New Member w/Question

Editorial Team / Admin · Aug 23, 2008

Hi everyone, this is such a great site!
I have been 'lurking' for awhile...finally thought I'd get into the swing of things and sign up!
Anyway, I am an experienced RN...15yrs, and about 8mos ago a friend, who is a paralegal referred me to the attorney she works for. They just lost their full time in-house LNC, and they needed chart review. I had not done that before, but had been thinking about getting certified, have been doing a lot of research, etc. So, I started, and then took a couple of online courses....etc.
Well, the work was sporadic...I didn't hear anythng after the 1st case, which, by the way, got 'rave' reviews! So 2-3mos go by, I proceed to get a F/T job, Nurse Manager gig, Mon-Fri. All of a sudden they had 3 cases for me and all sorts of extra request....meeting w/clients, conducting interviews, etc, and they wanted to offer me a job 'in-house'.
Great, I thought...the hours would be flexible, I could still work from some of the time, etc. So I planned on attending more courses, getting certified, etc.
Well, I finally got to meet w/the attorney, who had had been hemming and hawing about actually meeting w/me to discuss the logistics of the position.
Come to find out, they wanted me not only to do the nurse consultant duties, including ALL the bells and whistles, but they also wanted me to do some 'paralegal/legal secretary' duties, casue one had just quit! And, get this....no guaranteed hours, I was to be in the office minimum 3 days per week, but only get paid on a 'contract' basis....meaning I had to have 'billable' hours to justify my being there. And, they were only offerring me $35/hr for this job!!!! And I live in California... I happen to know the attorney's bill rate is around $300/hr!
She wouldn't budge on any of my terms....money, hours, benefits...nada!!
So, I turned it down....I'm making way more than that at my 'real' job.
Now my friend, the legal secretary, has a huge attitude w/me!
Anyway, bummer, but I was hoping to get some feedback from the experts....
Any thoughts?

Hello and Welcome to allnurses.com

Good to have you with us.

Most in-house LNCs do not command a huge salary, despite what the attorneys make. So, that figure could possibly be in-line with what is paid. I have no idea, however, what LNCs in-house make in CA. You need to research this and find out.

As for what duties they were going to have you do, it appears to me they wanted "cheap labor" and combine two positions by doing so. Don't blame you at all turning it down.

And, your "friend" will just have to decide that your decisions are you own......sorry that she is acting this way.

If you are seriously considering doing this, I always advise the RN to seek formal education. There are several avenues/entities. Check out the threads here. The most popular educative avenues are AALNC online program, the Milazzo program, and LNC STAT.

Good luck with your decisions. If you have further questions/concerns, please post here.

And, we hope you enjoy allnurses.com

Bluehair · Aug 24, 2008

I'm in no way experienced in CLNC, but have to agree with Siri. Sounds like the lawyer wanted to have her cake and eat it too. I'm guessing it was not exactly a benefited position. She doesn't even have to do paperwork with the feds (IRS, Social Security, yada, yada) if you are contract staff.

On the plus side, sounds like you are making a good salary at your day job, lol! I used to live in CA and realize the cost of living is so ridiculous you HAVE to make more to survive.

Best wishes as you continue your CLNC endeavors!!

RN1989 · Aug 24, 2008

After interaction with some inhouse LNCs, I have found that they do seem to do much more "paralegal" work than what independent LNCs do.

The ABA puts LNCs into the legal assistant/paralegal role and do not view them as being nurses practicing a nursing specialty. Independent LNCs have to market and educate attorneys on what an LNC is, does, and why they need an LNC when they already have legal assistants and paralegals.

They probably were going to pay you more than what they pay a paralegal per hour. I have no doubt that the money they were offering is inline with a lot of inhouse LNCs. It may even be more than what many of the insurance companies pay their inhouse LNCs.

Considering that $35/hr is a good wage for a full time hospital nurse in the south, that is not a bad wage for an inhouse LNC. If I was desperate for work, I would probably consider that job if I were interested in being an employee.

