Secrets of Success for Working as an Inhouse LNC

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Elizabeth K. Zorn, RN, BSN, LNCC attended Vassar College from 1972 to 1974 and earned a BSN with high honors from the University of Rochester in 1976. After graduation, she worked for two years in the Pediatric Intensive Care Unit at the University of Rochester Medical Center. From 1978 to 1985 she served as nursing manager of the hospital’s high-risk obstetrical unit. From 1985 to 1995, Beth worked as a legal nurse consultant at Nixon, Hargrave, Devans & Doyle, where she provided assistance in the defense of medical malpractice and other personal injury cases. Since 1995, she has worked at Faraci Lange, a plaintiff law firm in Rochester, New York, specializing in medical malpractice, products liability, toxic tort and other personal injury matters.

Beth is a member of the American Association of Legal Nurse Consultants (AALNC), Rochester Legal Nurses Network (RLNN) and the Monroe County Bar Association. She is author of the chapter “Legal Nurse Consultant Practice Within a Law Firm” in AALNC’s Legal Nurse Consulting Principles and Practice, 2nd (2003) and 3rd (2009) editions. She is also author of two chapters in AALNC’s Legal Nurse Consulting Online Course (2007), a member of the Audit Panel for the American Legal Nurse Consultant Certification Board (2006); member AALNC’s Outreach Advocacy Committee (2007); and chair of AALNC’s Awareness Committee (2008-09). She has spoken at seminars for the New York State Bar Association (2008) and the Monroe County Bar Association (2009). She has also authored articles for AALNC’s The Journal of Legal Nurse Consulting and Network News. Beth is co-founder of LNCExchange, a non-fee based medical-legal listserv for LNCs founded in 2006. Comprised of more than 1200 members, it has evolved into a unique educational and networking resource for LNCs and other professionals who work in the medical legal field.

Moderator: Patricia Iyer, who has 22-years of experience as a legal nurse consultant.

Sample Question

Pat: What are the kinds of considerations that a legal nurse consultant should think about when determining if an in-house job is right for him or her and if a particular law firm is going to be a good match?

Beth: Sure. I believe that nurses interested in in-house work should consider a few things. First of all firm size. Is the firm large, small or somewhere in between? This impacts firm culture and sometimes decision making and ease of communication within the firm.

Also does the firm do primarily plaintiff or defense work and what’s your comfort level doing one versus the other? I’ve run across some nurses who are just uncomfortable doing plaintiff work, much preferring to be on the defense side.

Also how many attorneys of the firm work on med mal and other personal injury cases and what is the ratio of LNCs to attorneys. Obviously this impacts both work load and job security. For example, at our firm we have three LNCs for approximately six attorneys who do most of the med mal and serious personal injury cases.

You want to ask about what is the firm’s measurement of productivity, typically as you may know, defense firms use time sheets and billable hours as a measure of productivity, whereas plaintiff firms do not. Although some plaintiff firms, including ours, may have some requirement to track time that you spend on various cases.

Another big one is what is the culture of the firm? For example is it quite hierarchical and formal or is it more informal? What is the dress code? Again what setting are you most comfortable in and finally an issue that’s very important to me is what is the reputation of the firm generally and among its lawyers individually. For me it’s very important to work at firms with very ethical and competent lawyers.
For example, you might want to find out if any of the attorneys are members of such organizations as Best Lawyers in America, The American College of Trial Attorneys, The American Board of Trial Advocates, or other prestigious professional attorney organizationsthat require peer review for admittance.

Also, what is the rating of the firm and the attorneys on the Martindale-Hubbell web site and finally do any of the attorneys regularly present at local and state bar seminars? Lastly, does the firm have a mission statement or a set of core values? Some of this information can be obtained by visiting the firm’s web site. I would say the vast majority of the firms now have websites.

In this information-packed program, Beth Zorn answered these questions and more:

• What are the kinds of considerations that a legal nurse consultant should think about when determining if an in-house job is right for her and if a particular law firm is going to be a good match?
• What are some ways an LNC can gain more information about a law firm?
• How often do these jobs come up and what’s the best way to try to find out who might be hiring?
• How would you suggest the LNC get a foot in the door of a law firm?
• Do you have to have prior experience as a legal nurse consultant to be considered as a viable candidate?
• What if an LNC wants to keep one foot in the clinical area and work part time at a law firm? Are there any potential advantages or disadvantages to that approach?
• Do you recommend that a nurse have any type of degree, Bachelors degree, Masters degree or does having a degree make a difference in terms of qualifications?
• What about certification in a clinical area and certification as a legal nurse consultant? How does that impact on the in-house role?
• What recommendations do you have for how to handle the interviewing process?
• What can an LNC expect with the role and the responsibilities of working in an in-house firm?
• Have you ever been asked to go to court to testify about what you saw at an IME?
• What happens when two attorneys are both asking you for services that would keep you busy full time taking care of one of the attorneys? How do you shift through those competing priorities?
• Are we talking about a job that’s typically 40 hours a week or is it longer?
• One of the biggest questions that I’ve had in marketing as an independent legal nurse consultant is from attorneys who say, “I have a paralegal, why do I need a nurse?” How would you respond?
• I can envision a firm with paralegals who’ve never worked with a legal nurse consultant who might have some concern or maybe even some resentment over a nurse coming in. Are there any suggestions that you might have to deal with that situation?
• You mentioned a few minutes earlier that LNCs are typically paid more than paralegals. Can you share any kind of a salary range that you’ve seen and being in this field for the last 25 years—specifically for legal nurse consultants or nurse paralegals, however we’re using that term?
• What can the LNC can do to help assure some job security? What suggestions do you have for our listeners in terms of becoming invaluable to the attorneys working in the firm?

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Related articles by Pat Iyer:

Keeping Your Horizons Open

The Marks of Success

Paralegals and Legal Nurse Consultants: Perfect Together?

To Err is Human

What did I say? — Miscommunication at the office