June 2010

I’ve stayed in a lot of hotels during my travels. Everything from Ramadas to Mandarin Orientals with more than a few Hiltons, Hyatts, Marriotts and the occasional Peninsula in between. As a result I’ve become quite jaded concerning hotel services. On a recent trip to Austin, Texas, I was stunned by the service at our hotel, the Four Seasons. The staff did much more than just meet requests, they seemed to anticipate every need. It started with the bellman who offered to find additional luggage stands. Then it was the waiter who, after I asked for the check and told him we needed to get to the airport, he offered to call a cab for us.

The front desk clerk who not only upgraded us to a lake view (without my asking) also suggested happy hour on the hotel’s terrace overlooking Lady Bird Lake and told us about a few of the appetizers we shouldn’t miss. The doorman surveyed the directions to our dinner spot (La Condesa – my favorite Mexican restaurant in the U.S.) and recommended a better, more direct route and even told us where to park. This service extravaganza ended with the valet who provided us with bottles of water for our drive to the airport.

From the time we arrived at the hotel to the time we left, it seemed the staff anticipated our every need and went out of their way to try and beat us to the punch. I couldn’t help but contrast this with so many other experiences where the staff simply wait until you ask them for help.

Are you doing the same for your attorney-clients? Are you anticipating their needs and offering different legal nurse consulting services than you’ve provided in the past or do you just sit passively by the phone or computer waiting for the call or email? The impression you want to leave with your attorney-clients is one of superior service and the best way to achieve that is by transcending your prior service.

As a Certified Legal Nurse Consultant, you know that you can provide more than 30 different CLNC^® services to your attorney-clients. Offer them! Don’t wait for the attorney to ask you. He hasn’t seen the list and doesn’t know the full range of your nursing knowledge and experience. Show him how you can stand out by anticipating his needs, not just meeting them.

Success Is Inside!

Every Certified Legal Nurse Consultant running a variation of Windows^® probably has at least one program that, instead of opening up to a full-screen view, pops up in a smaller window, a portion of a window or is just a quarter of its normal size. You then click it to full size, do your work and when you’re done, close the program. Next time you open it that same day, it comes up full size, or not. The next time you open it after a restart of your computer, it opens full-size, or not. Therein lies the rub, it’s not consistent, at least not as consistent as your other Windows programs.

So what’s a savvy CLNC^® consultant to do? If you’re running Windows XP and you use a shortcut to open your program, the solution is easy. First, navigate to the shortcut you use to open the program. This could be in one of three places:

1. Your Windows “Desktop” (that’s those icons on your screen).
2. Your “Quick Launch” toolbar in your Task Bar (that’s in the blue bar at the bottom left of your screen).
3. The “Start Menu” that you use to select your programs (it pops open when you click the Start button).

Mouse over the icon/shortcut for the program that’s giving you size trouble and right click it. When the menu pops up, left click Properties at the bottom and you’ll see the “Properties” box with the “Shortcut” tab open.

In the Run category, left click the Normal window selection and select Maximized. Then click Apply and Okay. Next time you run that program from that particular shortcut, it should open in the maximized, full-screen mode you selected and you’re back where you want to be!

Keep on techin’,

Tom

I asked the CLNC^® Pros to share the websites they use most often for researching their medical-related cases. I invite you to bookmark your favorites.

Agency for Healthcare Research and Quality
Offers links to clinical information and current clinical research.

American Academy of Family Physicians (AAFP)
Offers links to journals, policies, position statements, references and resources pertaining to family practice.

American Association of Critical-Care Nurses (AACN)
Provides clinical resources, standards, journals, education and certification information for the critical care nurse.

American College of Physicians (ACP) PIER^® (Physician Information and Education Resource)
Comprises over 490 modules focusing on clinical topics as well as an extensive drug database and helpful patient information. Free to ACP members.

American College of Radiology (ACR)
Outlines standard of care, quality and safety resources, clinical research and news and publications.

American Heart Association
Provides statements, guidelines, clinical updates, news, continuing education, publications and statistics.

American Medical Directors Association
Supplies links to AMDA’s publications and products, news releases and resource library. Specific sections address the interests of medical directors and physicians who practice in long term care.

American Nursing Association (ANA)
Contains the nursing scope of practice including administration.

American Society of PeriAnesthesia Nurses (ASPAN)
Contains standards, education, links and publications.

Association of periOperative Registered Nurses (AORN)
Contains education, standards of practice and peer networking for the OR nurse.

Centers for Disease Control and Prevention (CDC)
Promotes health, prevention of disease, injury and disability and preparedness for new health threats. Also provides intra-agency support and resource-sharing for cross-cutting issues and specific health threats.

CINAHL
Provides the Cumulative Index to Nursing and Allied Health Literature (CINAHL^®), the most comprehensive resource for nursing and allied health literature.

