Maryland Bar Bulletin
Publications : Bar Bulletin : October 2013

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The insider knowledge nurses have can be a powerful weapon in the toolbox. In the healthcare arena, nurses are the only professionals to interact with the whole system of healthcare.

Maybe you’ve been practicing law for several years, or maybe you’ve just started, but engaging a Legal Nurse Consultant (LNC) to assist you in developing your cases can help you in ways that you might not have previously anticipated.

Most attorneys who have been practicing a while know that occasionally a nurse expert witness is needed for specific kinds of cases involving nursing malpractice, but did you know that specifically trained nurses could act as consulting experts to help develop your cases where medical or nursing problems are a factor?

In order to appreciate why you need a Legal Nurse Consultant, you first need to know what they are and what they do. Simply put, an LNC is a nurse with additional training in aspects of the law and how nursing and medical issues fit within specific theories of liability.  An LNC’s primary role is to educate attorneys on the medical or nursing issues of the case and their strengths and weaknesses. LNC’s can play two main roles: one, as a testifying expert, which is how most attorneys know nurses can be involved in their cases and their work is discoverable; and two, as a consulting expert the nurse helps to develop the attorney’s work product and therefore their work is generally not discoverable.

The use of the LNC as a consulting expert is where major benefits of engaging an LNC can be realized. As a consulting expert, LNC’s can also help to develop cases in several different ways, including but not limited to chronology development, report writing, deposition analysis, medical research, to developing demonstrative evidence – not just providing analysis of the medical or nursing information of the case.  In total there are about 30 core services a consulting LNC can provide to an attorney to help round out a case to help you win it.

In the consulting and testifying expert roles, the insider knowledge nurses have can be a powerful weapon in the toolbox. In the healthcare arena, nurses are the only professionals to interact with the whole system of healthcare.  As a result, this gives them certain insights into the case that other professionals in the system won’t have.  Nurses know who does what and what should have happened. This can help to identify for attorneys areas of policy, procedures, potential defendants, and areas of corporate liability among other things that can help support the case.

A common objection to using an LNC is that the attorney only uses a physician or nurse paralegal for review and development of their cases.  While engaging these roles is a plus, they can be limited in their scope of effect due to the role itself.  No question physicians can spot issues with a disease process and care rendered. But by the very nature of their role in healthcare, their perspective is limited. A consulting LNC brings a broader perspective to identify these and other issues, and potential defendants while often costing less money.  And unlike some physicians, LNC’s will generally work on any case involving medical or nursing issues. A nurse paralegal’s responsibilities as a paralegal often preclude enough time to fully review and develop a case, whereas as a consulting LNC that is the sole focus.

The average attorney has no medical or nursing background except through experience in their practice, and it will take a lot longer to understand the issues in the case. Even then, because of the lack of experience in the role of a nurse or doctor, attorneys may miss some major elements and how they fit together. Engaging a LNC to review, analyze, and help develop the case can result in saving a lot of time and money.

Susan Bailey MSN RN-BC CLNC is the founder of TopNotch Legal Nurse Consulting, LLC.

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Publications : Bar Bulletin : October 2013

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