What is a Legal Nurse Worth to my Law Firm?

              Your law firm is a business; and running a successful business is HARD. There are myriad books, websites, and seminars dedicated to how to run your business, but there are some common threads. According to Forbes Magazine one of the most important steps you can take to run a successful business is to optimize your efficiency by outsourcing what you can.[i] Not a social media guru? Hire a virtual social media pro. Struggle with keeping track of costs? Hire an accountant or bookkeeper. Unfamiliar with medical lingo, the structure of EMRs, and the standard of care? Hire a medical professional to consult with you. A medical professional can greatly reduce the amount of time spent reviewing medical records just by virtue of understanding the structure and content of medical records on a fundamental level. Medical jargon can be as intimidating as another language and understanding the implications of different procedures, items in a medical history, and medications requires literally years of concentrated study and clinical experience- you don’t have time for that! So, “bring in the professionals!” recommends Business News Daily.[ii] A Legal Nurse Consultant is just that- a medical professional with legal knowledge and/or training who can help distill the most pertinent and relevant facts of the case into various reports to help keep your cases moving.
 
          The value of having someone with clinical experience review the medical documents in your case cannot be overstated. Anyone can read a medical record and pick up on the big things that have gone wrong, but if you saw a list of medications in someone’s record would you (or your paralegal) be able to spot one that wasn’t accounted for in the medical history? If a patient doesn’t list mental health problems in their history would your legal team know to look deeper just because the medication list had the medications divalproex (mood stabilizer) and risperidone (antipsychotic) on it? That’s just one example of case outcome-altering medication information I’ve found by reviewing records. Additionally, there could be documentation missing from a chart that only someone familiar with medical procedures and protocols would know to look for. Frankly, a nurse knows what is supposed to be in the medical record and can recognize when something is missing. I once saw a case of a patient who died following complications of a blood transfusion. Looking at the documentation, the patient’s vital signs were documented every hour during the transfusion and for several hours before and after. As a nurse I knew that the vast majority of (if not all) hospitals have strict procedures for vital sign monitoring during a blood transfusion- often the nurse must stay in the room with the patient during the first fifteen minutes (or more) of the transfusion and document vital signs every fifteen minutes during the first hour of the transfusion. We recommended the attorney request the hospital floor’s policy manual and sure enough the nursing protocol during the blood transfusion had not been followed.

          As established above, having a medical professional consult on your cases can help you to more effectively manage your most costly asset: your time, so you can focus on closing your cases in a more effective and efficient manner. You may be asking yourself, “Why even bother with a legal nurse consultant when there are doctors offering similar services?” The crux of the answer from a business perspective is cost. While it’s true that doctors have years more medical study and training than the vast majority of nurses, they also charge much high rates (and understandably so!). There are certain situations in which you will ALWAYS require a physician expert witness: when it comes to Expert Testimony a registered nurse should not render an opinion on a physician standard of care, for example. This is because a nurse is, by definition, not held to a physician standard of care in clinical situations. A behind-the-scenes LNC can, however, usually tell if what appears in a medical record is consistent with what is typical in a clinical setting and most can get you in touch with the right physician expert witness. S/He can summarize the records, put them in order, generate a chronology or other report, and assist with additional record/discovery requests as well as deposition questions, all at a fraction of the cost of a physician. Behind-the-scenes physicians typically charge at least $400 to $500 an hour[iii] for record reviews and many have variably refundable retainers starting at around $2000. I can’t speak for all LNCs, but a lot of Legal Nurse Consulting firms are small businesses and charge significantly less than that. Add to this savings the fact that a good LNC will always recommend escalating to a physician when parts of the case are outside of his or her scope of practice and you’re golden- you’re still getting physician input when needed but relying on a less expensive resource to tell you when it is needed.
 
 
 

Sources Cited:
[i] Heyward, C. (2021, June 17). Council post: 9 things to know before starting a business. Forbes. Retrieved February 22, 2022, from https://www.forbes.com/sites/forbesbusinesscouncil/2021/06/17/9-things-to-know-before-starting-a-business/?sh=716ae87b6646
[ii] What to do before starting a business. Business News Daily. (n.d.). Retrieved February 22, 2022, from https://www.businessnewsdaily.com/1484-starting-a-business.html
[iii] Nancy Hammond, M. D. (2018, February 9). Expert witness 101. physiciansidegigs. Retrieved February 20, 2022, from https://www.physiciansidegigs.com/single-post/expert-witness-101