by Elizabeth Rudolph | Mar 9, 2022 | Evaluating Cases, Legal Nurse Consulting
A lot has happened over the past two years which permanently changed nursing and legal nurse consulting practice. The way you, as a certified Professional Legal Nurse Consultant (PLNC), review medical records will never be the same as pre-pandemic. You need to know what the legal landscape is now and going forward to make the necessary adjustments.
Let’s look at selected nursing challenges that the Covid pandemic has brought. In order to be an effective PLNC, you need to be able to size up the current documentation situation. Pre-pandemic, documentation was, on average, ample. Since the coronavirus outbreak, you’ll find charting has suffered.
Documentation Has Suffered
In your medical record review, your focus is almost entirely on the patient’s history and treatment course. You’d expect to find what you’re looking for in the Medication Administration Record, the Nurses’ Notes, Healthcare Providers’ Orders, Progress Notes, and any number of sections. Absent those entries, the assumption would be that it wasn’t done.
After all, that’s what nurses are taught in nursing school. We’re told the old adage “if it’s not documented, it’s not done”. That is not necessarily true anymore. Covid has taught us that. With nurses and other healthcare workers completely overwhelmed, guess what went by the wayside? DOCUMENTATION.
Without the benefit of documentation, the challenge becomes how do we figure out what was, and was not, done for the patient? This is where your Professional Legal Nurse Consultant skills come into play. You need to make a list of what documentation should have been present but wasn’t. Furthermore, you need to make a “Missing Documents” list specifically enumerating the documents that are not there but should’ve been completed.
Nurses Not Fully Prepared For Critical Care Practice
You’ll see in the patients’ charts nurses are likely not documenting in the manner you’d expect if they aren’t used to working in that specialty. For example, a pediatric nurse is likely not used to working on an Adult Covid Unit. This is especially problematic as the medication dosing for children versus adults can be significantly different. A pediatric nurse administering adult meds might not catch a medication error. You, as the PLNC, need to be on the lookout for this.
Not just with medications, but nurses who are floating to other specialty areas might not be used to providing clinical care in accordance with those standards of care. It’s up to you to research the standard of nursing care. Whether you’re consulting on legal cases for the plaintiff or defendant, you’ll need to provide some degree of research on nursing standards of care. Ultimately, you’ll have to decide if you think there was a breach of standard of care or if the facts support the standard of care.
Less Time Performing Nursing Assessments
When a nurse cannot do an appropriate initial assessment of the patient, it’s a slippery slope. For example, if the nurse failed to appropriately assess the condition of the patient at hospital admission, and later there’s documentation of decubitus, the assumption will be the patient’s condition deteriorated during hospitalization. This could mean liability for the hospital and the nurses. If the patient was accurately assessed at admission and the wound was noted, this could reduce the liability exposure.
In your legal nurse consulting merit review, carefully read all nursing assessments. Are they thorough? The answer might be “yes”, but you need to decide what should’ve been in them. If your answer is “no”, be prepared to explain why.
Crises Occur Online and Offline
Just because you didn’t see anything noteworthy in the medical records during your legal nurse consultant review doesn’t mean there isn’t a problem. If you’re reviewing the medical records in support of the nurse, see if you have access to Incident Reports. Still yet, see if you are allowed to read employee files, but these are usually protected documents.
If you’re reviewing records on behalf of the hospital, you might ask the attorney for their notes of the meeting or risk management’s notes. These can provide even more info that can help paint the full picture.
You need to know the legal landscape has forever changed when it comes to legal nurse consultant medical record reviews. What you might’ve come to expect from patient’s hospital or nursing course is not necessarily the norm anymore. Stay current by reading articles, blogs, and other scholarly material on how nursing practice has evolved.
Your Professional Legal Nurse Consultant skills are invaluable. Be proud. Be smart. Be sure to stay ahead of the pandemic, or endemic, curve.
