If you are a current MLCI student or a CLNC®, you are automatically a member of the National Alliance of Certified Legal Nurse Consultants (NACLNC®). One of the many benefits of NACLNC® membership is FREE access to the exclusive online NACLNC® Community, including:
Interview Questions — This list of attorneys' most common questions — such as "What will this case cost?" — will help you prepare for your next interview. Each question comes complete with knock-the-attorney's-socks-off answers suggested by me and our CLNC® Pros.
Resource Links — Here you'll find hundreds of the best links on the Internet for relevant topics such as brain injury, MI, OB, oncology and surgery. The time you'll save in researching your cases will make this your first Internet destination.
Recommended Authoritative Nursing and Medical Textbooks — This extensive section points you quickly to the authoritative texts for each medical and nursing specialty. An added bonus — a handy link to Amazon.com for each book.
If you are a CLNC® or student of the Institute, tap into the Web's best source for legal nurse consulting resources today. Take advantage of the NACLNC® Community and the tremendous benefits this specialized collection of information delivers to build your CLNC® practice quickly and profitably.
If you are not yet a student or CLNC®, call today to inquire about our trademark certification program.
Success Is Yours!
Vickie L. Milazzo, RN, MSN, JD
P.S.
The NACLNC® Community is for use by CLNC®s and current CLNC® students only.
CLNC® SUCCESS STORY
Exhibiting Launched Me as a Successful CLNC®
by Theresa H. Smith, RN, CLNC
Several years ago, I was promoted to ER nurse manager in a major city hospital. After many years of hard work, I thought I had reached my ultimate career objective. Then I gave birth to our two little angels, and my former priorities were turned upside down. After our first child was born, I could hardly tear myself away to leave for work. By the time our second child was born, I had become a stay-at-home mom, at least until the children were older.
In hindsight, I was already dissatisfied with clinical nursing. Workplace politics, difficulties in hiring and retaining qualified staff, communication disconnects with upper management, increasing incidents of customer aggression and increasing health risks all contributed to a good deal of stress. With the birth of our children, I resolved to find a new career. I wanted to continue using my nursing experience, yet have greater autonomy, less health risk and better income.
I Shifted My Resolve Into Action
My resolve shifted into action when I attended Vickie's CLNC® 6-Day Certification Seminar. That week really changed my life. Not only was her seminar an intense learning experience, it was also exciting and challenging. Vickie and her wonderful staff exuded knowledge, charm and sincerity. And they were motivating. By the end of the seminar, I believed that I could, and would, accomplish anything I really wanted to do!
Taking Vickie's advice to heart, I began my new career the very day I got home. For the next three weeks, I spent at least 30 minutes every day putting together my portfolio. Since I didn't know any attorneys or have anyone to refer me, I had to make up a mailing list from scratch with names I got off the Internet and out of the phone book.
At first I was apprehensive about making follow-up phone calls to the attorneys to whom I had sent portfolios. I had never tried to sell anything, let alone myself. I knew I had a service to provide, and was sure I would find an attorney who wanted to use my service. So, I prepared a script, and with each call I became more and more confident.
Initially, I got a few responses from attorneys requesting help finding testifying experts. Although they seemed impressed with my portfolio and my performance, I wasn't getting requests for any additional services such as performing an in-depth analysis of the medical records. I tried to set up appointments to see some of them, but fitting into their busy schedules was difficult. Yet intuitively, I felt I could build better rapport by meeting them face-to-face.
Exhibiting Was More Comfortable Than I Thought
I thought it might be easier to meet attorneys in a neutral business atmosphere. With Vickie's encouragement to "go outside my comfort zone," I created my own exhibit for some local legal conferences. Sure enough, the conference atmosphere suited my personality. Furthermore, being treated as a fellow professional was refreshing.
I got my first REAL client from this conference. One of the attorneys I met gave my portfolio to a partner in his law firm. The partner retained me and has been a client ever since.
So far I've exhibited at four legal conferences. I was astonished to be the only nurse exhibiting; this market is definitely wide open. I gained at least one new client from each of these conferences, proving this to be my best marketing approach. From then on, my business really started to grow. In 4 months, I surpassed my year-end goal of bringing in $10,000.00.
At the fourth conference, I met the partner of a prestigious law firm. Until then, I had been unsuccessful in marketing to him because I couldn't get past his gatekeeper. Less than a week after the conference, he retained me for a case and in the course of conversation, mentioned the idea of hiring a full-time, in-house nurse consultant. Would I be interested?
Would I ever! Our youngest child was turning four and becoming more independent by the day, and our oldest was already in school. We could all manage with me working away from home during the day.
I Can Have it All
After a short and successful "trial run" to test our compatibility, I was offered a permanent job in this law firm, starting at 95% of my initial asking salary. I was also given my own office, complete with a new modular workstation, and a new computer, monitor and printer. In addition to my in-house job I have continued to run my independent CLNC® business. I truly can have it all.
As a student of the Institute and from the moment I graduated from Vickie's CLNC® 6-Day Certification Seminar, she and her staff were there for me. When I had basic questions about fee schedules and ethics, or major career issues, like joining the law firm, I have been able to rely on her guarantee of lifetime mentoring. The CLNC® Mentors offer firsthand experiences, facts, and resources, and often identify related issues and ideas I hadn't even considered.
Today, I am happier than I've ever been. I have launched a successful, on-going CLNC® business and joined a major law firm within 15 minutes of our home. I experience far less stress than I've ever had before and I am paid very handsomely. Best of all, I have the flexibility I need as a mother and spouse to remain an integral part of my wonderful family.
Now I'm proud to say that I AM A SUCCESSFUL CLNC®! Thank you, Vickie.
