on a plaintiff's case against one of your insurance company clients). Others are trickier to spot (i.e. representing both the driver and the passenger against a third party in a car accident).

Most Rules of Professional Conduct allow for representation, even in conflict situations, if a proper waiver is obtained from the parties involved. If you are contemplating getting your clients to waive the conflict of interest, you may want to pause to allow your common sense to guide you as to whether that is a good idea. Take a long, hard look at the situation and determine whether you truly can do the best for each client if you represent them both. Take my example above, trying to represent both the passenger and the driver against a third party in a car accident case. Many states are "comparative fault" states. This means that the passenger really should make a claim against both the driver and the third party in order to fully protect her interests. If you represent both the passenger and the driver, how is that going to make your driver-client feel when you start calling up their insurance company looking for a settlement. Common sense would seem to dictate that it would be best to take on one or the other, but not both. This will allow you to zealously represent your client without any concern for how that will affect the other parties.

This is just one example of how common sense may lead you to a better decision than the Rules of Professional Conduct. I am sure you all have your own examples of how common sense has helped you resolve ethical quandaries in your practice, and, in honor of "Use Your Common Sense Day" (November 4), I invite you to share them here so we can all learn from each other.