P.S. Get your FREE Guide here so you can stay up-to-date on legal nurse consulting.
by Elizabeth Rudolph | Mar 1, 2022 | Legal Nurse Consulting, Marketing
Your Professional Legal Nurse Consultant (PLNC) Certification resume is your personal, and most significant, marketing tool that’ll help you shine in your legal nurse consulting career. When you reach out to attorneys to assist them by reviewing medical records in cases, your resume speaks volumes. That’s why it’s essential you take this opportunity to make the most memorable impression!
Your resume should be designed to show off your skills and talents. It’s your opportunity to boast, but in a somewhat humble way.
Showing an attorney your nursing skills, experience, and education is an easily digestible format is absolutely key. The attorney doesn’t want to go fishing around for this essential info.
Five Tips To Make Your Resume STAND OUT!
1. Organize your resume into sections. There should be a rhyme and reason why you’ve grouped corresponding information into the same section.
Use These Sections:
- Contact Info
- Education
- Experience
- Licenses and Certifications
- Publications (if none, delete this section)
- Memberships and Activities
- Hobbies and Interests (not required, but definitely makes you more relatable)
2. Do NOT include this information: Don’t include the actual word “Resume”. It’s clear that this is your resume. Career Objectives: while you’re used to objectives being part of a nursing school syllabus, don’t include career objectives on your resume. You’ll essentially be saying why you want the job in your email to the attorney.
3. Send your resume via email. You don’t need to print it out and mail it. Make it easy for the attorney to open the PDF of your resume by telling the attorney in your email that you’ve attached your resume.
4. Research the attorney and the law firm, or company, ahead of time. This way, you can include the information you’ve gleaned from their website in your cover email. It shows you’ve done your research. That’s impressive!
5. Keep your resume to 1 – 2 pages. You can say in your cover email that you’ve attached your resume, but you have a more extensive curriculum vitae (CV) if they want it. This shows you’re mindful of the attorney’s time in not providing a long document to review, but that you have it if they want it.
As it’s been said, remember this expression and do it: “Measure twice, cut once”. Read and reread your resume BEFORE you click “Send”. You don’t want to have any typos in it.
Go get ‘em, PLNCs, with a striking resume that’s sure to make you shine.
P.S. Want more resume tips? Go here.
P.P.S. Tell your nurse colleagues they can gain financial and professional independence here.
by Elizabeth Rudolph | Feb 22, 2022 | Attorney Communication, Legal Nurse Consulting
We all want success. We want success in our legal nurse consultant careers. It’s natural to want it, but how do you actually attain success as a Professional Legal Nurse Consultant (PLNC)?
Let’s look at other PLNC’s methods for success, which we’ve compiled below for you.
Success Tips For Professional Legal Nurse Consultants By Professional Legal Nurse Consultants
Be accessible and available for work. Whenever an attorney, paralegal, or legal assistant contacts you, be ready to take on the assignment. No excuses. If they’re reaching out to you, it’s for a reason. They want and need you to review medical records in a case or potential case.
Oftentimes, you’re being contacted at what you perceive to be “the last minute”. Maybe they’ve had the medical records for a while, maybe they meant to send them to you earlier, or maybe they’ve tried others first. Regardless, if you want the experience, look for the good in the situation. You just might get other cases if you’re willing to review these records.
Be helpful. Nothing worse than constantly being a naysayer. There could be good reason not to recommend to the plaintiff’s attorney that they take the case. Carefully and meticulously spell it out for them. You want to be perceived as a resource. Someone they can go to for your scholarly opinion. Not someone who only finds the negative in a situation.
The most helpful PLNC will be able to look at both sides of a case: the strengths AND the weaknesses. Most medical records have good and bad aspects. You job is to discover those and let your attorney know them. No surprises later. Be helpful now.
Be confident. You’re being asked to review the medical records because you have the wherewithal to know what you’re doing. You have nursing skills and nursing experience. Parlay those skills and experience into reviewing medical records.
