Interview with Patricia MitchellRN, BSN, CLNC: From the Hospital to the Legal Arena

Attorney at Law Magazine First Coast publisher Thomas Brady sat down with columnist Patricia Mitchell, RN, BSN, CLNC to discuss her life and career.

Click here to read the full story at Attorney at Law Magazine.

AALM: Tell us what first drew you to your industry.
Mitchell: I had been working in the hospital setting for many years and was looking for a way to use all that knowledge in a new and exciting way. I learned about the field of legal nurse consulting, and thought that this would be the perfect marriage of nursing and medical legal litigation, and an new way to help people. Legal nursing is an extension of critiquing care; something done as a nurse on a daily basis. It is gratifying to help clients figure out the complexities in a case, explain the medicine and for the patients explain what happened, sometimes give closure.

AALM: What compelled you to start your own company?
Mitchell: I started Central Florida Legal Nurse Consultants because I wanted to be the Captain of the Ship so to speak. I wanted to have all the business interactions, products and services to have a personal touch I would be proud of, and the challenge of entrepreneurship was an added bonus.

AALM: How is your company different from its competitors?
Mitchell: Legal Nursing is a direct service to the client, so the culture of the company is very important and reflects whoever is at the helm. We treat our clients as we would want to be treated, just as in the hospital we treated our patients as if they were our family. Its not only a business, but an investment in the relationship, and is founded on trust.

AALM: How would you describe the culture at your company? The team?
Mitchell: We are passionate about our purpose, producing great work and helping people. The passion is the key, if you truly love what you do, the difference is apparent, then it becomes much more than a job.

AALM: Tell us about one of the most important lessons you learned from a personal or professional mentor.
Mitchell: Communication is key. This is the thing I find is the most lacking in the world today, and the easiest and most important to fix.
How has your field evolved since you first entered it? What’s the biggest positive and negative change?

The advent of the electronic medical record has been a game changer for everyone who does medical case review. It is critical to know how to navigate the records, what should be where, what is missing. On the up side, the records are no longer handwritten for the most part, illegible or difficult to decipher, and there is little need to sift through voluminous paper charts. On the downside, the EMR can be daunting to some folks, and change comes slower, there are still paper people out there.

AALM: What do you think is the most pressing concern for attorneys when it comes to your field?
Mitchell: I think there are a few big concerns — the first is the need to understand the medicine in a case. Often times this involves an in depth review of the medical record that few have time or background to do effectively.

The second would be finding someone to help whom they can trust and communicate with.

Location of experts can be a problems, particularly for plaintiff attorneys; finding the right expert for the case can be difficult, and more so if the case is regarding an unusual issue.

AALM: What changes do you see on the horizon for your field? How are you and your company preparing to stay ahead of the curve?
Mitchell: The medical field is constantly evolving with new standards of care, treatments, medications etc. This, of course, had upsides and downsides. It is critical to stay abreast of current trends in medicine through ongoing education, to continue the in depth analysis needed as a legal nurse consultant

AALM: What do you most enjoy about working with lawyers?
Mitchell: Lawyers in general are smart, curious people, necessary given the profession. The best ones know what they don’t know and are pro-active to seek answers, ask questions and quick to learn.

AALM: What is one of the biggest challenges you face in your industry? How do you overcome it?
Mitchell: Lack of knowledge about legal nurse consultants, what our role is, the services we provide and the benefits of using a legal nurse. There are still many attorney’s that don’t understand what we do, or how to best utilize our services. Education is the key; articles such as the ones published in Attorney at Law Magazine, explaining what an legal nurse consultant is, and does is valuable. We attend conferences to meet with attorney’s face to face, answer questions and teach about ways we can make the medical end of a case easier to navigate.

AALM: How are you involved in your industry as a whole? In the community?
Mitchell: We are very involved in our professional community, attending one or two conferences annually to network with other practitioners, and stay up to date on trends. We are active in the national organization , the American Association of Legal Nurse consultants (AALNC), and the National Alliance of Legal Nurse Consultants (NALNC). Patty Mitchell, founder , will be President of the local Greater Orlando Chapter of the AALNC for 2019, providing education, networking and resources to the legal nurse community in Central Florida.

AALM: Tell us about your ambitions for your career.
Mitchell: Working as a legal nurse and running Central Florida Legal Nurse Consultants is literally a dream come true. I plan to continue to grow the company and enjoy my clients and my work, as it evolves.