Theresa Smith, RN, CLNC, owns Blue Ribbon Consulting, and specializes in pediatric nursing. She works in-house at a plaintiff law firm in Virginia.
BEST PRACTICES FOR CASE EVALUATION
9 Strategies for Evaluating Medical-Related Cases
by Joan M. Gower, RN, CLNC
Always Keep the Attorney-Client's Request in Front of You
This simple guideline helps to maintain your focus and ensures that you provide the attorney-client with exactly what she requested within the needed time frame. Once you've fulfilled that request, you are then free to provide additional relevant information.
Take Brief Notes During Initial Record Review
The first time you review medical records, deposition transcripts, etc., jot down simple off-the-top-of-your-head notes as they occur. Also jot down names of key players in the case. Of course, don't write on the records themselves. Use sticky notes to point out thoughts related to a particular page on the document. Use forms to enable you to see the complete picture of the case as you go.
Tab Every Section of the Records for Easy Reference
You can use sticky notes to indicate each section. Use a bright color on those sections that contain issues you want to address with your attorney-client or in your report. For efficiency, always tab and organize records in the same manner.
Keep Large Volume Cases Manageable
For large volume cases, summarize the issues and highlight each medical record before you move to the next. This strategy will save you time and assist you in conferencing with your attorney-client and in writing the report. You'll also find the case easier to review months later as it develops.
Be Clear about Primary Case Issues and Findings
Sometimes, your client will inadvertently focus on a term or phrase that's part of the overall case but not one of the primary issues. Clarify case themes and findings throughout your case discussions. This helps the attorney stay focused, saves time and results in better strategic decisions.
Consider Transcribing Portions of the Record
Handwritten records often reveal important or surprising information when transcribed. For example, I have found significant pieces of information within progress and nursing notes that changed the focus of a case. Although not every attorney-client prefers complete transcription, reviewing the typed version of the relevant notes can help you clarify issues and avoid mistakes or oversights during case review.
Use Checklists to Stay on Track
A general checklist of your CLNC® services can help you keep track of your tasks in the early stages of a case. A second case-specific checklist is also helpful to ensure that each case review is comprehensive. These lists serve to track the status of case information, resources, quality, deadlines and billing. But lists are only valuable if they are pertinent, so refine your lists over time.
Research Additional Resources
Each case is a learning experience and an opportunity to expand your library of resources. Always be alert for potential resources, and make it a habit to clip articles or jot notes for future reference as you read. Having current resources available makes your job easier, saves time when the next pertinent case arrives, and helps to ensure that you provide your attorney-client with the latest information on key case issues.
Allow Sufficient Time to Edit and Polish
Meeting deadlines is mandatory and challenging. Submitting a report prior to deadline is a goal that is always very satisfying to meet. However, you must allow plenty of time to edit and polish. There is no point in submitting a report that will require endless revision and addenda and that may impact the attorney-client's confidence in your expertise.
4 Case Evaluation Strategies for Long-Term Care Cases
by Nancy Dion, RN, MSM, CLNC, CPHQ, CHCRM, LNHA
Keep Complex Case Chronologies Straight
Long-term care cases can cover years of material with numerous intermittent hospital stays for emergency treatment or admission. Sort records by date first, flagging the admission or data sheet for hospital events with a different color from those used for long-term care facility stays. Note the admission and discharge dates on the flag to help you keep track of the chronology. An overall list of admission and discharge dates is also helpful.
Carefully Cross-Check Relevant Sections of the Records
Once you have reviewed a record in general, spread out the sections you will need to correlate to assess completion of care and treatment. For example, in a long-term care case, you need to cross-check nurses' notes, flow charts, treatment records and aides' documentation records to determine whether care is provided or omitted. Look for such care as turning and positioning every 2 hours, providing bunny boots to be worn at all times and decubitus care.
Be Prepared to Find Information Fast
Use color-coded flags whenever you must refer back and forth quickly between assessments, care plans, narrative notes, medication and treatment records and deposition statements. This is especially valuable for preparing experts, sitting in on depositions or trials, and presenting opinions and supporting data. Flag all items that must be correlated with each other in the same color to shorten the time needed to find specific data. This simple exercise will make you feel more confident and professional when you're on the spot. To keep your presentation on track, you can even use the same colors to flag the relevant sections of your own copy of the report or notes.
Cover Yourself In Case Things Change
With the consent of the attorney-client, you can use your written opinions as the basis for your case presentation at deposition. Provide copies for your attorney-client and for opposing counsel. Do not say that your opinions are complete and final at deposition. At the conclusion of the review of your opinions, state that they are based on currently available information and may change if more information is received. Although opposing counsel does not like this statement, it's best to cover yourself because you may find information later that adds to the substantiation of your case.
1 Eye-Saving Tip
by Donna Adkins, RN, BSN, CRRN, CCM, CLCP
Buy the most expensive lighted, handheld magnifier you can afford. You'll be amazed at how much better those illegible entries jump out at you when they are well lit.
Donna Adkins, RN, BSN, CRRN, CCM, CLCP owns Medical Claims Analysis & Management Services. Inc., in Kentucky. The company focuses on developing life care plans, plaintiff and defense workers' compensation, medical negligence and malpractice, personal injury and criminal cases.
Nancy Dion, RN, MSM, CLNC, CPHQ, CHCRM, LNHA is a CLNC® based in Florida. She has more than 35 successful years in the healthcare and business arenas. Her expertise includes clinical services, organizational redesign, quality improvement, risk management, facility and agency executive team building and management.
Joan M. Gower, RN, CLNC is an independent CLNC® and owner of Florida Medical Legal Consultants, Inc., specializing in children's issues, forensics and managed care.
