Interview with a Legal Nurse Consultant

Find out what legal nurse consultants do from a veteran nurse.

Interviewee

Jan Aken, RN, IBCLC

Title: Legal Nurse Consultant,
President of Puget Sound Legal Nurse Consultants, and
Board-Certified Lactation Consultant

Years in Field: 36 years as an RN, 3.5 years as a Legal Nurse Consultant

How did you become a legal nurse consultant?

When I retired from doing OB nursing and lactation consulting, I was retired for a couple of weeks. Then I decided, "Nursing is my life, I've done this all my life, it's the love of my life, and I want to continue." I looked into doing something with attorneys, and found there was a program for legal nurse consulting, and a chapter of legal nurse consultants in Seattle. I took a home study program, and passed the exam.

What's a typical project like for you?

I try to stick to OB cases, though I will review other cases. The attorneys send me the medical records and I sit down and go through them. It can take anywhere from 4 hours to 3 days. I read through every line. With the records comes a cover letter from the attorney, telling me what the plaintiff is complaining of. I look through the records to see if I find that there has been fault, or that the standards of care have been breached, or if something was wrong, either the procedure, the consents, or the nurse went beyond her scope of practice, a whole host of things. I make notes on what I see in the records.

We can do the report several ways. Some attorneys will ask me to come to their office, and I'll brief them on things I see, standards of care that have been broken, the pros and cons of the case. I will only give my opinion; I will not tell them if they have a case or not. That is for them to decide. Another way is to do a phone conference. Some attorneys like to get a letter telling them what I think of the case, why I'm saying what I say, the literature to back it up.

There are two kinds of Legal Nurse Consultants: behind the scenes and testifying witnessing. I work behind the scenes. A lot of nurses will do both. If you work behind the scenes, then that is not discoverable from the other side. If you're a testifying expert, then every piece of paper can be discovered. The attorney and you have to be in synch about what you're doing. I can find experts for them, a specialist in the field, someone who's a good fit with the attorney.

What do you most enjoy about this work?

Reading and reviewing the records – especially if it's an OB case. Having been an OB nurse basically all my career, I put myself right in that chart. As I'm reading what's happening I'm there, I feel the excitement.

I don't look for things to tear down the nursing position, I love nursing. But I feel a bond to the patient. I'm certainly not against nursing or doctors, I'm not looking to find fault. In every chart you can find some mistakes. You're looking for something that really caused major problem in this person's life, that are really going to be devastating for the rest of their life. I don't like to spend my time on frivolous cases.

What skills are most important in this field?

You should have at least 5 years of nursing experience, but closer to 10 years is better, with a well-balanced clinical background in different areas of the hospital. You need to have a good educational background, writing skills. You want to be able to speak well.

Any advice for people entering the field?

Take classes in writing and conversation. Join the Toastmasters to help with speaking ability. If you decide to do expert witnessing you need to speak well on the stand. Expert witnessing is high pressure; the opposing attorney is really going to drill you. You must keep your composure. You can't get flustered or angry. You need to sound like a believable expert.

Besides working in medical malpractice, you can work for insurance companies, for law enforcement, as a forensic nurse, on nursing home cases. The Department of Social and Health Services hires legal nurses to work on fraud cases. You can work in any state, as long as you have a current nursing license in one state. This field is booming.