“The use of nurses as expert witnesses has evolved since the
late 1970’s and early 1980s. Before then, physicians served as
nursing’s voice and testified at court regarding the role and
accountability of professional nurses.” (Guido, 1997) A nurse
is the only professional with the knowledge, competency, credential,
and right to judge whether the appropriate standard of nursing care
has been delivered. As nurses stepped forth to assume this role in the
medical legal system, the system adjusted to incorporate them and actively
solicit qualified nursing assistance.
Unfortunately, the healthcare system has experienced an increase in
the number of lawsuits. And nurses have stepped forth to expand their
professional role within the legal system to educate attorneys, judges,
and juries. Nurses are consulting into an expanding area of medical
legal concerns such as personal injury, worker’s compensation,
product liability, criminal custody cases, risk management, life-care
planning, case management, healthcare licensing board issues, insurance
industry, as well as expert witness. While many nurses work in law offices,
and the insurance industries, nurses are also adopting an entrepreneurial
spirit and starting their own businesses.
This exciting program prepares Registered Nurses and Physician’s
Assistants for a career in the legal field as legal nurse consultants.
Building on the medical education and clinical experience of RNs and
PAs, this course provides the RN and PA with fundamental skills necessary
to advise law firms, health care providers, insurance companies, and
governmental agencies regarding medically-related issues and to appear
in court as expert witnesses. The curriculum of this course is designed
to comply with the educational guidelines specified by the American
Association of Legal Nurse Consultants. Successful graduates will be
awarded a Certificate of Course Completion from the university through
which they are registered.
This course will provide a comprehensive analysis of the principles
and practices of legal nurse consulting (LNC), with an emphasis on law
and expert witness testimony. The course content will also provide a
systematic review for those preparing to take the Legal Nurse Consultant
Certified (LNCC) examination. While most of the main subject matter
will pertain to legal nursing standards, professionals in other health
care disciplines (pharmacy, physical therapy, physician assistants,
etc.) may gain increased skills and knowledge of the medical legal system
to enhance their roles as service providers and functions as expert
witnesses, but participants without an RN background might not be able
to take the LNCC exam after graduation. For more information about the
LNCC exam, please contact the American Association of Legal Nurse Consultants
at 877-402-2562 or http://www.aalnc.org/page/LNCFAQs/?.
- Define the role of a legal nurse consultant and explain history
and evolution of the profession.
- Describe 2 major systems of law, the 3 types of law, and the 4 sources
- Review the law of Intentional and Unintentional Torts.
- Identify liability concerns of healthcare providers.
- Analyze the role of the LNC before the trial begins.
- Review the methods of obtaining medical records and other evidence
that is governed by the Rules of Evidence.
- Identify and review the legal documents used to obtain evidence.
- Explain informed consent, treatments decisions, and review the liability
concerns of health care providers in each.
- Discuss criminal law and complex litigation scenarios.
- Discuss the history of the Specialty of Legal Nurse Consulting.
- Discuss the skills needed for entry into special practice.
- Professionalism and Ethics: discuss the standards of practice and
performance expected of an LNC.
- Identify the 5 responsibilities of a LNC in the litigation process.
- Examine the role of the LNC in evaluating Toxic Tort and Criminal
- The damages stage of litigation: Identify the 4 types of damages
available and discuss the factors that determine their application
to the case.
- Recall the evaluation steps taken by the LNC in a professional negligence
- Identify and discuss the 3 different forms of Alternative Dispute
- Discuss the LNC's role in the Law Firm.
- Discuss the issues presented to LNCs in the insurance industry.
- Discuss the issues presented to LNCs in private practice areas.
- Discuss the issues presented to LNCs in Government Service.
- Discuss the issues presented to LNCs in Risk Management.
- Medical record analysis: discuss the protocol LNCs should follow
when receiving medical records.
- Legal Writing: Review the writing techniques that will captivate
your target audience.
- Discuss the literature research process and the methods of research.