You need to evaluate your goals and abilities. If you don't have the business acumen and startup capital to run an independent consulting firm, then this is an option. It takes a lot more money and business knowledge to run an independent firm than you think. It is much more work than most people want to do or even know how to do successfully.

It is highly unlikely you would ever make $100+ per hour as an employee. Since you had no experience and no certificate in legal nurse consulting, you probably won't be able to command a higher salary as an employee.

Don't burn bridges in this business by snubbing what you think is inadequate pay. It would be better to decline such offers for other reasons or learn to negotiate things like pay and hours than to anger someone. The LNC world is small and you can lose business quickly by the wrong words or how they perceive your words/attitude.

Editorial Team / Admin · Aug 24, 2008

Don't burn bridges in this business by snubbing what you think is inadequate pay. It would be better to decline such offers for other reasons or learn to negotiate things like pay and hours than to anger someone. The LNC world is small and you can lose business quickly by the wrong words or how they perceive your words/attitude.

Totally agree.

And, at the same time, you have to consider what is in your best interest (in-house/independent).

Good advice as usual, RN1989.

redhotchilepepper · Aug 24, 2008

Thanks for the reply and the welcome! Like I said...this is a great community!

It is true that in-house LNC's make less than independent, 'consultants', for sure. I feel the same....this attorney is trying to fill 2 jobs w/one, getting someone to do legal secretary work, and also the benefit having an RN.

I'm not quite sure why my friend got an attitude....could be some kind of 'loyalty' to her boss, or perhaps she was counting on me to take some of her work load....not sure.

I was already in process of doing the online aalnc program, so I hear 'ya about pursuing the education.

Thanks again for the reply!

Hello and Welcome to allnurses.com
Good to have you with us.
Most in-house LNCs do not command a huge salary, despite what the attorneys make. So, that figure could possibly be in-line with what is paid. I have no idea, however, what LNCs in-house make in CA. You need to research this and find out.
As for what duties they were going to have you do, it appears to me they wanted "cheap labor" and combine two positions by doing so. Don't blame you at all turning it down.
And, your "friend" will just have to decide that your decisions are you own......sorry that she is acting this way.
If you are seriously considering doing this, I always advise the RN to seek formal education. There are several avenues/entities. Check out the threads here. The most popular educative avenues are AALNC online program, the Milazzo program, and LNC STAT.
Good luck with your decisions. If you have further questions/concerns, please post here.
And, we hope you enjoy allnurses.com

Editorial Team / Admin · Aug 24, 2008

I'm not quite sure why my friend got an attitude....could be some kind of 'loyalty' to her boss, or perhaps she was counting on me to take some of her work load....not sure.

She may be embarrassed that you didn't take the position and reflected poorly on her. But, as I said, it's your life.......your decision. Hopefully, once she gets over the initial disappointment, she'll come around...

I was already in process of doing the online aalnc program, so I hear 'ya about pursuing the education.

Good deal. I think you will really enjoy this course. Good luck!!

redhotchilepepper · Aug 24, 2008

Yes, I agree, this attorney thought she was gonna get a '2 for 1' special, LOL! And, you are correct, being contract...no taxes witheld, etc, and no benefits.... :rolleyes: That would be one thing if I were going to be an independent contractor running my own business, consulting for different firms, etc; but she wanted specific days/hours, a set schedule, etc....an in-house 'employee' status job...without any benefit for me!

Fortunately, I do have my 'day' job...so that's something... :smokin:

Thanks for your reply. :)

I'm in no way experienced in CLNC, but have to agree with Siri. Sounds like the lawyer wanted to have her cake and eat it too. I'm guessing it was not exactly a benefited position. She doesn't even have to do paperwork with the feds (IRS, Social Security, yada, yada) if you are contract staff.
On the plus side, sounds like you are making a good salary at your day job, lol! I used to live in CA and realize the cost of living is so ridiculous you HAVE to make more to survive.
Best wishes as you continue your CLNC endeavors!!

redhotchilepepper · Aug 24, 2008

Yes, I had seen that already...the ABA classification, etc.