As a nurse, you’re used to reading others’ entries in the medical record. You know the value of careful nursing documentation. You were taught that in nursing skills and you’ve carried that talent forward in nursing practice. Draw on your confidence when you’re working for an attorney as a PLNC.
Be thorough. As it’s been said “leave no stone unturned”. This means review the medical records completely, even if the stack is taller than your head. You’re being PAID to review the medical records.
Know that there could be missing pages. Plan on this. Make a list of documents you’d expect to be in the medical records but aren’t there. This, alone, can make you invaluable to your attorney.
Be knowledgeable. Let your fingers do the researching. Could be that there’s a disease or condition you’re unfamiliar with, or never even learned about in nursing school. No problem. Look it up.
There’ll kinds of ways to do “research”. Start where you’re most familiar. Use your phone, tablet, or laptop computer. Put in keywords and start reading up. You can do it. This is how most healthcare providers “look up” aspects of health care that they’re unsure about.
Be involved. There’s no substitute for connecting with other PLNCs. Join the PLNC Facebook Community. It’s great to see what others are talking about and how they’ve solved problems and issues.
Go to conferences and events. Whether that’s in-person or virtual or a mix of these. You’ll meet others, learn something, and get some great takeaways.
Don’t forget to interact with the vendors and exhibitors. One can never have too many friends. You might even get referrals from them. Remember, we’re all just six degrees of separation.
Be thankful. You got the job to review the medical records. That’s an honor! The law firm, or company, thought enough of you to ask you to review the medical records and give your opinion.
You ought to be pleased that you’re the PLNC who gets to review the medical records! Your reward? Being selected and earning the $$$ from it.
With these tips in mind, go be successful in your Professional Legal Nurse Consultant practice.
P.S. Get yourself certified as a Professional Legal Nurse Consultant. Grab this Freebie.
by Elizabeth Rudolph | Feb 8, 2022 | Legal Nurse Consulting, Marketing
You want to get medical records to review from attorneys. Let’s talk about cost-effective ways to market yourself. No more guessing how to get attorney-clients. Use these effective tips, pointers, and strategies to get yourself maximizing your potential!
All of these methods work. You, as the Professional Legal Nurse Consultant (PLNC) decide what works for you. Give them all a try. It’s all about getting medical records to review so you can give your opinion in cases and in potential cases.
Selected cost-effective marketing tools:
Networking: Also known as meeting people. Quite frankly, the best and often easier way to get medical records is to know an attorney who wants your PLNC services. The next best way is to ask attorneys and others if they know any other attorneys who might need help reviewing and analyzing medical records in legal matters.
Attend legal seminars and events: A great way to meet attorneys and law firms is to attend legal seminars on medical malpractice or other legal issues related to healthcare. These events can be virtual or in-person. They’re great networking resources and at the same time, you’ll be educating yourself about legal issues that may be unfamiliar to you.
Attorneys take mandatory classes to keep their law licenses. Attorneys need Continuing Legal Education (CLE) to keep their law licenses active. Each state has its own requirements, but attorneys must obtain the requisite number of CLE annually. Knowing this, PLNCs should consider attending a CLE. Better yet, offer to set up a table at a CLE and have brochures about your PLNC business to hand out. Be sure you have business cards and that all your information is current.
Make it a habit to check on local event listings, especially on topics of interest to attorneys. You’d be surprised how many lawyers attend local events on legal or political topics. Even neighborhood association meetings often have attorneys present. After all, attorneys have to live somewhere, right? Or, they might be representing the neighborhood association or a particular neighbor.
Attend events at your local area law school, college, or university. There may be open seminars available at the academic center that you can also attend. Don’t forget to bring your business cards with you.
When attending networking functions with attorneys, ask them for their business cards and send them a follow up email letting them know it was a pleasure to meet them. This is also an opportunity to send your brochure or follow the email with a phone call. On the phone, ask the attorney if they received your email and if the firm needs your services at that time. Also, ask if you can put them on your mailing list. Whether it is an email, direct mail or both, you should establish a client or potential client list that you periodically send updates about some of the work you’ve been doing.