Republished from Attorney at Law Magazine with permission.

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Legal Nurse Consultants: Who, What, and Why

This article by Patty Mitchell appeared in the January 2019 edition of Attorney at Law Magazine.

Who:

Legal Nurse Consulting has been around for close to 30 years, yet there are many attorney’s that do not know the profession exists, have little understanding of our role or how to effectively utilize our skills.  A speaker at a recent conference cited a study indicating only 28% of attorney’s polled could state what a legal nurse consultant (LNC) did.  We all know nurses; our sister, our mother, or spouse, however the LNC is a nurse with specialized training in merging medicine with the law.  We have taken courses, continuing education, and done apprenticeships in our field to prepare to be of the most benefit to attorneys, insurance firms, and other clients with their health-related cases.  We have our own professional organization the American Association of Legal Nurse Consultants (AALNC) formed in 1989 and have been a recognized “specialty” by the American Nurses Association since 2006.  Utilizing an LNC may not be necessary on every case, but for complicated or catastrophic cases we are invaluable.  We shine in the arena of medical malpractice, personal injury, toxic tort, product liability, Worker’s Compensation, and criminal cases with a medical twist.

What:

There are two distinct types of Legal Nurse Consultants.  Nurse expert witnesses, who are clinically active, able to testify, and review the medical records related to the case for that purpose.  Consulting nurses have a different perspective and are part of the team pulling the case together with 50% working as independent contractors.  The balance of LNC’s are employees of law firms, insurance companies, government agencies, healthcare facilities, health maintenance organizations, patient safety organizations, and legal departments in business and industry.

Nurses have been the most trusted profession for 16 consecutive years per a Forbes magazine report.  Our focus in all aspects of our careers is to solve problems both for our patients and in the LNC world.  The LNC provides many services for both plaintiff and defense, that can expedite and simplify legal cases.  The idea is to get medical expertise on the front end, leading to less expense and a clearer picture moving through the process.  Our knowledge makes us uniquely qualified to identify all the issues in a medical record that would be overlooked by someone not intimately familiar with healthcare/medicine.

The LNC can be of value in the legal arena in many ways and just a few are highlighted below:

  • Location of expert witnesses: finding qualified experts can be challenging and time consuming.  LNC’s are a valuable resource, with networks of thousands of colleagues, making it easier to locate the right person to speak to a case.  We locate experts in all fields for example: physicians, nurses, therapists, dieticians and EMS.
  • Participating in client interviews: a medical background makes it easier to read between the lines of the client’s story and see the weak and strong points; in this way nurses help with case selection early in the game.
  • Screening Medical Malpractice cases: review for the plaintiff with identification of non-meritorious cases before time and money is expended, and before experts are obtained.  Cases with merit have the strengths and weaknesses highlighted, with recommendations given.
  • Defining standards of care in medical malpractice cases: not only for nursing, but for anyone with a duty to the patient.
  • Preparation of medical chronologies: Record review with pertinent information placed in a timeline.  Comments are included to explain medical issues or jargon and highlight discrepancies.  Entries are referenced to the page in the medical documentation for easy location of issues in voluminous records.
  • Preparation of medical summaries: Case overviews, with an in-depth explanation of the diagnoses/medical issues found in the record, conclusions are drawn, and recommendations are given.
  • Literature searches: to refute or substantiate allegations in a case.
  • Deposition reviews: preparing questions prior to deposition and finding discrepancies afterward.
  • Preparation of Medicare set asides, medical cost projections, and life care plans.
  • Medical billing review: determining bills associated with the case and correlating bills with service.
  • Knowledge and understanding of the electronic medical record.
  • Record organization, bates stamping: identification of missing records, and producing a user-friendly record, that is easily searchable.
  • Attending defense/independent medical exams: who better than nurses to attend as the eyes and ears of their clients.  Nurses streamline the process, protect the client, and notice discrepancies that may prove invaluable in the court room.

Why:

Many attorneys perform their own case review or rely on review by a paralegal.  It is logical to believe that any complex or catastrophic case would be better served with evaluation by a trained medical professional for quality, accuracy and finding key issues.  Insider knowledge can be a secret weapon for success, which is why firms who use legal nurse consultants depend on our knowledge, experience and resourcefulness.

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