- Discuss the advantages and challenges of working as an independent
This is an accelerated course. You will be expected to spend an average
of about 10 hours per week reading and completing assignments outside
of class. Please note that extensions will not be granted for this course.
This course is the equivalent of 45 clock hours of study. 70% is the
minimum passing score on all tests and assignments for this course.
Course Goals Include
- Increase knowledge of legal terminology, medical malpractice, and
the evolving legal system.
- Demonstrate the knowledge of professional skills necessary to enhance
one’s medical legal consulting role.
- Identify new arenas for expanding one’s interests and skills
for professional mobility and growth.
- Consider and contrast working as a full-time, part-time, or freelance
legal nurse consultant.
Required textbooks for this course:
- Legal Nurse Consulting: Principles and Practices,
3rd edition (2 volume set), edited by Ann M. Peterson and Lynda Kopishke
(2010). New York: CRC Press. (Volume 1 will be referred to as LNCPrinciples
and Volume 2 will be referred to as LNCPractices throughout the course).
- Volume 1: Legal Nurse Consulting Principles
- Volume 2: Legal Nurse Consulting Practices
To order, call The Center for Legal Studies at 1-800-522-7737, or Click
Here to order online.
Session One: Legal Theory and Practice
SESSION TWO: LEGAL NURSE CONSULTANT ETHICS AND LNC PROFESSIONAL ENVIRONMENTS
A. History of the Specialty Practice of Legal Nurse Consulting
B. Entry into Specialty Practice-LNC
- Early Nurse Consultant Practice
- Formation of AALNC
- Continuing Education
- Standards and Guidelines for LNCs
- Scope of Practice for LNC
- Discussion of Code of Ethics
- Always a Nurse First
- Intrapreneurial and Entrepreneurial Skills
- The Nursing Process in the Legal Environment
Time Management Skills
C. Professionalism, Standards of Practice and Performance
D. The Legal Nurse Consultant in Litigation
- Nursing Process applied to Legal Nurse Consulting
- LNC as a Specialty Practice of Nursing
- Standards of Professional Practice and the LNC
- Legal Ethics and the LNC
- Communicating with and interviewing plaintiffs
- Interacting with defense clients (health providers)
- Medical Record Analysis
Evaluating Professional Negligence Cases
- Compilation of complete medical records
- Review of hospital medical records
- Review of other medical records
- Comparison of allegations with medical records
- Re-review of medical records
- Altered medical records
- Summary of medical records
- Health care bill analysis and auditing
The Nurse as an Expert Witness
- Key elements of professional negligence claim
- Filing a professional negligence claim
- Negligence in health cases
- Physician malpractice
- Nurse malpractice
- Hospital malpractice
- Qualifying LNC as an Expert
- Treatment of Expert Witnesses
- Exception to Hearsay Rule
- Cross-Examination of Witnesses
- Scientific Basis for Opinion
- Credibility of Nurse as Witness
- Credentials equal to those of defendant
- Active practice
- Most income does not come from testifying
A. LNC Evaluating Toxic Tort Cases
B. LNC evaluating Criminal Cases
- Introduction to Toxic Torts
- Physics of Chemical Exposure
- LNC rule in establishing and evaluating causation
- Identifying experts
C. LNC Evaluating Damages
- Mental capacity of defendant
- Physical capacity of defendant
- Extent of injuries to victim
D. LNC Evaluating Professional Negligence Cases
- Personal injury cases (auto accidents, etc.)
- Malpractice cases
- Life-Care Planning
- Vocational and Hedonistic Damages
- Key elements-the 4 D’s
Was this action the proximate cause of the injury?
Exception to proximate cause-loss of chance
Selecting the best expert witnesses
- Duty owed by defendant to plaintiff?
- Dereliction of that duty?
- Damages as a result of this breach of duty?