Actually, my friend the legal secretary/paralegal is getting $35/hr, as is their other paralegal in the healthcare division of this firm...this is a huge firm, offices across the nation, and interestingly enough, this attorney was/is an RN as well. She used to work at one of the same hospitals here that I did, LOL! I realize $35/h is good money, and believe me, from where I used to live...it is great, but here, that is not in line at all w/nursing salaries. In fact, I just found out the previous LNC in the office was making $50/h before she left...without the official "LNC" certification! :stone

I have been reviewing records, doing chrons and summaries for her for about 9 mos. now, as well as doing my online courses...making the $35/hr....so when she said she wanted me to come into the office as an "employee", and expand my role....have me commit a certain number of hrs per week to her, I felt like she should've been willing to offer me more money and "true" employee status...

As well, I know one of the outside LNC's she contracts with in addition to myself and believe me she's paying at least $100/hr for her work, more if it's a 'rush' job...which more and more have been lately, and she has been giving to me....

No, not worth it for me to be her 'employee'...I was very polite about it, and I will still do some review, etc. for her, but I declined the 'employee' job...she was OK w/it...she's a business woman, so she knows the score.

Thanks for your input...it is so true, I never want to burn my bridges...

After interaction with some inhouse LNCs, I have found that they do seem to do much more "paralegal" work than what independent LNCs do.
The ABA puts LNCs into the legal assistant/paralegal role and do not view them as being nurses practicing a nursing specialty. Independent LNCs have to market and educate attorneys on what an LNC is, does, and why they need an LNC when they already have legal assistants and paralegals.
They probably were going to pay you more than what they pay a paralegal per hour. I have no doubt that the money they were offering is inline with a lot of inhouse LNCs. It may even be more than what many of the insurance companies pay their inhouse LNCs.
Considering that $35/hr is a good wage for a full time hospital nurse in the south, that is not a bad wage for an inhouse LNC. If I was desperate for work, I would probably consider that job if I were interested in being an employee.
You need to evaluate your goals and abilities. If you don't have the business acumen and startup capital to run an independent consulting firm, then this is an option. It takes a lot more money and business knowledge to run an independent firm than you think. It is much more work than most people want to do or even know how to do successfully.
It is highly unlikely you would ever make $100+ per hour as an employee. Since you had no experience and no certificate in legal nurse consulting, you probably won't be able to command a higher salary as an employee.
Don't burn bridges in this business by snubbing what you think is inadequate pay. It would be better to decline such offers for other reasons or learn to negotiate things like pay and hours than to anger someone. The LNC world is small and you can lose business quickly by the wrong words or how they perceive your words/attitude.

RN1989 · Aug 24, 2008

If she is having a lot of rush jobs, sounds like she needs some time management classes. That is not cost effective. Had she been willing to offer you more money, she would not be having so many rush orders. Sounds like there may be more poor business management on the attorneys part than anyone knows.

redhotchilepepper · Aug 25, 2008

If she is having a lot of rush jobs, sounds like she needs some time management classes. That is not cost effective. Had she been willing to offer you more money, she would not be having so many rush orders. Sounds like there may be more poor business management on the attorneys part than anyone knows.

You know what...you are probably right about that! I couldn't figure out what the heck was going on...but that's got to be it... Very good point!

Thanks for the reply. :)

TXJDRN · Sep 5, 2008

For what it is worth, I think you made the right decision by leaving. I worked as a "non-trained" LNC while I was working full-time as a nurse before going to law school in 1998. As I recall, I made around $40/hr for case chronologies. I don't use LNCs often, but when I do, they typically get $85-100/hr. One nurse once told me that her hosptial would buy the nurses lunch if they would do chart reviews! I reminded her that the only way to keep LNC salaries reasonable is to demand reasonable salaries. Good luck!