Understanding scope of practice will help you land your first case

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Tammie Clark-Heller, RN, BSN, CLNC
Tammie Clark-Heller, RN, BSN, CLNC

As a registered nurse and legal nurse consultant I am not an attorney, nor do I render legal advice, but I can speak to nursing opinions in a legal case as both a consulting and expert witness. I serve primarily as an educator. And what nurse isn't familiar with that role? We educate our patients, their families and doctors. Okay, mostly doctors.

New LNCs, myself included, tend to think that attorneys are more challenging to deal with than doctors. But that's not the case at all. Like doctors our attorney clients just need a proper dose of invaluable education.

LNCs also offer services to other LNCs, as subcontractors; insurance companies; health care facilities; and government agencies, as well as private corporations that are looking for someone with risk management or utilization review experience. Once you know to whom you can target your services, you will be ready to take on your first case.

I recall mine very well and all the nervousness that went with it. I received a call from another well-established LNC who saw my name on an association registry. She asked me to take over one of her cases, since it dealt with my area of expertise — nursing home litigation.

This attorney was looking for a testifying expert. To clarify, there are two different types of experts in legal nurse consulting:  the consulting expert and the testifying expert. I was a little unsure of the differences at first, so let me explain. This case had already been filed in a court of law and had been reviewed for merit. The lawyer now needed an expert witness to render a nursing opinion that would be used during the trial.

Again, I reiterate nursing opinion. Whereas consulting experts work behind the scenes, providing opinions in other disciplines as they review a case, testifying experts specifically speak to nursing standards of care and deviations that are relevant to the case at hand. There are big differences between the two, and you will want to know what you are doing before assuming either role.

LNCs serve as patient advocates. We speak for the nursing profession in our role as educators. As a testifying expert, our job is to educate the judge and jury, if we are called to stand as an expert witness. Not all LNCs take on expert witness work. Many choose only to be a consultant.

The choice is certainly yours to make, but I never say no to any opportunity for professional growth. If the idea of “taking the stand” intimidates you, remember that you are a nurse, you have years of experience and you are an educator.  Even if you decide not to work as a testifying witness, be sure to ask upfront what your client expects of you before taking on any case.

Once you've done this, get out there and educate your clients about “the good, the bad and the ugly” of the case. They will appreciate all you can offer them, even if you find that the case has no merit. Attorneys would rather hear this than take a case to trial and lose.

In fact, most cases settle out of court; only about 5% actually go to trial. This means that attorneys choose their cases wisely, and your role is extremely crucial in helping them decide whether or not a case has merit.

If you are still confused about the differences between expert witnesses and consulting experts, please feel free to email me your questions. Next blog, I'll be discussing how the role of LNCs impact the legal system. In the meantime, begin to consider whether you would want to work independently or in-house for your clients.

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