- Due to (or direct result of) negligence of the provider
Defense LNC-realizing when a case is indefensible
Effective triage of medical malpractice claims
E. ALTERNATIVE DISPUTE RESOLUTION
- Well educated and experienced
- Current active practice
- Does not always testify for the same side
- Articulate, sophisticated presenter
- An effective teacher
- No prior malpractice cases against expert
- No “skeletons” in the expert’s closet
- Consistent opinions
- Expert testimony a small part of the expert’s annual income
- Other private dispute resolution means
SESSION THREE: TYPES OF NURSE LEGAL CONSULTANT PRACTICE
A. LEGAL NURSE CONSULTANTS IN THE LAW FIRM
B. LEGAL NURSE CONSULTANTS IN THE INSURANCE INDUSTRY
- Interaction with Clients (interview with plaintiff)
- Interaction with Lawyers
- Instructional Role of LNC
- LNC in malpractice defense firms (liaison with defendant)
C. LEGAL NURSE CONSULTANTS IN PRIVATE PRACTICE
- Claims Consultant/Adjuster
- Case Manager
- Benefits Coordinator
- Workers Compensation Manager
- Medical Policy Coordinator
- Utilization Review Coordinator
- Risk Manager
- Medical Malpractice/Liability Consultant
- Credentials and Certifications-specialized fields
D. LEGAL NURSE CONSULTANTS IN GOVERNMENT SERVICE
- Consultant to various law firms
- Avoiding Conflicts of Interest
- Managing the Business
- Marketing and Nurse Ethics
E. LEGAL NURSE CONSULTANTS IN RISK MANAGEMENT
- State government-clinician and investigator
- Assist law enforcement
- US Department of Justice-investigators
- Assessment-Identifying Sources of Risk
- Management of Losses
Role of LNC
- Loss Control
- Loss Prevention
F. MEDICAL RECORD ANALYSIS
- Risk Assessment Consultation
- Risk Education
- Qualitative Claims Analysis
- Report Preparation
- Compilation of Complete Medical Records
- Records that May not be Part of the “Medical Records”
- Other types: Visiting Nurse or Home Care
- Incomplete Medical Records
- Organization of Records-job for LNC at law firm
- Indexing and Paginating of Medical Records
- Review of Other Medical Records
- Altered Medical Records
- Minimizing Loss, Fabrication or Concealment of Record
- Pitfalls in Medical Record Analysis
A. LEGAL WRITING
- Actually, there is no such thing as “Legal Writing”
- Consider the Potential Audience
Forms of Legal Writing
- Medical witnesses unfamiliar with legal proceedings
- Experts in law or medicine
- Informative Writing
- Commemorative Writing
- Inquisitive Writing
- Persuasive Writing
Use Plain English
- Short Words
- Short Sentences
- Short Paragraphs
- Omit redundant words
- Omit personal beliefs
- Rigorous Editing is required
B. LITERATURE RESEARCH
- French and Latin words had a place in the law, but not today
- Clear transition from one idea to another
- Organize your text
- In a logical sequence
- With informative heading
- For long documents, a table of contents
- Research Process
Computerized Literature Searches
- Issue Identification
- Outcome Identification
C. STARTING A BUSINESS AS AN INDEPENDENT LNC
- National Network of Libraries of Medicine
- Internet Access to Biomedical Communication
D. FINAL EXAMINATION CONGRATULATIONS!!!!!
- Legal and Economic Considerations
- Finding a Business Lawyer
- Finding the Right Business Entity
- Writing a Business Plan
- Conclusion-on your own!!!
Your grade will be based on your completion of 3 exams and class participation.
Your final grade will be figured as follows:
- The three exams are 100 points each and comprise 90% of your grade.
- Your participation in class participation assignments comprises 10%
of your grade.
- NOTE: Students must receive a 70% or better on every
assignment to receive a certificate.
We understand that your schedule may change at the last minute and prevent
you from attending this course. If you must cancel your registration,
please call us at least one week in advance of the program and we will
issue you a refund less a non-refundable $15 administrative fee. No refunds
will be given after the first class meeting.