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Legal Nurse Consultants Wanted
Consider a career where law and medicine meet.
By Diane Petropulos

March/April 1999 Issue

In response to a growing need for understanding medicine in various legal contexts, legal nurse consultants (LNCs) are becoming sought-after experts. Not surprisingly, paralegal programs are beginning to offer legal training for nurses who decide to pursue this specialty which combines nursing expertise with legal knowledge.

Susan Howery, paralegal program director at Yavapai College in Prescott, Ariz., said she added an LNC program for registered nurses (RNs) to her school’s curriculum because of a good experience she had with an LNC.

“Like many of you, I was a working paralegal. While I had many specialty areas during my tenure in the law, the last one was the most interesting to me — the field of medical malpractice,” Howery said. “From the beginning, it was very challenging.

I had no knowledge of the medical field and medical terminology was like Greek to me. Luckily, I was assisted by a very capable ‘nurse consultant’ we hired to analyze medical records and assess issues of causation and damages.”

And the pay isn’t bad either Howery noted. “This was over ten years ago, and even now I am impressed by the sum we paid the nurse consultant to do this work. This ‘new’ specialty has now been expanded well beyond consultation on medical records.” Legal nurse consultants who work as independent consultants are paid on an hourly basis, while LNCs who work in law firms, insurance companies and other institutions are paid a salary.

So what exactly are LNCs and what do they do? According to the American Association of Legal Nurse Consultants (AALNC), LNCs evaluate, analyze and render informed opinions on the delivery of health care and the outcomes. Essentially, LNCs apply their specialized education and clinical expertise to health care issues by analyzing medical facts in relation to legal concepts. Certification is not required for LNCs, but AALNC does offer a certification program. A registered nurse’s license and 2,000 hours of legal nurse consulting are among the requirements for certification.

LNCs work in a variety of settings, either as independent consultants or as employees. They can be found in hospitals, clinics, nursing homes, HMOs, insurance companies, government agencies, law firms and, of course, in private practice. Their areas of practice may include administrative health care law, case management, criminal law, elder law, life-care planning, medical malpractice, personal injury law, products liability, rehabilitation, risk management, toxic torts and workers’ compensation.

Tammy Novak, RN, BSN (bachelor of science in nursing), co-teaches a course in the Yavapai College LNC program entitled “Medical Legal Ethics.” She is also the owner of Mountain Medical Legal Consulting, located in Chino Valley, Ariz. Novak said she became interested in the field because of the flexibility.

“I knew I wanted to combine my nursing degree with law,” Novak said. “And I realized you could start up your own business and get out of the clinical setting and still utilize a nursing degree. You can work for a law office, in risk management or for an insurance company. You don’t have to work the graveyard shift anymore.”

The most obvious area where LNCs apply their expertise is in medical records review, where they may prepare summaries, reports and chronologies to help assess the merits of cases. This, in turn, could lead to another practice area: litigation support. LNCs can prepare charts, slides, models, videos and other demonstrative evidence to aid in the visual presentation of cases. They can perform medical research, prepare and respond to discovery requests, attend independent medical evaluations, and identify the types of expert witnesses that will be necessary. And they are, of course, potential expert witnesses themselves.

There are two other common areas of practice for LNCs: They are often involved in identifying services, costs and life care plans for catastrophically injured patients, and they may assist in cost-containment services by auditing and conducting peer reviews of hospital, clinic and nursing home services.

The legal nurse consultant specialty is a good example of a “hot” new field of law. The area where the two professions of medicine and law meet provides a wonderful opportunity for students with nursing expertise to apply their skills in the legal field.

I would like to acknowledge the substantial contributions of Susan Howery, paralegal program director at Yavapai College in Prescott, Ariz., in preparing this column. Susan is also a member of the Board of Directors of the American Association for Paralegal Education.

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