Ask friends and family for names of attorneys and law firms they know. They might be willing to pass your resume along. You need to carry brochures, and business cards, everywhere you go, because you never know who you might meet.
You can also utilize job posting websites. Much like the traditional classified section of a newspaper, these online job boards post jobs let you view and apply to jobs. There are also online websites that will allow you to post your resume where prospective clients may also be searching.
Another invaluable resource is the Jurex Expert Directory. The Jurex Expert Directory is the place attorneys and prospective employers look to locate a Professional Legal Nurse Consultant. Its sole purpose is to help get you hired. Your personal profile will help attorneys determine if you’re a match for their specific case needs. They’ll be able to search based on multiple criteria, such as location and specialty. Attorneys can access the directory for free, but only after they have registered. And only PLNCs are allowed to place profiles on the directory, so you’ll be in a select pool of legal nurse consultants.
Search listings of lawsuits filed. Whether you’re looking online at your business newspaper or journal, PLNCs are looking for cases where they can be of assistance. Find recent malpractice cases or even personal injury cases in your area. Then, branch out and research medical malpractice cases or other cases in different jurisdictions. Your goal? More clients. You can achieve that with even just a little diligence.
Another good resource for PLNCs is to join the Professional Legal Nurse Consultant Community Facebook Group which is an exclusive benefit of being a PLNC. In this Professional Legal Nurse Consultant Community, you’ll know you’re in a private group where you can stay informed of the latest trends in the industry and keep connected to other PLNCs. This is a great networking tool as it affords you the luxury of staying close with other PLNCs.
There are multiple ways to market yourself. Take one step today by picking from the list above and do it. Let’s hear which one you selected to do first by commenting below.
P.S. Get your Bonus: The Newest eBook Live Life on Purpose: 7 Steps To Live The Life You Love. Go here.
by Elizabeth Rudolph | Feb 1, 2022 | Attorney Communication, Evaluating Cases, Legal Nurse Consulting
In your Professional Legal Nurse Consultant (PLNC) practice, your main concern is with the medical record. Whether you’re reviewing a paper document or electronic health record, your approach will be the same.
Let’s look at charting from the perspective of a nurse. Whether you’re reviewing the documentation on behalf of the plaintiff or defendant, think about how the nurse goes about documenting nursing care. After all, if the nurses’ notes are at the center of a potential lawsuit, you’ll need to understand and interpret what was in the nurse’s mind at the time the event occurred.
Attorneys Want Your Nursing and Professional Legal Nurse Consultant Opinion
As a nurse, and a Professional Legal Nurse Consultant, the attorney is relying on your nursing opinion. What you say matters. So, let’s go into the mind of a nurse…
Here’s what a nurse should’ve been taught:
One of the most vital components of good nursing care is proper documentation. This practice of thoroughly and completely recording each interaction with patients is made even more important when you consider the possibility of legal action against you, the nurse providing care.
- The first thing a patient considering a lawsuit will do is request their medical records. This includes any and all charts and documents created. They will, of course, be searching for errors. These records are of great consequence in the legal process.
“The first thing a patient considering a lawsuit will do is request the medical records.”
Knowing that the patient will get the medical records should be motivation enough to make the records thorough and detailed. Remember, anything you write or record could be read in court. So when you chart in the medical record, think in the back of your mind that a judge or jury might both hear and see them.
“Anything you write could be read in court.”
2. Strive to document in the most comprehensive and detailed way possible. Time restraints are the biggest obstacle between a nurse and thorough charts. With the busy nature of the job, sometimes nurses are forced into leaving documents incomplete, or they make only vague notes.
It can take years for a lawsuit to culminate; it is unlikely that you’ll remember everything clearly if you get sued. Your charts and documents are the key to knowing what you did and why you did it, so be sure you write and record enough information to recall the specifics of the case, or at least what your usual and customary practice would have been in the situation.
