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Expand Your Future with Legal Nurse Consulting
By Vickie L. Milazzo, RN, MSN, JD

If you are a forensic nurse, you are in an ideal position to expand your career opportunities and success potential as a legal nurse consultant (LNC). An LNC is a registered nurse who uses specialized healthcare knowledge and expertise to consult on a wide variety of medical-related cases, including criminal cases. As a forensic nurse, you have two kinds of expertise that give you a head start on establishing a successful legal nurse consulting practice: Your practical experience with the legal system and your inside knowledge of the healthcare system. Why not put all this invaluable know-how to work for you as an LNC?

Multiply Your Marketability With Your Clinical Expertise

First, by becoming an LNC, you'll be able to profit from all aspects of your nursing experience in a vast number of new and exciting ways. Your nursing expertise can be invaluable in resolving healthcare-related cases. There are approximately 900,000 attorneys in the United States and many of them need help addressing forensic nursing issues. The majority do not know how to read a medical record, much less understand it. Most have no firsthand experience with the healthcare system, let alone an insider's knowledge of its inner workings, so they rely on legal nurse consultants for this kind of experience.

In addition to plaintiff and defense attorneys, you'll discover a whole new set of prospective clients eager for your services as an LNC. Insurance companies, utilization review firms, government agencies and private corporations need your nursing know-how. In fact, any business or facility involved in health-related legal issues need your professional LNC services. All you have to do is set your sights beyond forensic nursing.

Build on What and Who You Know

You won't be starting from scratch. As a forensic nurse, you already have three key advantages in starting your LNC practice:

You have inside knowledge of the legal system and how it works. You have firsthand experience in dealing with the rules of evidence and other aspects of legal and courtroom procedures. Many LNCs from other nursing specialties spend years developing your kind of expertise.

You already know and work with some of your best potential clients -- attorneys. Attorneys are likely to be your first and most consistent clients, and you have a built-in prospect list, people who know and trust you and your work. Most LNCs start out knowing a few attorneys who might not even handle medical-related cases.

You've mastered skills as a forensic nurse that will support you in developing your legal nurse consulting practice. For example, your knowledge of proper forensic procedures (e.g., use of rape kits) will help you spot inconsistencies in evidence collection that other LNCs might miss.

You're tuned in to the possible destruction of evidence, either deliberate or accidental, so addressing issues of tampering with the medical record will come naturally to you. As a forensic nurse, you've no doubt sharpened many of your nursing skills, such as attention to detail and ability to communicate your findings verbally and in writing, and these skills will continue to serve you well as an LNC. As with forensic nursing, the attorney is still the expert on the law and the legal issues. When you become a legal nurse consultant, the attorney will look to you, not just for your forensic background, but also for the full range of your nursing knowledge and expertise.

The Justice System Abounds with Healthcare-Related Cases

Best of all, you don't have to spend a single day in court to prosper as an LNC. You can develop a thriving LNC practice consulting behind the scenes. In addition to the criminal cases you're accustomed to consulting on, you'll play a key role in many types of cases where your in-depth knowledge of nursing and the healthcare system is relevant, including:

1. Medical and Nursing Malpractice. Cases involving the professional negligence of a healthcare provider, facility or learning institution

2. General Negligence. Cases involving nonprofessional negligence (commonly called personal injury or PI cases), such as "slip and fall," auto accident, aviation, liquor liability, railroad, admiralty and maritime, water accident and sports injury cases

3. Products Liability. Cases involving manufacturers and sellers of defective products, including:

  • Medical devices, including everything from pacemakers to defibrillators.
  • Drugs, such as Prozac, Phen-fen, etc.
  • Nonmedical devices, such as motor vehicles and parts, aircraft, machinery, equipment, appliances, toys, cigarettes, food, and household, personal care, consumer and industrial products.

4. Toxic Torts and Environmental. Cases involving release of toxins, such as asbestos, radiation, hazardous chemicals, hazardous waste, pesticides, secondary smoke and lead, as well as oil spills and sick building syndrome.