Code of Federal Regulations – Title 42 – Public Health
Presents Chapter IV – Centers for Medicare & Medicaid Services, Department of Health and Human Services.

Department of Health and Human Services Office of the Inspector General
Allows you to check on the exclusion status of a healthcare provider or facility. Contains the list of sanctions and definitions of exclusions for Medicare fraud and other sanctions.

Elder Abuse Information
Helps you recognize and fight against elder abuse. Discusses different forms of elder abuse, causes and symptoms and gives the legal rights of the elderly.

Elsevier
Contains access to a variety of science and health information, books and journals.

eMedicine
Contains peer-reviewed online medical textbooks. Physicians continually update and revise this site. The standard format for each disease or condition includes diagnosis and treatment, differential diagnoses, and a list of additional references.

Federation of State Medical Boards
Contains a databank of board actions and physician disciplinary actions. Includes links to state medical boards.

Food and Drug Administration (FDA)
Helps you investigate concerns about products in the FDA database.

Harrison’s Online
Features the complete contents of Harrison’s Principles of Internal Medicine, 17th Edition.

Health Medicine refdesk.com
Contains an alphabetical list of health and disease-related links useful as a starting point for finding medical literature and other sites.

The Health Pages
Allows you to search for a physician by name and state or by specialty practice. This site has more current contact information than other physician directory sites, particularly telephone numbers. Links to state medical boards offering physician discipline information and reports on physicians and facilities are planned for this site.

Healthcare Financing Administration
Links to Medicare, Medicaid, SCHIP and other federal search resources.

Hippocrates Magazine
Contains clinical updates in primary care and practice management with access to archives and search features.

Infusion Nurses Society (INS)
Sets the standard for infusion care.

Institute for Healthcare Improvement (IHI)
Provides access to improvement knowledge and trustworthy content focused on healthcare quality across a broad array of topics.

Institute for Safe Medicine Practices
Presents links to newsletters, educational programs, medication safety tools and resources, articles, guidelines, products lists and reports.

Johns Hopkins Division of Infectious Diseases Antibiotic Guide
Provides information about infectious diseases and antibiotics. The site requires registration (free).

The Joint Commission
Accredits and certifies more than 17,000 healthcare organizations and programs in the U.S.

The Journal of the American Medical Association (JAMA)
Offers the most widely circulated, peer-reviewed, general medical journal in the world.

Manufacturer and User Facility Device Experience Database (MAUDE)
Gives links to reports of product and device failure and other information.

Mayo Clinic
Provides online resources for diseases and medical conditions, drugs and supplements and tests and procedures.

MDLinx.com
Contains links to 40 medical specialty websites for the latest developments and access to top journals. Also offers an email subscription service to alert you to news in specialties you select.

MedBioWorld
Contains links to publishers of medical and nursing journals in all fields and a complete list of all available journals worldwide.

Medical Library Association (MLA)
Provides educational opportunities, supports a knowledgebase of health information research and works with a global network of partners to promote the importance of quality information for improved health to the healthcare community and the public.

Medical Matrix
Provides ranked, peer-reviewed and annotated clinical medicine online resources for a variety of journals, texts, diseases and medical conditions.

Medical News Today – Litigation/Medical Malpractice News
Includes news and articles published daily on lawsuits, legislation, compensation claims, pharmaceutical company disputes and more.

Medicare
The official U.S. government site for Medicare.

MediLexicon
Contains searches, information, news and resources for the medical, pharmaceutical and healthcare professional, including medical abbreviations, medical dictionary, medical news, ICD-9 search, drug search, medical equipment and surgical instruments and other searches.

MedlinePlus^®
Presents health information from the National Library of Medicine.

Medscape
Supplies medical news, full-text journal articles and resource centers.

MedTerms
Clarifies difficult medical language as defined by doctors in easy-to-understand explanations of over 16,000 medical terms.

Merck Manuals Online
Contains links to search the Merck Manual of Medical Information, Merck Manual of Geriatrics and Merck Manual of Diagnosis and Therapy.

Merck Medicus
Contains information specific to your specialty, including clinical tools, specialty textbooks, journals and professional societies.

Micromedex Healthcare Series
Contains information on drugs, diseases, acute care, toxicology and alternative medicine.

Mosby’s Nursing Consult
Offers a vast array of information relevant to nurses including 38 leading nursing textbooks, 38 leading full-text nursing journals, evidence-based nursing monographs, drug information and calculators, over 370 practice guidelines, 8,000 patient handouts, 8,000 images, “Best Practice” clinical updates, dictionary, MEDLINE, Mosby’s Index and nursing and medical news.

National Association for Home Care & Hospice
Represents the interests and concerns of home care agencies, hospices and home care aide organizations.

National Cancer Institute
Contains information on cancer topics, clinical trials, cancer statistics, research and news.

