Legal Nurse Consulting for the Attorney

Introduction

Legal Nurse Consultant: what does this phrase mean? As experienced nurses who specialize in a field of medicine, legal nurse consultants bridge the gap between medicine and law. Nurses are natural teachers, and, much as nurses teach their patients at the bedside, legal nurse consultants teach their attorney-clients about the nuances within their case that may not have been caught by someone with a non-medical background. Legal nurse consultants have two main branches: non-testifying and testifying experts. Legal nurse testifying experts have been used since the eighties, when, in Maloney v Wake Hospital Systems (1980), the court held that “the role of the nurse is critical to providing a high standard of health care in modern medicine. Her expertise is different from, but no less exalted, than that of the physician.” Thus began the expansion of the role of the legal nurse testifying expert.

Legal Nurse Consultant Subspecialties

Legal nurse consultants may choose to work behind-the-scenes or as a testifying expert. Working as a non-testifying expert, legal nurse consultants may write chronologies of complex medical cases in non-medical jargon for the attorney to use in their proceedings. They may also screen cases for merit based on nursing standards of care, work within pharmacovigilance, or assist with toxic torts. These nurses may work in-house with a law firm or as an independent contractor. A legal nurse consultant who does testifying expert work may work within a wide realm of subspecialties, such as Nurse Expert Witness and Independent Medical Exam Nurse Observers.

Nurse Expert Witnesses

Nurse Expert Witnesses typically work as independent contractors as unbiased medical experts who review cases and provide (typically written) affidavits or declarations of their expert opinions. These nurses may also testify to these opinions in deposition or trials. Nurse Expert Witnesses can speak to the nursing standards of care as well as to any deviations from what a reasonable nurse would have done in the same situation. Although it varies from state to state, many states now recognize that physicians and nurses have very separate job roles, and nurses alone should be able to testify towards the nursing standard of care. These nurses typically have at least five years of experience within a specialty, have their Bachelor of Science in Nursing or higher, and may have certifications or publications within their specialty. They also typically still work at the bedside, lending further credibility as an expert witness who is up to date with the current standards of care.

Independent Medical Exam Nurse Observers

Independent Medical Exam Nurse Observers are nurses who work as the client’s legal representative during the Independent Medical Exam (IME). These nurses are familiar with their state’s Code of Civil Procedures that govern the IME, and they act as observers during the exam. Some states, such as California, permit audio recording. IME nurse observers will write a timely report for the attorney after the exam, and they are willing to testify as a rebuttal witness for any discrepancies that may be noted in the IME physician’s report. Having a medical background lends credibility to the jury if the nurse needs to testify, and IME physicians are also more likely to perform a more thorough, in-depth examination if they know the legal observer has a medical background. Clients also report feeling more secure during this high-stress exam because they have a legal representative that has a medical background.

Benefits of a Nurse Expert

Nurse Experts are seeing growing trends within healthcare. Patient falls, miscommunication between providers, and failure to follow hospital protocol are frequently seen issues. The Nurse Expert knows not only the most up to date standards of care for each issue, but they also know where to find supporting literature for his/her expert opinion. Nurse Experts know which hospital policies/procedures to request on any particular case, and they also use their natural teaching skills to educate their attorney-client about any nuances that may have been caught during the chart review. As medical experts, Nurse Experts can read between the lines of a medical chart, often catching subtle deviations from national standards of care that may not be noticed by untrained personnel.

Nurse Experts are also a cost-effective way for the attorney to secure an unbiased medical opinion/review regarding the standards of care for his/her case. Whether the legal nurse consultant is working as a testifying expert or not, as educators, they can assist the attorney-client in fully understanding the fine details and possible variations within their medical case. They may also assist in deciphering medical jargon and/or abbreviations, finding other medical experts pertinent to the case, and aid in writing deposition questions. Nurse Experts are objective and analytical, and they are not hired because they will give the “right answer” to their attorney-client. Rather, they seek truth within the medical chart and depositions, striving to bolster their expert medical opinions with evidence-based practices.

Conclusion

Nurses have been voted the most honest and ethical profession for 19 years in a row, according to the most recent Gallup poll published December 2020. Legal Nurse Consultants endeavor to uphold that reputation within their profession by delivering unbiased expert medical opinions fortified by evidence-based literature and practices. Juries and clients feel secure and inherently trust nurses, a fact many attorneys have discovered since utilizing legal nurse consultants. Attorneys are finding that legal nurse consultants are an exceptional asset to the legal team, as legal nurse consultants assist in a plethora of roles within the legal realm, and their medical background begets a successful attorney-nurse relationship as the attorney utilizes their neutral, impartial expert opinion.