5. Workers' Compensation and Workplace Injury. Cases involving job related injuries such as back injuries and repetitive motion injuries

6. Any case where health, illness or injury is in issue, such as the following:

  • Access to care issues
  • Family law cases, such as paternity issues, adoption cases and custody battle cases
  • Probate cases where competency is in issue
  • School health cases
  • Americans with Disabilities Act (ADA) cases
  • Cases involving physician/facility relationships
  • Sexual harassment cases
  • Cases involving the right to die and living wills
  • Insurance, Social Security and Medicare benefit issues
  • Psychiatrist/therapist abuse or injury cases
  • Healthcare professional board disciplinary actions

21 Services LNCs Can Provide to Attorneys

How do you start prospering as an LNC? By giving attorneys what they need -- the expertise they don't have themselves. And you don't have to limit yourself to consulting on forensic issues. Your LNC services can include any or all of the following:

1. Screen or investigate medical-related cases for merit.

2. Define the applicable Standards of Care and point out the deviations from and adherences to those standards.

3. Assess damages and injuries and identify contributing factors.

4. Identify and review relevant medical records, policies and procedures, other essential documents and tangible items.

5. Summarize, translate and interpret medical records.

6. Identify and recommend potential defendants.

7. Conduct literature searches and integrate the literature and standards or guidelines into the case analysis.

8. Interview plaintiff and defense clients, key witnesses and experts.

9. Consult with healthcare providers.

10. Identify types of expert witnesses needed and locate and work with these experts.

11. Analyze and compare expert witness reports or other work product.

12. Serve as a liaison between the attorney and healthcare providers, testifying experts, parties, witnesses, other consultants and service providers.

13. Prepare interrogatories and deposition and trial examination questions.

14. Help prepare witnesses and experts for deposition and trial.

15. Assist in developing exhibits.

16. Review, analyze and summarize depositions and past testimony.

17. Attend depositions, trials, review panels, arbitration hearings and mediation.

18. Produce written reports for use as study tools by the attorney.

19. Coordinate and attend independent medical examinations.

20. Develop life care plans.

21. Coordinate and assist in facilitating focus groups or mock trials.

Enhance Your Ability to Make a Difference

Most nurses I know went into nursing because they wanted to help others. Like forensic nurses, LNCs serve the legal system in several ways:

1. LNCs promote integrity in the legal system by identifying fraudulent and non-meritorious claims, and helping to defend against them or keep them out of the system.

2. LNCs promote accuracy in the courtroom by helping to assure that the legal system uses accepted scientific, medical and nursing information properly and without distortion.

3. LNCs help curb the rising cost of litigation by providing cost-effective services.

4. LNCs promote justice by helping make our court system work fairly for all, protecting innocent victims and compensating them for negligence and other wrongdoing.

5. LNCs help to improve quality of nursing care by upholding Standards of Care and identifying meritorious cases involving deviations from recognized standards.

You can expand your ability to make a difference both in the legal arena and in the nursing profession by becoming a legal nurse consultant. Take advantage of a professional LNC training program -- rather than a nurse-paralegal program -- to maximize your chances of success.

Your Future Is Wide Open

In addition to the personal rewards of legal nurse consulting, you can achieve substantial financial rewards as an LNC. You can keep your forensic nursing job and diversify into legal nurse consulting part-time, or you can work toward establishing a full-time LNC practice.

Thousands of LNCs have succeeded, and they had to develop their expertise with the legal system and their list of attorney-prospects step by step. Your prosperous legal nurse consulting practice should practically build itself. You'll earn more with less effort and enjoy more time with family and friends or your favorite hobby. Ultimately, becoming an LNC is about taking control of your time and your life while expanding your nursing career in a satisfying, profitable new direction.

Vickie L. Milazzo, RN, MSN, JD, is founder and president of Medical-Legal Consulting Institute, Inc. In , she developed and implemented the first national certification program for LNCs.

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