If you are on my mailing list, you recently received a gift from me, a paperback book entitled CLNC® Success Stories. This special
collection of my favorite success stories provides an inside look at the personal journeys of success followed by my most successful graduates. We hope you enjoyed these inspiring tales of triumph in the challenging world of legal nurse consulting.
If you'd like your own FREE copy of CLNC® Success Stories (a $12.95 value), click here to add your name to our mailing list or phone us toll-free at 1-800-880-0944. When your gift book arrives, use its tips and strategies to create your own CLNC® success story.
We'd like to consider YOUR success story for the next edition of CLNC® Success Stories.
In an article titled "Medical Entrepreneurs Provide Dose of Innovation," Employment Review, November 2001, Vickie speaks out about how nurses are looking for entrepreneurial career options. The article includes Vickie's comments on a recent survey of her students which established some of the key reasons nurses seek entrepreneurship:
"To make a difference in people's lives"
"To be financially independent"
"To be your own boss"
"To be in charge of your future"
"To have flexibility and control over your life"
"To be part of something new and exciting"
"To keep your brain functioning"
Entrepreneurs are innovators who have a desire to revolutionize. RNs are no different. RNs go into legal nurse consulting because it allows them to stay in the medical field yet do something totally different, challenging and stimulating. To be a legal nurse consultant, Vickie says, takes "...commitment, persistence and perseverance....Being an entrepreneur is very demanding and very time-consuming." She suggests that entrepreneurs find mentors to guide them along the way.
In summary, Vickie says, "There is no magic to being an entrepreneur. It's not about what someone's IQ is or how many degrees you have behind your name. It's about getting in there and working at it."
CLNC® SUCCESS STORY
Shocked to Success with Vital Signs Still Intact
by Arlene Santiago-Tribbett, RN, BSN, CLNC
For the past eight years, I've been a home-care and ER/trauma nurse. My nursing career had become unsatisfying, so I began searching in a new career direction. I thought about graduate school, but none of the programs seemed worthy of my time or money. Before becoming a nurse, I was a police officer, and the law always fascinated me. So when I saw an ad for Vickie's CLNC® Certification Program in a nursing magazine, I researched the
field and signed up for Vickie's program.
The CLNC® 6-Day Certification Seminar impressed me from the first day. Vickie gave away information so freely, and I experienced nurses from all over the country coming together in unity and full support for each other. The seminar was so motivating, that I regained the pride I once had for nursing. Vickie and her CLNC® Certification Program did that for me.
The week after the seminar was like a dream. I had an appointment to see an attorney for personal reasons. I told him I was a legal nurse consultant and mentioned the services I provided. He stopped me in mid-sentence and called his associates into his office to hear what I had to say. "Where have you been?" he asked and explained that his firm desperately needed a qualified legal nurse consultant. They had a part-time consultant whose work wasn't very good or very timely.
I told him I charged $125/hr and needed a 50% retainer, and he gave me three cases with the promise of two more. He went on to say that when I got business cards (I didn't even have business cards!), he would introduce me to other attorneys who could use my services.
I am still in shock. I never expected any of this. That one week with Vickie was the most challenging, yet the most exciting of my life. Now, I actually have work in my hands. My life is headed in a new, exciting and profitable direction I could never have imagined before I attended Vickie's CLNC® 6-Day Certification Seminar.
Arlene Santiago-Tribbett, RN, BSN, CLNC is the owner of Critical Thinking, Inc. in New Jersey. Her company specializes in medical-malpractice, toxic-tort, and locating expert witnesses.
MY MOST MEMORABLE CASE
Complex Cases Often Hinge on Simple Issues
by Lisa Ellison, RNC, CLNC
I was asked to provide an initial opinion on an OB case involving a vaginal delivery after Cesarean section that resulted in a ruptured uterus and a very badly injured infant. Every case I work on is a learning experience, and this one was a lesson in the importance of the KISS principle (Keep It Simple, Stupid).
The attorney-client asked me to create a detailed chronology and case summary, conduct literature research, prepare deposition questions and requests for production, review deposition responses, and locate an expert nursing witness.
I did a lot of research on the causes of uterine rupture, on safety issues affecting vaginal delivery after Cesarean section, and on cerebral palsy, neonatal resuscitation and Apgar scores. I scoured ACOG, AWHONN and neonatal resuscitation standards.
However, the real issues of the case were much simpler. The gross deviations from the standards of care related directly to the Nurse Practice Act. Among other basics, this particular case involved failure to assess, failure to notify the physician, failure to notify the house supervisor and failure to change a malfunctioning piece of equipment — basics every nurse knows or ought to know. My point is that complex cases sometimes come down to the rules we learn in Nursing 101. Pointing out the deviations from those rules can win a case for a plaintiff attorney.
