Legal nurse consultant

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A legal nurse consultant (LNC) is a registered nurse who uses expertise as a health care provider and specialized training to consult on medical-related legal cases. LNCs assist attorneys in reading medical records and understanding medical terminology and healthcare issues to achieve the best results for their clients. According to the New York Times, Vickie Milazzo RN, MSN, JD created the profession by "crossing nursing with the law.^[1]

A legal nurse consultant bridges gaps in the attorney's knowledge. While the attorney is the expert on legal issues, the LNC is the expert on nursing and the health care system. LNCs screen cases for merit, assist with discovery; conduct the existing literature and medical research; review medical records; identify standards of care; prepare reports and summaries on the extent of injury or illness; create demonstrative evidence; and locate or act as expert witnesses.

The legal nurse consultant acts as a specialized member of the litigation team whose professional contributions are often critical to achieving a fair and just outcome for all parties. There are several courses and certifications available for LNCs. Some offer basic education while others offers more comprehensive training. The LNC is paid for their education and years of experience in the medical field, not just their LNC certification or training, but having the training is suggested and being certified as a LNC is suggested. Attorneys should seek out LNC for their expertise because of their training.

A LNC differs from a paralegal in that a paralegal assists attorneys in the delivery of legal services and frequently requires a legal education. Legal nurse consulting is defined as a specialty practice of nursing noting that the professional foundation is first and foremost, nursing. While many legal nurse consultants have acquired knowledge of the legal system, legal education is not a prerequisite to the practice of legal nurse consulting. A legal nurse consultant uses existing expertise as a health care professional to consult and educate clients on specific medical and nursing issues in their cases.

References

Helping Nurses Move from Hospitals to Law Offices Published: February 18, 2001 SIGN IN TO RECOMMEND TWITTER SIGN IN TO E-MAIL PRINT REPRINTS SHARE CLOSE

HOUSTON -- When Vickie L. Milazzo was growing up in one side of a shotgun house in New Orleans, her parents could not fathom the unbroken hours she spent teaching an imaginary class of students.

"My father would tell the class to take a break and I'd say, `No, no, come back,' " she said. It was good training for the six- day, eight-hour seminars that she teaches today. But now her students are real: legions of nurses are paying Ms. Milazzo to instruct them on how to become legal nurse consultants.

The increasing number of lawsuits related to injury and health care has fueled demand for such consultants to help lawyers interpret most anything from medical charts to health insurance claims. And more nurses, unhappy with their profession under managed care, are looking to make a career change.

Indeed, hospitals nationwide are finding it hard to hire as many nurses as they need, while the American Association of Legal Nurse Consultants, an 11- year-old professional organization based in Glenview, Ill., reports unprecedented growth. Most of its 4,000 members have joined since 1998.

"I have never seen more dissatisfaction among nurses," said Ms. Milazzo, 46, who was a nurse and then a self-educated legal nurse consultant before she received a law degree and founded the Medical-Legal Consulting Institute Inc. in 1990. The company, with offices in Houston, trained and certified more than 2,000 legal nurse consultants last year, twice as many as in 1995.

Seven times a year, nurses crowd hotel conference rooms to learn the tricks of the trade from Ms. Milazzo, who charges $1,597 for the seminars around the country. She also offers videotapes of the course at $2,197, as well as books she has written and T-shirts and lapel pins bearing a company motto, "Cover Your Actions." Her company, privately held, employs 15 people and had revenue of $4.2 million last year.

In addition to learning how to detect evidence tampering, the elements of toxic tort cases and the intricacies of product liability law, nurses who take Ms. Milazzo's course receive a strong dose of motivation. She emphasizes their value as nurses and how they have the power to take control of their lives.

The nurses are generally enthusiastic in their praise. Gail Neuman, an obstetrics nurse in Tustin, Calif., said she decided to take the course last year after posting a question on an Internet bulletin board devoted to legal nurse consulting. "I asked what was the best preparation for legal nurse consulting," she said, "and over 50 people immediately responded that Vickie was just the best."

With the exception of a few advertisements placed in nursing magazines, Ms. Milazzo relies on word of mouth to attract new students.

To be sure, she had little competition until recently. She essentially pioneered the field.

Donna J. Schoebel, co-director of the University of Cincinnati's legal nurse consulting program, which is in its third year, said, "It's been just within the last couple of years that practically every Tom, Dick and Harry has started a legal nurse consulting program." The Cincinnati program is one of 28 in the United States that is approved by the American Bar Association because they include already sanctioned paralegal curricula.

They have not been much of a threat, according to Ms. Milazzo, because of their emphasis on paralegal skills like understanding trusts and estates and filing motions. Her program, which does not include such training, has not been endorsed by the A.B.A.

"Nurses don't want to train to be a paralegal," she said. "It's a step down."

Legal nurse consultants earn $60 to $150 an hour, compared with $18 an hour for a typical paralegal. Many hospital nurses are paid around $20 an hour.

The university and technical school programs also require several months of regular class attendance, which can be difficult for nurses, who often have erratic work schedules.

More of a threat to Ms. Milazzo's institute is a correspondence course offered by Kaplan Inc., a subsidiary of the Washington Post Company, which bought the National Institute of Paralegal Arts and Sciences in Boca Raton, Fla., in 1999.

"Really, they've helped more than hurt us," she said. "The fact that they are offering a legal nurse consulting program has increased the validity of the profession."

Unlike the classes offered by competitors, however, Ms. Milazzo's legal nurse consulting course qualifies in most states as one of the continuing education credits that nurses need to retain their licenses.

"I've always had a passion for teaching even when I was little," Ms. Milazzo said, explaining why she started her business. "It was a way to combine my passion with everything I've learned over the years."

Remembering how underappreciated and overworked she felt as a critical-care nurse in Houston, she says she also wants to raise nurses' self-esteem.

"I want them to know that they possess valuable skills even if they decide not to become a legal nurse consultant," she said.

Along with her courses, Ms. Milazzo holds an annual conference for graduates -- the meeting this year will be on a cruise ship -- at which they learn about changes in the law that could affect their practice. The conference is also required for nurses to renew their legal nurse consultant certification, which her Medical Legal Consulting Institute confers on the basis of an examination at the end of her course. Renewals give the company a continuing source of revenue from nurses even after they have graduated; the certification expires every two years. Another moneymaker is the $60-a-year quarterly newsletter, National Medical-Legal Journal, edited by Ms. Milazzo.

FTER working by herself out of a one-bedroom apartment for 10 years, the first five before she incorporated, Ms. Milazzo says the hardest part of building her business was hiring employees. One of them is her husband, Thomas M. Ziemba, whom she met at the South Texas College of Law in Houston. Both are now members of the Texas bar.

"It's harder when it's not just you," she said. "Before I thought, `If I fail then I fail and I'll go get a real job.' Now if I fail, it's a much bigger deal."