National Center on Elder Abuse (NCEA)
Helps national, state and local partners in the field be fully prepared to ensure that older Americans will live with dignity, integrity, independence and without abuse, neglect and exploitation.

National Council of State Boards of Nursing (NCBSN)
Offers links to most U.S. nurse practice acts, regulations and state boards of nursing.

National Guideline Clearinghouse
Serves as a public resource for evidence-based clinical practice guidelines.

National Hospice and Palliative Care Organization (NHPCO)
Promotes access to palliative care and to maintaining quality care for persons facing the end of life and their families.

National Patient Safety Goals (NPSGs)
Delivers outlines and chapters for all applicable programs published by the Joint Commission.

National Pressure Ulcer Advisory Panel (NPUAP)
Contains online resources for pressure ulcer staging and links to public policy, education and research of pressure ulcers.

The New England Journal of Medicine
Contains a variety of clinically relevant medical information, including clinical and research articles, analysis and opinion articles and materials for both learning and teaching.

Occupational Safety and Health Administration (OSHA)
Presents comprehensive information about OSHA regulations, services, safety programs and employee training manuals with news and an online library.

Oncologic Nurses Society (ONS)
Represents over 37,000 registered nurses and other healthcare providers dedicated to excellence in patient care, education, research and administration in oncology nursing.

Pam Pohly’s Net Guide – Medical Academies & Healthcare Professional Associations
Contains links to hundreds of healthcare societies, academies, professional organizations and associations.

PubMed
Comprises more than 19 million citations for biomedical articles from MEDLINE and life science journals. Citations may include links to full-text articles from PubMed Central or publisher web sites.

Spine Universe
Contains detailed information involving conditions, treatments and wellness surrounding the spine. Additional resources include links to clinical trials, glossary of terms, recommended textbooks about spinal anatomy, videos and animations.

STAT!Ref
Offers access to cross-searchable, full-text medical, nursing and pharmacology electronic textbooks from a wide variety of reputable authors, publishers and societies.

Surgical-Medical-New Terms Glossary
Offers the most complete list of medical products, devices and pharmaceuticals, with links to manufacturers’ websites and Food and Drug Administration information on each product.

UpToDate
Provides evidence-based, peer-reviewed-information resource for clinical knowledge and improved patient care. Available by subscription.

Wound Care Strategies
Contains products, education and news related to wound care.

Wound, Ostomy and Continence Nurses Society
Represents an international society of nurses who are experts in the care of patients with wound, ostomy or continence problems.

Wrong Diagnosis
Contains links to symptoms, diseases, diagnosis, videos, tools, misdiagnosis, doctors, hospitals, drugs and articles.

Thank you to Suzanne Arragg, RN, BSN, CDONA/LTC, CLNC; Laura M. Averette, RN, MSN, CPHRM, CLNC; Dale Barnes, RN, MSN, PhN, CLNC; Nikki J. Chuml, RNC, CCE, FMC, CLNC; Larry Frace, RN, CLNC; Margaret Gallagher, RN, BSN, MSN, CLNC; Dorene Goldstein, RNC, CLNC; Sandra Higelin, RN, MSN, CS, CWCN, CLNC; Jane Hurst, RN, CLNC; Camille Joyner, RN, CCM, CLNC and Mildred Mannion, RN, BSN, CNOR, CLNC for sharing the websites they use most to research their legal nurse consulting medical-related cases.

Success Is Inside!

Our CLNC^® Pros deliver their top techniques to boost the efficiency and thoroughness of your medical research.