3. Stay on top of your nursing charting. Sure, you may need to put off fully completing some charts on particularly busy days, but try not to wait too long. The longer you wait to fill out the necessary paper work, the more it may look you are trying to falsify the actual occurrence after the fact.
The nursing adage “if it is not documented, it is not done” should always be applied to your work. Also consider that, unless you documented an action or treatment, legally speaking it never occurred. Don’t just note what was abnormal in a case, record the commonplace, typical events in a patient’s care. It could be the normalcy of your treatment – the fact that you followed basic protocol – that helps you avoid getting sued.
4. Check all items and fill in every blank space, every question, every box on each form for which you’re responsible. Again, don’t think that you’ll be able to remember the details of the care given down the road if you don’t properly document. Even if it seems obvious or mundane, make a note of it.
If you’re unable to fully complete your orders for a patient’s care, be sure to note that. For example, if a patient is sleeping when you check in on them, don’t simply leave certain areas of their chart incomplete. Note the circumstance as to why the document isn’t fully complete (i.e. “patient is sleeping, therefore did not check temperature”) so you cannot be accused of deficient care later.
“It’s better to write too much in your charts than to write too little!
Of course not every mistake rises to the level of a lawsuit, and accurate charting is important for the proper care and treatment of patients. But, the need for understandable and comprehensive charting becomes far more important if a case goes to court.
5. A fundamental aspect for healthcare providers named as defendants in a lawsuit is the ability to recall. Sometimes this is years after caring for a patient and the details of a case even after examining your notes from the charts is hard to do accurately. The more information you include in your charts, the easier it will be for you avoid being unfairly accused.
Look For These Entries In The Medical Records
You’re looking to see the four basic elements in the nurses’ documentation: Assessment, Plan, Implementation, and Evaluation. Whether you’re reading the Nurses’ Notes, Medication Administration Record (MAR), or Nursing Care Plan, watch for these basic elements. The more complete the nursing care record, the greater the chance the correct care was provided.
Whether you’re approaching it from the plaintiff or defense side of the case, these principles apply. Remember, while you’re focusing on the case from your perspective as a legal nurse consultant, you’ll need to consider the strengths and weaknesses or opposing counsel’s case. That’s what makes your Professional Legal Nurse Consultant services even more valuable. It’s your ability to spot issues and bring them to the lawyer’s attention.
You’ve been trained as a nurse and a Professional Legal Nurse Consultant. That’s quite an impressive combination! Rely on your legal nurse consultant training and your nursing education as well as your experience to explore all aspects of the patient’s medical record before you draw conclusions.
Looking at the clinical care that was provided to the patient, does it meet the nursing standard of care? Does it fall short or does it exceed it? You’re in the best position to determine this from reading the notes. The nursing entries should be contemporaneous with the event but consider that they might be anecdotal. It’s yours to decide.
P.S. If you like what you’re just learned here, you’re going to love our freebie. Get it here.
by Elizabeth Rudolph | Jan 11, 2022 | Attorney Communication, Legal Nurse Consulting
You want to review medical records for an attorney in your capacity as a Professional Legal Nurse Consultant (PLNC). How do you effectively prepare for the attorney interview?
Here are the best attorney interview tips to help you earn the job:
In-person or online. Knowing whether your interview will be live or virtual impacts how you prepare. Live attorney interviews affect what you wear, your physical notetaking, and your transportation. Virtual attorney interviews mean you must have a distraction-free and quiet location, have alternate connectivity plans should things go awry, and dress the part, at least from the waist up.
You act differently when you’re talking with an individual in-person. You might feel less “on” because there’s no camera. While you initially could feel stressed, often the interviewer helps alleviate this by asking you easy-to-answer questions in the beginning. Thus, you’re more relaxed as the interview progresses.
