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.
Thank you Mr. Fischesser. I am a new CLNC, but not a new nurse. I have come across a lot of attorneys who feel that Legal Nurse Consultants are too expensive and that we do not save them time and money. So thanks again for your BLOG.
ReplyDeleteThank you for your thoughtful comments, and thanks for reading. For more perspective on the value of LNCs check out Hope Wade's blog post here: http://www.thejerklnc.com/blog/?p=986
ReplyDeleteI have a legal nurse consultant and a physician's assistant on my staff and still will use, from time to time, LNC's. I agree, they are invaluable. As much medicine as we "think" we know as lawyers - they are or have been there and can bring the clinical experience to the case. Nice post.
ReplyDeleteMr. Fischesser,
ReplyDeleteAfter 27 years in the medical profession (17 years as an RN and 10 years as a Certified Surgical Technologist prior to that) I have finally decided to leave clinical nursing. I have been witness to daily breaches in standards of care, blatant malpractice, fraud...the list goes on. I take pride in abiding by policies and procedures and actually doing all the things I document. I am appalled at what is happening in medical facilities and it's no wonder everyone should have a nurse in their family to stand vigil when they suddenly find themselves as a patient in an ER or in the hospital. I know where the skeletons are buried, so to speak, and where and when nurses take "short-cuts" in order to accomplish assigned tasks. It is near impossible to properly perform all the tasks one documents and actually document all tasks performed...something has to give. Those of us who care about 'doing it right' cannot move patients through the ER fast enough, turn over cases in the OR fast enough, provide the best care for ICU patients, etc. Experienced nurses know where to start digging for information and it's often the documentation that isn't present that says the most.
I appreciate your positive comments about the usefulness of LNC's and I'm encouraged to know my vast experiences in critical care settings will be of benefit to attorneys such as yourself.
This comment has been removed by the author.
ReplyDeleteYou are perceptive in your grasp of the value of LNCs. Our knowledge of the healthcare system enables us to see things that attorneys (and doctors) miss. About 8 years after I started reviewing cases as an expert witness, I sat with an attorney and a set of medical records and pointed out something that profoundly affected the liability of a nursing malpractice case. He said, "I've had 5 doctors look at this case and none of them picked that up." Our insider knowledge makes those facts jump out at us, just as the attorney's knowledge of the legal system helps him spot obvious truths. See www.medleague.com for more articles and blog posts on legal nurse consulting. Pat Iyer MSN RN LNCC
ReplyDeleteThank you for the affirming insight and continued success.
ReplyDeleteMr. Fischessar,
ReplyDeleteFortunately there ARE attorneys such as you that understand the value a legal nurse consultant can provide. Are they few and far between? I think not. With our profession becoming increasingly visible, the healthcare delivery system more complex, I
believe legal nurse consultants will continue to make a difference. As a result, those savvy forward thinking attorneys will continue to be a step ahead of their peers and reap the benefits! Thank you for your support! Valerie Lane, RN, CLNC, ALNC your “Correctional Healthcare” expert.
Mr. Fischessar,
ReplyDeleteI'd like to join the others who have offered their thanks to you for openly stating your appreciation of LNCs. Breaking into this work can be a long and arduous road and I've seen many people become discouraged and give up efforts to be successful because they've only had contact with attorneys who don't know the value of an LNC. Your viewpoint is refreshing and welcome.
I've been working in the clinical setting for 35 years as an RN and for 9 years as an OR Tech before that. I feel that my experience during that time offers an attorney a different viewpoint than what could be gained from an MD regardless of the number of years he/she has been in practice. The most obvious reason is that I am an RN, he/she is an MD and these are different worlds of practice. While I can't do everything the MD can do (not because I couldn't learn, but because I haven't had the training), MDs can't do everything I can do for the same simple reason. I know what really happens in the nursing 'world' and MDs have an idea (not necessarily a realistic idea) of what should be happening in our world. I don't mean to sound as if I'm disparaging MDs, I hold them in the highest regard, but this is simply reality...they don't really know what we do.
Thank you again for your support of LNCs, we need more people such as yourself to speak out for us to their attorney colleagues in order for LNCs to begin to be seen for the important team members that we can be.
Lin Holly, RN, BS, CNOR, CLNC, SANE-A