NEWS FLASH
Vickie Shares 4 Entrepreneurship Tips with TV Viewers
Sunday morning viewers of Houston's number one television station recently heard from entrepreneurship expert, Vickie L. Milazzo, RN, MSN, JD.
Vickie revealed to the KTRK-TV (ABC) audience the 4 commitments she made to herself back in 1982 when she first started her legal nurse consulting business. These promises helped her get where she is today, and she coaches every CLNC® student to make these same promises when starting their CLNC® practices.
Find your passion and turn it into a business.
Go for it or reject it outright.
Take one action step to advance your business idea each day.
Commit to being a lifetime student.
Even after 20 years, Vickie still makes these commitments daily.
Make Vickie's 4 commitments a part of your life and you too will live your career dreams.
CLNC® SUCCESS STORY
My Expanded Perspective Took My Business to Explosive Levels
by Susan LaFollette, RN, BSN, CDMS, CLNC
When I did bedside nursing, I worked with a nurse who limped down the halls on her rounds due to arthritis in her hips. It scared me to imagine myself like that in 40 years. I realized I had to find a career that wasn't so tough on my body. I had worked hard to become a nurse and enjoyed the satisfaction of my profession. I found what I was looking for when I became a case manager for insurance companies consulting on workers' compensation, auto, long-term disability and catastrophic cases.
I Needed More
The first case management company I worked for offered legal nurse consulting services. I had seen articles about legal nurse consulting and thought it might be an interesting field. I spoke with an LNC, and she told me she sometimes had to testify. At the time, this discouraged me from becoming a legal nurse consultant. I become tongue-tied and cotton-mouthed when I'm nervous, and I knew testifying would make me nervous.
In my many years as a case manager, the insurance company's attorney occasionally had me review cases for medical issues. I wish I had taken Vickie's course prior to these assignments. My supervisors had no clue what to do in these situations, so I basically made it up as I went along. Let's just say I wouldn't put those reports in my marketing packet today. Nevertheless, these projects fascinated me. I also realized I didn't need to testify in order to provide a valuable service to attorneys.
As the years passed, I became my own boss and started doing case management independently. I loved the autonomy. As most businesses do, mine started out slowly. When I felt the need to add another service, I thought again of becoming a legal nurse consultant.
The CLNC® Certification Program Was My Missing Link to Success
About three years ago I purchased the CLNC® Certification Program (Home-Study) and took the CLNC® Certification Exam.
Being a Certified Legal Nurse ConsultantCM (CLNC®) has made me a better case manager. I attribute the success of my case management business to the CLNC® Certification Program. It has made me aware of issues I didn't focus on before. With my expanded perspective, my caseload has exploded. My case management services better prepare the insurance company for court hearings. Recently, an insurance adjuster asked me to review a file for medical issues. For this project I used the report writing skills I had learned in the CLNC® Certification Program, and my report showed it. It was more impressive and the positive comments I received were quite rewarding.
My real success occurred when I was asked to testify about a workers' compensation case I had worked. My cotton-mouthed nightmare was about to become reality. If not for Vickie's course, I would not have known what to charge or how to prepare. My fee for testifying more than paid for the course. I confidently took the stand. What I thought would be a nightmare became a fascinating learning experience, and I enjoyed every minute of it.
I will be forever grateful for the CLNC® Certification Program. It was the missing link I needed in my training, and I highly recommend this course for all nurses, no matter what their career goals. Thank you, Vickie, for pushing my business over the line of success.
Susan LaFollette, RN, BSN, CDMS, CLNC is president of LaFollette & Associates, Inc., a medical-legal consulting company in Utah. Susan specializes in medical case management and legal nurse consulting for workers' compensation claims.
BEST PRACTICES FOR REPORT WRITING
9 Strategies for Creating First-Class Comprehensive Reports
by Pam Hollsten, RN, BSN, DABFN, CLNC
"Two attributes separate the successful from the herd:
First, a sense of urgency
Second, attention to detail." — Author Unknown
The following strategies for paying attention to detail will make your comprehensive case reports memorable and your attorney-clients coming back for more:
Identify the attorney's preferences — After ensuring that the attorney-client is requesting a comprehensive report, inquire about the intended purpose of the report, potential users of the report, and any preferences for format or design. This accomplishes several things in advance:
You can more easily judge the format (chronology or narrative) and amount of detail required for specific portions of a comprehensive report.
You'll know whether to incorporate your consulting comments into the report and how much you need to translate or explain the medical terminology.
You both know what is being requested, which decreases the risk of providing an unwanted, unnecessary or surprise work product to an attorney.
This approach will never fail to earn you positive feedback.