When you’re doing an online interview, you generally will be less relaxed. The technology might interfere with your ability to fully engage. Know this ahead of time and plan for it.
Regardless whether your Professional Legal Nurse Consultant interview is live or virtual, maintain your professionalism at all times. Don’t reach over and grab your coffee cup, for example. This is not a “meet and greet”. It’s a job interview and treat it as such.
Research attorney and law firm. By far the most important preparation you can do is to research the attorney and their law firm in advance. You want to come across as knowledgeable and reliable. Let your fingers do the Google, or other online, search in advance of the interview.
Law practice areas. There is no substitute for knowing ahead of time the type of law practice of the attorney. You’ll likely be interviewing with attorneys who do litigation. Specifically, medical malpractice litigation and personal injury matters.
Limit distractions. For example, during an online job interview, one interviewee’s cat was walking around in the background throughout the entire interview. This is not only a major distraction, it lowers the interviewee’s degree of professionalism. By the same token, the preferred mode of online interview is the use of a desktop or laptop computer. You can’t have your phone ringing or dinging in the background.
Lighting. If you’re interviewing virtually, your voice must be heard clearly and distinctly. Sounds simple, but it might not be. You’ll need the appropriate amount of light in the background without shadows. An overhead ceiling fan often creates a strobe light kind of effect that’s disconcerting, to say the least.
Background. Remember the adage, KISS. Keep is simple, sweetheart. If you’re going to be interviewing virtually, either have a nice and clean background or use a professional virtual background. You’ll likely need a green screen. By now in the Covid pandemic, you’ve probably seen the halo affect that happens when people don’t use a green screen. Don’t let that be you.
Your resume. Regardless whether you’re interviewing in-person or online, have your resume easily transmittable. For in-person attorney interviews, bring extra copies of your resume with you. For online attorney interviews, have your resume on a desktop file so you can easily screenshare. You don’t want to fumble around for one of the most important pieces of documentation.
You should’ve already emailed your resume to the attorney well in advance of your interview. Just like you wouldn’t give a gift unless it were wrapped or in a gift bag, don’t send your resume without an introductory email. You want to pave the way for your success. This can be accomplished with just a few sentences in your email. Some jobs may require a separate cover letter, but you might also need to send an email with it.
Not all job application materials are the same. Be sure you’re sending the items the interviewer is requesting. For example, a cover letter, resume, application, and references could be required. Other attorneys just want an email with your resume. Send what they want even though you have these other items.
Anticipate questions. You’re a Professional Legal Nurse Consultant (PLNC). You’ve already attained your PLNC certification. Professionals anticipate questions they might be asked in an interview. For example, “tell us about yourself”. This is your time to shine. Answer the questions directly and be sure to include your nursing experience. Whether you’ve worked less than one year or thirty years, you have nursing experience. Show it off, however use some humility as well.
Questions like “tell us two of your strengths and two of your weaknesses” are common in interviews. Know in advance your strengths and weaknesses. We all have weaknesses. Not to worry. When it comes to your weaknesses, be sure they could easily be perceived as strengths. The goal is to secure the job, so you want to present yourself as not only competent but knowledgeable.
Come prepared with questions. Almost all interviewers ask interviewees if they have any questions. Come prepared with at least three to five of them. It could be that the interviewer answers a couple of your prepared questions during the interview, so then you’re down to three pre-prepared questions left. You want to be interactive and friendly.
Thank you. Saying “thank you” regardless of how the interview went is the professional thing to do. But, saying it is not enough. You MUST send a thank you note.
There are different schools of thought on whether it should be handwritten or electronic. In this day in age, an email thank you is perfectly appropriate. Regardless which way you decide to send your thank you note, it must be timely. If there were multiple interviewers, send each a separate thank you with slightly different wording. The interviewers could forward your emails to each other, so you want them to be personalized.
Now, go secure that job. You can do it. You’re a Professional Legal Nurse Consultant!
P.S. What, specifically, do you think helped you land the job?
