Following a year with unprecedented clinical demand due to the coronavirus pandemic, a number of career roles in health care are experiencing immense growth and present a strong career outlook moving forward. Health care career professionals in these positions play an important role in the care of patients across the country, who rely on them…
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How to Become a Legal Nurse Consultant
Alternative Career Titles:
Legal Nurse Consultant Job Description: A Legal Nurse Consultant helps clients and colleagues navigate the legal side of healthcare.
Legal Nurse Consultant Salary (Annual): $150,000
Legal Nurse Consultant Salary Range: $115,000 to $195,000
How Long To Become a Legal Nurse Consultant: 9 years
Legal Nurse Consultant Requirements: Bachelor of Science in Nursing Degree (BSN)
Become a Legal Nurse Consultant
A Legal Nurse Consultant (LNC) is a Registered Nurse whose experience in healthcare makes them a valued resources in the legal arena. LNCs cannot give “legal guidance”—that is called “practicing law without a license” and can get an LNC in trouble. The attorney client is in charge of anything related to legal matters, including LNC practice in litigation. LNCs also do other kinds of work.
This is a good career for Nurses interested in healthcare and law. Even though some may no longer engage in bedside patient care directly, LNCs assist and advise attorneys, healthcare facilities, executives, practitioners and other healthcare staff members on legally-related clinical issues, concerns and potential liabilities. Legal Nurse Consultants work as part of legal teams and may be designated as testifying experts.
“In this career, a Legal Nurse Consultant will review medical records and depositions that have been obtained to that point,” Phyllis Quinlan, PhD, RN, a Legal Nurse Consultant practicing in New York, explained. “Then, they weigh their findings against the reason for the cause of action or the lawsuit. Next they will report findings to the attorney to determine if there’s merit to the case.”
Only attorneys determine merit; they want LNC guidance on cases with medical components, but LNCs cannot determine merit. Also, Nurses cannot legally opine on medical or other professions’ standards of practice or on medical causation. They can opine on nursing standard of practice and other matters if they have relevant experience. They can and do, however, often recognize problems with medical standards of practice and causation and then assist the attorney in the case by identifying qualified medical experts. Their clients also rely on them to help them understand when a bad outcome might not be the result of an error, to avoid costly litigation with little chance of success.
Furthermore, an LNC may be asked to consult on a wide range of litigation beyond medical or nursing malpractice. For example, they may consult on an employment law case involving a Nurse, a life care plan for a person with extensive injury and sexual abuse cases. Other cases can involve divorce and child custody for a sick child, administration issues such as staff development or state regulations for health facilities, public health matters, insurance fraud, toxic exposure, helping a trust officer allocate funds in an elder case and many others.
“We act in the capacity of an expert Nurse within our clinical specialty, and not in the capacity of a paralegal or an attorney,” Quinlan stressed. “To me, this career is like reading a mystery novel. Some cases can be thousands of pages long, so you really have to look for the evidence to support your case and client.”
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Education & Training
To become a testifying Legal Nurse Consultant, you must have a current valid Registered Nurse license and considerable experience in the field. Learn about other nursing careers, such as that of a Nurse Practitioner.
After graduating from an approved nursing program, prospective LNCs must apply to their state Board of Registration in Nursing to take the National Council Licensure Examination (NCLEX-RN) to become licensed. Experience as an RN is required to become an LNC. (Note: Maintaining RN license requires continued education.) Fingerprints and a background check may be required prior to any RN licensure and employment.
After practicing as a registered nurse for a minimum of five years, prospective Legal Nurse Consultants should begin training for the position to ease their transition. Online and live programs are offered by the American Association of Legal Nurse Consultants. No formal LNC education program is required to practice. However, certification as an LNCC through the
American Legal Nurse Consultant Certification Board (ALNCCB) documents experience and competence in the field to potential clients. Other commercially-available credentials designed for entry-level work do not require past experience and are not certifications.
“There are many advertisements out there claiming that one can become a Legal Nurse Consultant by taking one online course,” Quinlan said. “I’ve been an LNC for 15 years, and I can tell you that to work in this field you have to be able to justify yourself as an expert in terms of clinical knowledge and attorney thinking.”
Advancing in your nursing career increases your credibility as a Legal Nurse Consultant. Consider pursuing specialty certifications and advanced degrees in nursing or related fields, such as MSN, DNS, PhD, APRN, or business degrees such as MHA. LNCs should also attend conferences, participate in professional organizations and seek out additional certifications to gain recognition in the field.
“I certainly recommend having a baccalaureate degree in nursing, a clinical certification in your specialty, and at least 10 years’ experience as a Nurse. The more diverse experience you have, the better your credibility as an expert,” Quinlan advised. “In order for your credentials for being considered acceptable by a court to testify as an expert, you have to show a breadth and depth of experience.”
Additionally, many LNCs are in independent practice. When ready to open an independent business, Legal Nurse Consultants must obtain a business license from their state. They will also need IRS and state Tax ID numbers and a W-9 form to satisfy their clients’ IRS reporting requirements for paying independent contractors. The investment in appropriate software, a good bookkeeper, and tax advisor will save them considerable time and money.
LNCs hoping to advance should still plan to keep their clinical position to allow time for the learning curve while they build their practice. They will increase their credibility by being currently employed in nursing, and by by accepting both plaintiff and defense cases.
Experience & Skills
Well-educated LNCs can more easily assess and interpret patient information, case histories and legal documents. Successful LNCs also have strong interpersonal, research and analytical skills. They must be able to work both as a team member and independently without micromanagement.
“Regardless of specialty, you want to have a diverse background in the field of nursing. If you think at some point you want to become a Legal Nurse Consultant you need to push the boundaries of your skills as a nurse first,” Quinlan explained. “Testifying experts usually need specialized experience but having a good broad base in nursing will often meet the needs for someone to do effective records review.”