Assess the attorney's medical knowledge — Try to learn how much medical knowledge and experience with similar cases the attorney has. For example, if an attorney handles a large number of failure-to-diagnose cancer cases, you may not have to include an extensive discussion about anatomy, physiology or the cancer staging process because the attorney is probably familiar with this information. Instead, tailor this portion of the report to the specific case issues or type of cancer. Conversely, if an attorney does not have extensive medical malpractice experience, you may devote a section of the report to a review of the disease process, current treatment modalities and literature summaries. Don't assume the attorney knows how this information applies to the case. Always explain how it applies both to the case and the client the attorney is representing.
Identify your authoritative resources up front — Review applicable standards of care, literature and authoritative texts, and identify the sources you will use before drafting your report. This time-saving procedure helps you organize your thoughts and determine where to include the relevant resource material.
Create an outline to be sure you cover all important issues — A comprehensive report typically includes sections such as:
Introduction or overview of the case.
Missing medical records or documentation issues to explore further.
Pertinent previous medical, surgical, psychiatric and family history.
Summary of the case facts (brief paragraph or detailed timeline).
Review of diagnosis or medical condition, current treatment, risks or complications of treatment, prognosis and individual patient factors impacting the case.
Potential defendants and deviations from standards of care (with or without cited references).
Areas for further review (additional research, issues for expert witnesses to address, suggested issues for deposition and items for discovery).
Conclusions and recommendations for additional case development.
Show the attorney how to use your chronology — When preparing a minute-by-minute chronology of events, you may want to include descriptive paragraphs in the report discussing specific events on which the attorney may want to focus. Your descriptive paragraphs may be quite detailed if the chronology includes just the case facts and no "comments" section. This will help the attorney understand how to best use the chronology you have prepared.
Apply a systematic approach to keep chronologies reliable — Even a small error in date or time can influence the rest of your report. To minimize these costly typos (requiring you to rework the report on your own time, not the attorney's), enter data from one complete section of the chart before moving on to another section. For example, start entering data with nursing and vital sign graphic entries because these data are usually dated and timed and occur more frequently than entries by other healthcare providers. Then, enter all lab report data in the appropriate order before moving on to radiology reports. It may then be possible to place undated or, more often, untimed physician's progress notes and orders based on the chronology you have already created. In putting the pieces of the puzzle together in this fashion, you may identify other important issues to address in your evaluation and report.
Recycle your research from other reports for greater efficiency — Depending on the type of case, you may be able to re-use sections from previous reports or summaries prepared for similar cases. For example, in two cases involving delay in diagnosis of myocardial infarction or chest pain evaluation (R/O MI), the process or the standards may be similar. Review your other reports on similar cases to determine if any of the material applies to your current case before starting the report. Of course, there is no "one size fits all" approach to report writing – each case must be analyzed individually – but occasionally, you may be able to avoid duplicating your effort and research.
Customize your report style and format to meet the attorney's needs — Avoid using a specific format for each and every case. You may wind up including sections that may not be relevant for the sake of keeping with one format. Instead, write your comprehensive reports creatively in a style and format that meets the attorney's needs and presents the information in the most logical manner. If you have difficulty organizing your thoughts or facing a blank computer screen, use one of the computer software programs that can help with formatting case reports and chronologies. The key, however, to producing an attorney-pleasing work product is not only format and visual appeal, but the content, analysis, and conclusions you draw – this is the value you bring to case reviews that other members of the legal team may not be as qualified to do.
Make your report shine by setting it aside — If time allows, put the report aside for one or two days before doing any final proofreading or editing. Check the report for overall continuity and format, then review each paragraph for content, relevancy and grammar. Finally, analyze each sentence for grammar and proper placement and check spelling. While these steps may appear tedious and repetitious, keep in mind that this is one way you will distinguish yourself from other legal nurse consultants.
Your comprehensive report will linger in the case file long after your meeting with the attorney. It may travel to other firms or co-counsel, and will be used by many members of the legal team before the case concludes. What type of first (and sometimes, only) impression are you leaving with your clients and potential future clients? Make every report the best ever by paying stellar attention to detail.
Pam Hollsten, RN, BSN, DABFN, CLNC, an independent CLNC® in Virginia, owns Hollsten & Associates, specializing in medical malpractice.
2 Tips for Presentation Time
Keep a dry-erase board and marker in your briefcase. We're talking the cheap-o five-dollar deal from Kmart. You may find it easier to draw a hip fracture than to flip through a book, drag out the anatomy model or find the perfect PowerPoint slide to illustrate your discussion. If you need to do more "art," you can just erase and start again instead of using reams of legal paper or napkins.
— Dorothy Lowry, RN, Georgia
When writing a report for an attorney, explain a medically complex situation by prefacing with, "This is how I would explain it to a jury." This allows you to get down to the attorney's level without insulting his intelligence.
— Dorothy Lowry, RN, Georgia
