CLNC® PROS REVEAL
Our Biggest Mistakes and What We Learned From Them
EDITOR'S NOTE: I asked our CLNC® Pros to share their biggest mistakes, how they handled them and the lessons they learned. As Patsy Howard, RN, CLNC says, "Even as children, we are often admonished for mistakes rather than guided to learn from them. As nurses, we may forget to look at our mistakes as learning experiences. It's very frightening to make mistakes in our profession, but mistakes will happen. It is how we manage them and learn from them that determines our growth."
I hope the mistakes made by these experienced CLNC® Pros will help you give yourself permission to make your own mistakes and learn from them so that you can advance to higher levels of CLNC® success. At least now you'll be able to avoid their mistakes!
Vickie L. Milazzo, RN, MSN, JD
It Pays to Be Prepared
The biggest mistake I ever made was with my first attorney interview. When I first sat down, I couldn't think of anything to say. I had forgotten how to start the interview and how to sell my service as a CLNC®. The situation only got worse as the interview continued.
On my way out of his office empty-handed, I recalled the story about the preacher who decided he would not prepare for his sermon, but would let God speak through him. Sunday morning came and when the preacher got up to speak, God did speak to him. God said, "You are not prepared." That was exactly how I felt, very unprepared. I thought I could waltz into the attorney's office without practicing beforehand, and everything would go smoothly. But that's not the way it works.
Before my next attorney interview I re-listened to Vickie's tapes from the CLNC® Home-Study Certification Program and practiced interview questions, opening lines and closing comments. When I arrived for that interview, I was very prepared and I walked away with a case. Whatever the assignment, I have learned to always be prepared.
– Gina I. Rogers, RN, BSN, NMCC, CLNC
Never Underestimate the Power of Marketing to Triple Your Income
My biggest business mistake involves not spending money to make money. I am talking about marketing. When I first began my CLNC® business, I was a seasoned nurse but an unseasoned businesswoman. I did not comprehend the importance of getting my name out there, not once, but over and over and over again.
If I was launching my business today, I would allocate a much higher percentage of my start-up funds for marketing. Marketing strategies that have worked for me include exhibiting at legal seminars, sending out a newsletter and advertising in legal publications. All these things must be done repeatedly to be effective. When I began spending more on marketing, my income doubled and then tripled because I was getting my name out there.
The old adage is true: You have to spend money to make money. Go ahead, dip into your wallet. Your investment will pay for itself many times over.
– Susan J. Burnham, RNC, CLNC
Don't Jump to Conclusions Too Quickly
Early in my CLNC® career I researched a case and concluded it was meritorious. Well into the case, what I thought was impossible occurred. The client started to improve, and therefore the damages started to disappear before our eyes. The case was not as tragic and not quite as "slam dunk" as I had led the attorney (and myself) to believe.
Once I overcame my embarrassment, I immediately confronted the issue and was honest with the attorney. At first, he was furious with me. Based on my opinion, he had put a lot of his own money into the case. I told him that I had not foreseen a recovery and that I would assist him in developing a new strategy. We now based the case strictly on the losses during the shorter time the client had been affected. We canceled the life care planner and scaled down our demands. This strategy worked.
This case taught me to peel away many more layers before formulating a definitive opinion on merit and outcome. Before relying on my own personal experience or gut reaction, I learned to confer with my colleagues and with experts and to research every possible foreseeable outcome extensively.
My attorney-client shared that because I was honest with him about what I should have done differently and because I tried to help him resolve the dilemma, he was able to trust me and to this day we still work together.
– Dale Barnes, RN, MSN, CLNC
Follow Through Is Even More Important When You're Busy
When I'm very busy, I do not follow through with my contacts or with attorneys with whom I have only done one case. I just move on to the next case. I manage to stay in frequent contact with quite a few attorney-clients, due to the volume of service I regularly provide for them. However, I know I must make time for communication with the new clients and prospects to sustain my CLNC® business for the long term.
– Marie Wendle, RN, BSN, CCRN, CLNC
You Have to Take the Time Even When You're Out of Time
When I was a very inexperienced CLNC®, I worked in-house with a defense team. In preparation for a big trial, I had to quickly send volumes of material cross-country for our expert to review. I frantically organized and copied numerous sets of medical records, prepared my letter to the
expert and packed everything for shipping. Just before FedEx® arrived to pick up the boxes, I realized everything I had copied was from the wrong file. I had to rectify my mistake immediately. If the material did not reach our expert in time, his lack of information at trial could cost us the verdict.
Luckily, I had a good working relationship with a local copy service that answered my distress call. They copied the medical records and files and shipped the materials from their office by special courier late that night. Although the materials reached the expert in time and we were able to proceed, my mistake did cost the law firm a large sum of money in additional copying fees and personnel time that could not be billed to the client.
After taking a deep breath and evaluating what went wrong, I realized I could apply the same rules as a CLNC® that nurses use for administering drugs:
Get clear and specific instructions from the attorney.
Identify that you have the right file material and medical records.
Double check all file material and medical records before sending them out.
Verify with the expert that the correct materials were received on time and in good condition.
Now when planning any project, small or large, I apply the problem-solving techniques used in my nursing career. Accepting my mistake and viewing it as a learning experience allowed me to evaluate what went wrong and implement appropriate changes in the system. Making a mistake is still scary and painful, but I also relish my ability to grow and improve as a CLNC®.
– Patsy Howard, RN, CLNC
Develop a System to Keep Control of Your Growing Caseload
During the rapid and exciting growth my CLNC® company experienced last year, cases came in left and right, piling up on my bookshelves, tables and floor. Although managing the caseload became very difficult, I made the mistake of thinking I had everything under control.
