BYOB Part II of III: Putting your nose to the grindstone

This post will delve more deeply into what to expect in legal nurse consulting.

First, expect to do a LOT of research.

Unlike testifying experts who specialize in a nursing niche, legal nurse consultants are asked to assist in many types of healthcare claims. No two are alike and I have never worked on a case that did not require a great deal of research on injuries or conditions. For me, learning is one of the perks of this field, and you really have to enjoy the process of discovery (not in the legal sense).

Your responsibility does not change with the side of the claim you are on, because your job is to find facts without preconceived notions of causation. You need solid research on this disease, its incubation and likely sources of exposure, the preferred treatment, the long term effects and cure rate, and the medical history of the patient before and after exposure. You need to open those records and find out what’s missing so you can inform your attorney immediately what he needs to request from other sources.

This brings up the second point:

Expect to look at medical issues from completely different angles.

You have a case. You have the stationery to write the report. You have all the equipment to produce it.

Suddenly, you don’t know where to start. This is puzzling because, after all, you are a nurse, and you do know about the standard of care, how to spot a deteriorating patient, when to challenge a questionable order, and what the inside of a hospital chart looks like.

The problem is that the case may not concern the delivery of care. For example, the claimant is a heating and cooling maintenance man who has worked in his field for 15 years without a hitch. Now he says that one blast of air from an older home has resulted in aspergillum lung infection with encapsulating scar tissue and he can never work again. That may be true, but as a legal nurse consultant you never accept a claim at face value. This man is not a patient, he is a claimant. You need to learn everything you can about this disease even though you are not the testifying expert.

Third, give aspirations time…and feed them with hard work.

I get many emails from aspiring LNCs who want advice on getting started. Some just want a nudge in the right direction so they can find things out for themselves. Some have not pursued any training programs. Some have completed a program but complain that “I read the books, took the test at the end, started emailing attorneys and it’s been three whole weeks without a nibble. What am I doing wrong? Just tell me what to do.” Or, “Let me work for you”. Or, “Do you know anyone who needs my help…I’m so discouraged.”

Do you know what these situations remind me of? Weddings. Two people love each other and plan a formal wedding. The sheer amount of work and money that goes into this event is staggering. They (she) get caught up in reservations, gift registries, invitations, flowers, catering, the dress, the dress rehearsal, and oh my God—the bride’s maids’ dresses. You can lose sight of what this wedding is for – the beginning of a new life with challenges and rewards, neither of which depends upon the wedding itself.

But eventually you do get married or you do get that first case and it is so exciting! You can tell your family you haven’t been wasting money, neglecting the house and starving the cat in vain. There’s nothing like the thrill of a new referral…and “putting your nose to the grindstone” to turn out an excellent report.

It’s time to work.

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