Legal Nurse Consultants are accountable for their decisions and pursuits. In accordance with the Code of Ethics and Conduct of the AALNC, Legal Nurse Consultants must consistently maintain professional nursing competence and use informed judgment, objectivity and individual professional competence as criteria when accepting assignments. They have an ethical duty to provide accurate information, independent and sound opinions, as well as professional recommendations, while working to achieve client goals.
“You want to be in a position where you have knowledge of policies, procedures, standards and how to interact with oversight agencies,” Quinlan shared. “This will add depth to your knowledge and help enable you to know whether the standards for care are being upheld or not.”
“I believe there are two types of personalities that succeed in this profession,” Quinlan explained “Those choosing to seek employment with a law firm must be comfortable transitioning from a clinical work environment and culture to working collaboratively with non-clinical professionals. Learning to reorient to a legal culture helps establish credibility.”
She added that the second type of successful LNC personality is that of an entrepreneur. While Legal Nurse Consultants working in law firms have a more structured agendas and case lists, entrepreneurial LNCs need to have independent, can-do spirits. This will help them in completing all elements of a business, including the marketing, customer focus, accounting, record-keeping, and reporting skills.
Your nursing experience with compassion, emotional stability and patience are beneficial in this career in healthcare. (Again, the LNC’s client is the attorney, not the party in the lawsuit.) Clients and other professionals appreciate honesty and objectivity. These characteristics allow clients feel comfortable working with their LNC and shows legal teammates that they are receptive to alternative perspectives. This open-mindedness helps LNCs remain bias-free.
Any career in nursing, including as an LNC, comes with great responsibility, and often stress. Legal cases can be long, difficult and detailed, causing emotional and physical exhaustion.
Most Legal Nurse Consultants in law firms work relatively normal schedules, although weekly hours will ultimately depend on caseload. A typical case will take four to six weeks to develop.
“If you’re working for a law firm, this career can result in a very conventional 9 am to 5 pm schedule. There may be some extra hours and crunch time prior to going to court, but by and large this is a more conventional lifestyle overall,” Quinlan said. “If you’re an entrepreneur, you may do more traveling, reading cases in a variety of places.”
Quinlan added that an independent’s practice may be more about work-life integration rather than balance. This can mean reading cases at a hotel or airports and making the time to support and grow your business. However, experienced independent LNCs know that being self-employed also means they have more freedom to choose or accept cases and to set their own work schedule.
Now is a great time to be a Legal Nurse Consultant! They are increasingly sought out by employers for their unique expertise. Legal Nurse Consultants can find many opportunities for work with law firms, insurance companies, government agencies and advocacy groups relatively easily.
“Seeking out LNC positions is like looking for a middle-management type of position in nursing,” Quinlan compared. “Not every law firm has a Legal Nurse Consultant, so you must do your research online first. Then, once you get your first client, your work can help pave the way to future opportunities.”
A career as a Legal Nurse Consultant can be financially rewarding. Earnings depend on education, experience, and employer. Experienced independents typically charge between $150 to $450 per hour. In-house employees can expect a salary range between $115,00 and $195,000 per year.
“If you work for a law firm, you will negotiate your salary with the partners,” Quinlan explained. “If you’re an entrepreneur, word of mouth regarding your performance and delivery means everything in terms of the growth of your company. Then, earnings are dependent upon your prices which stem experience and what you bring to the table.”
Depending on the economy, Quinlan noted that she now raises her rates every two to three years. For the first couple of years of her working as an LNC, she was just handling medical chart review. Yet, once she had testimony experience, she became more marketable and raised her hourly rate accordingly.
Unions, Groups, Social Media, and Associations
The American Association of Legal Nurse Consultants (AALNC) is dedicated to the professional enhancement and growth of registered nurses practicing in the specialty of legal nurse consulting and to advancing the specialty. The AALNC provides networking opportunities, educational advancement, professional development, networking, and mentoring.
The International & American Association of the Legal Nurse Industry (IAALNI) is an online community for Legal Nurse Consultants and medical-legal related professionals. The organization provides the unique opportunity to locate and network with other Nurses and experts from around the world.
- Obtain a high school diploma or GED
- Graduate from a nursing degree program approved by your state Board of Nursing
- Pass the National Council Licensure Examination (NCLEX) to become licensed in your state
- Gain clinical experience as a nurse (at least 5 years)
- Pursue education in legal nurse consulting
- Network with working LNCs
All statistics are provided by the Bureau of Labor Statistics.
Meet the professional: Phyllis Quinlan, PhD, RN
Practice: MFW Consultants To Professionals
Location: New York, NY
What is the single biggest suggestion you would give to someone wanting to get into this career?
“Really know your standards of care and be able to read how the nursing process plays out in the medical records.”
What’s the number one mistake people make when trying to get into this career?
“They enter the profession too quickly and are really not seasoned experts in their specialty.”
What is the question people should ask about this career but rarely do?
“What’s the time investment involved, especially when becoming an entrepreneur. This is because some cases can take days to read and review.”
Why did you choose to become a Legal Nurse Consultant?
“I became a Legal Nurse Consultant in 2003. I had previously started a consulting company in 1994, and most of the services offered dealt with training, re-training and cross-training within the nursing profession. When the training and retraining money available through the Unions in New York and the matching funds from the government started to dry up, I as a businesswoman had to look for the next big market. This is when I decided that legal nurse consulting would be a very good fit for me.”
If you could describe in one word what makes you successful, what would it be?
Credentialing organization: The American Legal Nurse Consultant Certification Board (ALNCCB)