The Benefits of a Nurse Ally

by Clarann P. Hull, RN, CCM, CLNC

Although nurses have consulted behind the scenes for years in litigated medical cases, most recently attorneys, insurance companies and government agencies have come to more fully appreciate the value that a nurse brings to the litigation process and are utilizing them more and more. Seasoned nurses have demonstrated their ability to bring their unique knowledge and skill to cases involving toxic exposures, liability, medical malpractice, and wrongful death thereby improving the outcomes of the litigation process.

This knowledge base has been developed over the years through the use of the nursing process. The student nurse is introduced to this process in nursing school where it is impressed that this is an essential process that is to be applied throughout the nurse’s career. It is much more than a lesson learned. It becomes a way of thinking. In short, the process is ongoing and dynamic. It begins during medical treatment initiated by a physician and includes an assessment of the situation or patient, the development of a plan, implementation of the plan, assessing the response, and then adjusting the plan as necessary. This process eventually forms a very individual course for each situation or patient.

During this process the nurse is reporting, recording, caring, counseling, teaching, supervising, delegating, and consulting with her colleagues; and reviewing the medical record and the patient’s response to the planned medical treatment developed by the physician. This nursing process becomes second nature to a seasoned nurse.

It is no secret to any legal staff that these men and women are helpful in reviewing and organizing a medical file. They have developed essential skills that are of tremendous value and that transfer to the tasks involved in assisting legal staff in their review of medical files. But what are some of the other benefits that accrue to the legal firm who hires an experienced nurse to work with staff on a legal file?

To begin with, the seasoned nurse is accustomed to speaking when others could not or would not speak. This is a result of the patient advocacy role that they have assumed over the years and the battles they have fought with doctors and other interested parties on behalf of their patients. I have found through my experience, and to my surprise, that it is just this quality that attorneys value most. Every attorney I have had the pleasure of meeting and with whom I have worked, bar none, has placed significant value in knowing the truth.

Of equal importance to the attorney or hiring agency, the nurse has learned the value of cost containment. This derives from the nurse’s experience with Medicare and DRGs. It was in the 1990’s that hospitals began to see their reimbursement shrink substantially from the Medicare program. It seemed no area of medicine was left unscathed from cost containment. Who could forget when they stopped supplying us with coffee and pens! As a home care nurse, there were many times I would use half a roll of kerlex to cover the wound. In order to save on the cost of tape or prevent wasting the more expensive kerlex, I used clean tube socks and panty hose cut to fit to cover the dressings. We even started boiling and washing foley catheters for patients who used more then two per month. A seasoned nurse understands how to cut corners and be creative with it!

How do these skills transfer to the legal field? Perhaps my personal experience can shed some light on this question. I was one of ten nurses hired to review toxic tort cases for an international defense firm. As we neared the end of the case reviews, there were just three of us left. (Case review isn’t for everyone). We had the pressure of providing case reviews, chronologies, research supporting our findings, and our opinion of the strengths and weakness of the case to the law firm by specific deadlines.

As the direct result of our efforts many of the cases rescinded their claims. In a significant number of the remaining cases the judgment was favorable. The attorneys were very pleased. When asked if they would recommend using our services again, the response was “Wouldn’t take a case without them and would definitely recommend them again.” Even the physician attorney on staff held us and our work product in high regard.

Considering the knowledge, skills dedication that an experienced nurse has developed over the years what individual, employer, or firm wouldn’t benefit from having a nurse as an ally?

I am respectfully yours,

Clarann P. Hull, RN, CCM, CLNC
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