1. Use only authoritative websites for medical research. Accessing research studies may require a fee which is billable to the attorney.
2. As a member of the NACLNC^® Association, Certified Legal Nurse Consultants have free access to the Internet’s preeminent legal nurse consulting resources including CLNC^® resource links, a peer-reviewed collection of hundreds of the best Internet links on medical, nursing and scientific research.
3. Simplify your medical research with the National Library of Medicine. From this site you can enter MedlinePlus^®, a comprehensive database of article summaries from international medical literature and also search biomedical journal literature from MEDLINE/PubMed.
4. Subscribe to MD Consult and conduct a minimal search for general and specific information. The site contains many authoritative and up-to-date text and journal references. As you review individual journal publications, you can search for more articles on specific topics, instead of starting a new search. This time-saver allows you to cross-reference pertinent literature and identify key search words during your original search. You can even identify literature that is critical of the researchers or their methods, sometimes with notes citing conflicting results from other studies.
5. Screen the case to analyze and prepare a brief overview of the essence of the case. This helps you focus on the relevant injuries, treatment protocols and causation issues when researching.
6. Always review the standards of any pertinent professional organization. You can identify the relevant associations through the Healthcare Standards Directory (HCS) Online. This ensures that you include these standards in your research so you don’t miss professional standards that aren’t found in your online search. For example, for an emergency room case, contact the American Board of Emergency Medicine. For an obstetrical case, contact the National Association of Neonatal Nurses and The American Congress of Obstetricians and Gynecologists. These sites offer a wealth of information. Request the information these associations publish for consumers as well. The references cited in the bibliography of any standards are also useful.
7. Decide whether you want to conduct broadly defined research or narrowly defined research. This will shape the words that you use for your research. For example “GI bleed” is more broad than “stress-related mucosal bleeding manual ventilation.”
8. Keep your beginning search simple, then do a more complex search. Sometimes the simple things are the most pertinent to the case. Don’t make it harder than it has to be. Ask yourself what you really need to find, verify or compare. Recognize when enough is enough. Gain a sense of when you’ve got enough material and move on to applying the research to the case.
9. When searching for a primary subject, such as diabetes, remember to search at the same time for related issues relevant to the case, such as decubitus. This helps you avoid duplicating your efforts later.
10. Always check the bibliography of any journal article for additional research sources. While searching for general information in texts and Internet sources, make a list of the authors who are most widely published or referenced. This list could provide additional literature sources or potential testifying experts.
11. Make note of the medications and medical products used. Then search for any drug interactions or medical device incidents that could have contributed to the case in any way. Systematically reviewing this information keeps you from overlooking any potential product liability issues resulting from defective products. If you need to research a particular drug, or medical device, don’t overlook company sponsored websites.
12. Provide copies of the research articles to the attorney and highlight relevant information in the article to emphasize what is significant and to expedite the attorney’s review.

Thanks to Suzanne Arragg, RN, BSN, CDONA/LTC, CLNC; Laura M. Averette, RN, MSN, CPHRM, CLNC; Dale Barnes, RN, MSN, PhN, CLNC; Nikki J. Chuml, RNC, CCE, FMC, CLNC; Larry Frace, RN, CLNC; Margaret Gallagher, RN, BSN, MSN, CLNC; Dorene Goldstein, RNC, CLNC; Sandra Higelin, RN, MSN, CS, CWCN, CLNC; Jane Hurst, RN, CLNC; Camille Joyner, RN, CCM, CLNC and Mildred Mannion, RN, BSN, CNOR, CLNC for sharing their strategies for researching medical-related cases.

Success Is Inside!

Microsoft^® Outlook^® is probably the most widely used and accepted email client throughout the U.S. Many law firms choose Outlook for their attorneys’ email clients. If you’re a CLNC^® consultant and Outlook is your own email client, you have a unique opportunity to create what is known as a vCard for your legal nurse consulting business.

Think of a vCard as a “virtual business card.” It can contain your name, legal nurse consulting business name, address, phone/fax numbers, email address and possibly even a thumbnail photo of you or your logo. This vCard, when attached to your outgoing email, allows the attorney-client/prospect recipient of that email to simply import the vCard into their contact list without having to retype or cut and paste the information. If you’ve ever manually added a contact, you know how painful that can be. Attaching your vCard to an email makes the process almost painless for the recipient and prevents any possible typos they might make when entering your information as a new Outlook contact.

A vCard is not a Microsoft invention – it has been around for a long time. Outlook just made it easy for its users to create a vCard for themselves. Here’s how:

1. Open Outlook and left-click on “Contacts“
2. Click on “New Contact” – you’ll see this form:
   
   
3. Fill in your information (name, company name, email, website, etc.) in the “New Contact” pop-up.
4. Left click in the box with the little “photo” icon. This will open “My Pictures.” Navigate to the photo or graphic you’d like to include then double-click to add it to the vCard.
   
   
5. Once the information is complete click the so-called Pearl, then click “Save As” and select “vCard files *.vcf” from the drop down list. You can also simply select “Export to vCard File” and make sure you know where you saved it. This way you can use your vCard with email applications other than Outlook. If you’ll only be using Outlook, then just click “Save Contact” – you’ve just created your new vCard!

Now, to add your vCard (or *.vcf file) to your outgoing Outlook email you’ll need to do the following:

1. Open Outlook. Click Tools, then Options, then Mail Format, then Signature, then select the email signature you’d like to add your vCard to, or if you don’t have one, click on New at the open box “Business Card,” then select the business card from the “Insert Business Card” drop-down and select your card and “OK” your way out.
   
   
2. You’ve just added a vCard to your email signature in all your outgoing email! All your new attorney-clients and prospects will have your vCard. They can simply right-click and save it to their own Outlook Contacts folder without keying in your info.
   
   

Congratulations on being an up-to-date Certified Legal Nurse Consultant. Just make sure your photo is a professional-looking headshot or a good rendition of your company logo. It will show up in your signature so also make sure it compliments your email signature and doesn’t detract from it. Remember, you want to make communication as simple as possible. This is one way to do it.

Keep on techin’,

Tom