The attorney-client in this case was generous with his praise for my work. He appreciated my research and my assistance in interpreting the Nurse Practice Act as well as the fetal monitor strips. But what he appreciated more was my dedication to the KISS principle.
While detailed clinical research on complex medical and nursing issues is essential, we must look for the basic issues as well. We must always remember
that the most fundamental nursing errors can cause devastating outcomes for patients. I feel certain the verdict will be for the plaintiff who was so badly damaged.
Lisa Ellison, RNC, CLNC is the owner of Premier Nursing Consultants in Texas. She assists attorneys in preparation of medical malpractice and personal injury cases and provides in-depth research, chronologies and reports.
BEST PRACTICES FOR STANDARDS OF CARE
JCAHO Issues New Patient Safety Standards for Hospitals
by Claudia Loring, RN, BSN, MSSW, CLNC
Effective July 1, 2001, JCAHO has implemented new patient safety standards which require hospitals to implement mechanisms to prevent medical errors and to inform patients if they have been harmed by the care provided. These new standards focus on having organizational leaders create a safety culture that encourages open discussion of errors and identifies systems or processes that contribute to errors.
Charlene Hill, media relations manager for the Joint Commission on Accreditation of Healthcare Organizations (JCAHO), stated, "When the new standards are implemented, over 50 percent of all JCAHO's hospital standards will relate directly to patient safety."1 Here are just a few examples of the revised standards that went into effect July 1, 2001:
Leadership standard LD3.4.1 says that the leaders provide for mechanisms to measure, analyze and manage variation in the performance of defined processes that affect patient safety.2 Inconsistent performance of such processes, as designed and described in organization policies and procedures, frequently leads to unanticipated and undesirable results. In order to minimize risk to patients due to such variations, the leaders ensure that the actual performance of processes identified as error-prone or carrying high risks regarding patient safety is measured and analyzed. When significant variations are identified, appropriate corrective actions are taken to enhance the system. At any given time, the performance of critical steps in at least one high-risk process is the subject of ongoing measurement and periodic analysis to determine the degree of variation from intended performance.
Improving Organization Performance revised standard PI.4.4 provides that the organization identify changes that will not only lead to improved performance but also improved patient safety.3 This standard is intended to assure that the organization uses the information from data analysis to identify system changes that will improve performance or patient safety.
Management of Information standard IM.9 was not changed but the intent was changed to include knowledge-based information management consisting of systems, resources and services supporting activities to reduce risk to patients.4 Knowledge-based information refers to current authoritative print and non-print information resources, including successful practices.
Patient Rights and Organization Ethics standard RI.1.2.2 states that patients and, when appropriate, their families are informed about the outcomes of care, including unanticipated outcomes. The responsible licensed independent practitioner or his or her designee clearly explains the outcome of any treatments or procedures whenever those outcomes differ significantly from the anticipated outcomes.5
Education standard PF3.7 was not changed but the intent was changed. The safety of healthcare delivery is enhanced by the involvement of the patient, as appropriate to his condition, as a partner in the healthcare process. Specific attention is directed to educating patients and families about their role in facilitating the safe delivery of care. The patient and family are responsible for reporting perceived risks in care and unexpected changes in the patient's condition.6
Continuum of Care standards CC.4 and CC.5 were not changed, but the intent was changed to state that communication and transfer of information between and among healthcare professionals is essential to a seamless, safe and effective process.7
Human Resources standard HR.4 was not changed, but the intent was changed to state that the orientation process emphasizes specific job-related aspects of patient safety.8
Human Resources standard HR4.2 provides for ongoing in-service and other education and training...and supports an interdisciplinary approach to patient care.8 These education and training programs emphasize specific job-related aspects of patient safety. As appropriate, this training incorporates methods of team training to foster an interdisciplinary, collaborative approach to the delivery of patient care, and reinforce the need for and ways to report medical/healthcare errors. This intent also defines error, sentinel event, near miss and hazardous condition.
For a detailed summary of these revisions, go to: http://www.jcaho.org/standard/fr_ptsafety.html. For more information on standards go to the JCAHO web site, www.jcaho.org. To order quarterly updates call the JCAHO customer service line: 630-792-5800.
REFERENCES:
Hill, Charlene, "Hospitals Face New JCAHO Patient Safety Standards on July 1," Joint Commission on Accreditation of Healthcare Organizations, June 28, 2001. Website: www.jcaho.org/news/nb333.html
2001 Comprehensive Accreditation Manual for Hospitals: The Official Handbook, Joint Commission on Accreditation of Healthcare Organizations (JCAHO), Update 1, February 2001, p. LD-7a.
Ibid. p. PI-4.
Ibid. p. IM-26.
Ibid. p. RI-11.
Ibid. p. PF-7.
Ibid. p. CC-6.
Ibid. p. HR-13.
Claudia Loring, RN, BSN, MSSW, CLNC is the CEO of Loring & Associates, Inc. in Florida. She is a certified nurse life care planner.