What happened next was frightening. During the course of a usual harried day, I was going through the stacks with my makeshift checklist in hand, and I found a file that wasn't on my scribbled list. On top was a letter from my client with a date...more than six weeks past due. After picking up my internal organs from the floor and resuscitating myself, I had to come up with a plan to get this case reviewed, but quick.
Since I was in the middle of preparing trial exhibits for another case, I called one of my CLNC® subcontractors. She came to my rescue. We reviewed and analyzed the case within a week.
To prevent this disaster from happening again, I created a Case List Flow Sheet with the following headings:
Case Name
Firm
Date Records Received
Assigned CLNC
Date Report Due
Date Completed
Additional Record Review Required
I create this list in alphabetical order by case and update it weekly. When a case settles, I mark it and keep it on the list for one month, then remove it and place it on a Case List by Facility Sheet. I keep this list on my desk for easy reference.
The Case List by Facility is an alphabetical listing of every facility, hospital or agency that has generated a case. Under each facility, I enter the names of cases categorized by plaintiff or defense. This list allows me to easily cross-reference cases and to avoid conflicts of interest. When a new case comes in, I immediately assess for potential conflicts.
Today I write things down rather than rely solely upon recall. My new system has helped me not only avoid mistakes, but feel more organized and in control.
– Suzanne E. Arragg, RN, BSN, CDONA/LTC, CLNC
Get Your Full Retainer Up Front
One of the first things Vickie impressed on me in the CLNC® Certification Program was the importance of asking for a retainer every time and providing service only after the retainer is received. I've been really hard-nosed on this issue. However, when another legal nurse consultant contacted me about serving as an expert, I took her word that the attorney-client was a good person she had worked with before. Since this was a small case, I agreed to provide my services with only one-fourth my usual retainer.
Not a good idea – I got stuck. When the case dissolved in the attorney's hands, I had an outstanding balance for work I had done. I continued billing for the next six months to no avail. I even started sending my statements by registered mail. Finally, I had my attorney request settlement of the account. Nothing. I lost the remaining balance on the case. The amount wasn't large, but the principle was an issue for me.
So if you ever want a long term care expert, I'm still available, but not without receiving my full retainer in advance.
– Nancy L. Dion, RN, MSM, CPHQ, CHCRM, LNHA, CLNC
Be Honest About Your Mistakes and Your Integrity Will Pay Off
When generating a detailed chronology for a client, I listed multiple references throughout the report. Although I proofed the report several times before submitting it, I made the mistake of focusing more on content and less on references. Consequently, I missed the fact that some of my reference numbers did not correlate with the correct exhibits in my report. Unfortunately, I didn't realize this until after the report had been submitted.
I knew the report would be used as a basis for other steps, such as preparing for depositions. It would confuse my attorney-client, and I needed to resolve the problem promptly. If not corrected, the report could cause more damage than good.
Fortunately, I discovered the error shortly after sending in my report. I notified the client immediately, told him that revisions were in progress and advised him when the revised report would be ready. I reviewed the entire report again in detail, carefully checking not only the references, but content as well. The last thing I wanted was for my client to discover a new error. I then personally delivered the corrected report to the client's office.
The lessons I learned include:
1.
Proof, Proof, Proof! – Regardless of the deadline, the expression "haste makes waste" will apply if you don't allow adequate time for proofing. Cross-checking references is essential. It is important to treat all portions of a report equally during the proofing process.
2.
Refine Your System – The time needed to correct errors after the fact far exceeds the time required to carefully proofread first. Therefore, I improved my proofreading system to decrease the risk of errors.
3.
Make Time for a Fresh Perspective – I manage my time to allow for breaks from a project. This increases my accuracy and decreases the risk of errors. It is amazing how easily I can pick up mistakes when returning to a project with a fresh perspective.
4.
Be Honest and Remedy the Mistake – Although it was difficult to bring my mistake to the attorney's attention, being open and honest actually increased my credibility with the client.
My fears about the client losing faith in my abilities ultimately had no foundation. We are human, and when mistakes occur, it is our integrity and ability to resolve the problem that may be remembered most.
– Joan M. Gower, RN, CLNC
Suzanne E. Arragg, RN, BSN, CDONA/LTC, CLNC is the owner of SEA Consultant Company in California. Her firm specializes in long term care cases.
Dale Barnes, RN, MSN, CLNC, an independent CLNC®, has owned Barnes Medical Legal Services in California since 1999. She consults on medical malpractice, bad faith insurance, general personal injury, home care, elder abuse and research services.
Susan J. Burnham, RNC, CLNC owns Burnham and Associates in Washington state. She has been an independent CLNC® since 1996 and specializes in quality of care issues.
Nancy L. Dion, RN, MSM, CPHQ, CHCRM, LNHA, CLNC has more than 35 years of experience as a healthcare professional. She is a Florida-based CLNC® with expertise in clinical services, organizational redesign, quality improvement, risk management and 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.
Patsy Howard, RN, CLNC is the owner of Metro Legal Nurse Consulting in Missouri. She has 23 years of nursing experience in hospital nursing, home health, management, medical malpractice litigation and legal nurse consulting.
Gina I. Rogers, RN, BSN, CLNC is the founder of Medical Review Consulting, LLC in Kentucky. Her company consults with plaintiff and defense attorneys as well as insurance companies throughout the country.
Marie Wendle, RN, BS, CCRN, CLNC is the president of Medical Legal Nurse Consultants of Washington in Seattle, Washington. She specializes in working with law firms on medical malpractice and personal injury cases, attends IMEs for her attorney-clients and serves as an expert witness on standards of nursing care.
– Gina I. Rogers, RN, BSN, NMCC, CLNC 
