For those working LNC- have you been questioned about the ethical aspect of this job?

The attorneys that I have worked with never ask me to do anything unethical. No truth bending, nothing. An LNC's job is to make sure that the truth is found, even when someone tries to hide that truth. An LNC can also assist an attorney in keeping inappropriate cases out of the court system. The LNC course that I took did review ethics and brought out some excellent points and tips on dealing with problems you might face.

As an LNC, your job is to review facts. Sometimes you are specifically looking for deviations from the standards, other times you are looking for adherences to standards. And even other times you are simply reviewing a record to help an attorney's client fully understand the diagnosis and prognosis of someone so that they can make appropriate decisions regarding long term care, wills, and estate planning or even whether or not to pursue a course of action at all.

I got to thinking about the "nurse bashing" comment that you recieved. I can see where others might feel insecure about someone reviewing medical records and make this un-enlightened comment. As a manager, I can tell you that the staff dreaded me coming to the unit and reviewing charts because they knew that I was looking to see that the documentation was complete and appropriate. I was not specifically looking to see who "screwed up" but because I was looking to see that they had followed policy and regs, when I did find a problem I had to speak to that person and ask them to rectify the situation. That of course can feel like a personal assualt on someone who is stressed out from work. Perhaps these people you have spoken with feel some insecurity because they are being hounded at work about paperwork or things that they may or may not have done and that just transferred to you when you tried to discuss your interest in being an LNC.

I am employed full-time by a plaintiff's firm, and like RN 1989, have never been asked to do anything unethical. I have a lot of input as to which cases we accept, and we will not consider any frivolous lawsuits. As for "nurse bashing", it doesn't happen at this firm. However, if a nurse has breached the standard of care, something should be done, if only to prevent future occurances. I still consider myself to be a patient advocate.

I think that both responses from RN 1989 and silmas RN are right on target. My own first thought was, also, that those who are concerned about "nurse bashing" might feel insecure about their own work, and are concerned that the truth will reflect badly on them.

There are those in nursing who unfortunately believe this is a sisterhood that should not be touched in any way by anyone in the group, and that is dysfunctional. Truth is truth and should be found. If corrections need to be made, they should be brought to light.

My practice is mostly testimony as I have a rare speciality. The first thing I tell clients is that I am not a "hired gun" and they will get an honest opinion whether they like it or not. I have had to give several clients an unpopular opinion. None of them were happy. Only one decided she was paying for my opinion not my time. I will probably face her someday in trial and will make sure to bring up her failure to pay.

That being said, attorney clients will give you their version of the case. When the record comes I frequently find that the verbal version I got does not quite match the facts. Sometimes the client is focused on the wrong thing and totally misses the real deviation from the standard. I start every review in an unbiased objective fashion. When I give the client my report I talk about both the strengths and weakness of the case.

As far as nurse bashing goes, I love to defend a nurse who has met the standard. A number of my cases have had nurses who I felt not only should lose their license to practice but should be held criminally liable.
I don't know about you but these nurses bring us all down and endanger the public.

Excellent, crystalwomn.

I follow this exact routine. Many attorneys welcome my honest opinion as it relates to the SOC. Some do not.

Yes SirI. The most important part of being an expert is the ability to remain unbiased. If you allow the attorney to interpert the case for you or fail to look at the strengths and weaknesses of both sides, your practice will suffer in the end. I have had varying response to my honesty. One client, who went back and forth with me on a nurse who failed to meet the standard, and was very unhappy that I would not sign on to defend her. He did pay promptly and referred me to another attorney. Another client who didn't like my opinion on a fetal demise has yet to pay.

Another client who does nothing but civil rights cases was convinced his case was about the gas (pepper spray). After going thru 10 years of records he was not happy to hear that his case wasn't about the gas but was far more serious than he even imagined. He ran my opinion by a specialist who agreed with my summation. He has become a repeat client.

So true.

Often, the attorney will give me the MR fully expecting my opinion to correlate with his/hers. When I come back to the attorney citing appropriate (adherence to the) SOC, they have tried to get me to alter my opinion. Needless to say, I do not engage that attorney again for dishonesty is definitely not my policy.

Often, pointing out the SOC/SOP allows them to actually see that the client, although may have had a negative experience, did not have claim of nursing negligence and/or malpractice, therefore, no case.

This is how I, as a nurse, advocate for my peers as well as try and elevate nursing as a whole and at the same time, advocate for patients.

I can sleep well at night knowing my opinions are true, honest, and evidenced-based.