Report Writing

One of my favorite things to do in Austin, Texas, other than eating at La Condesa, is walking the trail around Lady Bird Lake. It’s peaceful and relaxing being by the water. You get to see aquatic wildlife and, if you’re fast enough, sometimes you can catch a glimpse of a turtle or two sunning themselves on the bank. On our last trip, while walking the trail, Tom and I had a pretty good laugh over a warning sign we ran into on the trail, obviously put in place by a well-meaning worker from the City of Austin’s Public Works Department. It reads: SIDEWALK CLOSED, USE OTHER SIDE.

While the sign, does indeed seem to point out the obvious, it made me think about legal nurse consultants writing reports for attorney-clients. Whether you’re writing a brief or comprehensive report, you need to point out the obvious, salient points from the medical record for that attorney-client. This includes deviations from and adherences to the standard of care. As a Certified Legal Nurse Consultant, you’re the expert on the medical record and you are the one who must point out the obvious. The attorney is the expert on the law. While you may work with an attorney or two who knows enough about medicine to open a practice as a doctor (unlicensed), the majority of attorneys do not. Those attorney-clients depend upon you to tell them what they need to know about the treatment, injury and actions of the parties. This includes pointing out the obvious.

As a nurse, you have a tremendous amount of knowledge about nursing, medicine and just about every aspect of healthcare. This brings its own dangers. Sometimes incidents, deviations or lapses in care that are obvious to you in their effect on the case, won’t be obvious to your attorney-client. Certainly you need to write your legal nurse consulting reports to the skill level of each particular attorney-client, but, at the same time, you don’t want to overestimate their ability to see and understand the obvious. You can’t assume that the attorney will recognize the importance of a critical deviation if you give it the same weight as every other deviation you address in your report. What’s obviously important to you, may not be obvious or important to the attorney-client. If you don’t believe me, think of some of the obviously important things you point out to your spouse (“Honey, remember what happened last time you tried to rewire a lamp? I think you should unplug it first. Or Honey, don’t let the baby get too close to that alligator.”).

If something is obvious to you and importantly obvious to the case, point it out. Tell the attorney-client why it’s important. Don’t assume they’ll pick up on it themselves. Do this religiously and you just might keep them from getting soaked in court or in a lake.

Success Is Inside!

A common question I get from Certified Legal Nurse Consultants is whether or not you should supply your legal nurse consulting work product to attorney-clients as a Microsoft^® Word document or as a paper printout.

I’ve never been a fan of letting an editable document out of my control. Not only do you run into issues where different users/recipients have different versions of Word software and suffer formatting issues, but you also have the very real concern that your words may be edited and end up not being your own. That is especially unsettling to me if my name is on the document or the document is on my letterhead. Attorneys, like everyone else, prefer to have paper printouts to work from so that we can highlight, make notes, etc. We also like to be able to reproduce a clean copy after we ruin the first one by writing all over it or dripping Russian dressing from our Reuben sandwiches on it while we eat lunch at our desks.

There is a way to solve everyone’s needs (beside offering extra napkins). Send the document to the attorney in portable document format (PDF), a file format created by Adobe Systems back in the early 1990s. Any document created as a PDF will maintain its formatting no matter what printer is used to print it or what computer is used to view it and you can also restrict whether or not someone can cut and paste or edit the document. Most people use the free Adobe^® Reader to view PDF files (which restricts cutting/pasting) but to create PDFs, you once needed to buy a full or professional version of Adobe Acrobat which will integrate into Microsoft Word 2007.

A free alternative is Bullzip PDF Printer, a program that allows you to create PDF documents from just about any Microsoft Windows program, including earlier versions of Word. Bullzip PDF Printer installs and operates as if it is a printer. You simply print to Bullzip PDF, supply the output file name and it will create the PDF file for you. Anyone with the Adobe Reader can open, view and print the file and it will look exactly as you intended.

Simply set your PDF document properties (protection level) and email it to your attorney-client. Now you can sleep without worrying about what’s happening to your legal nurse consulting work product after it has left your control.

Keep on techin’,

Tom

When you’re writing reports for your attorney-clients’ medical-related cases, one of the most important principles, no matter the size or type of report, is that if you provide theory, you are sure to provide application also. In other words, the theory must not only relate to the case, but you must explain the actual application of the theory to the case at hand. Theory alone is not enough. Keeping your reports based in the “real world” will make the real attorneys you consult with really appreciate you and your legal nurse consulting reports.

Success Is Inside!

The original Impressionists were considered radicals in their day as they departed from what was considered the “old-school” of artists. Time after time, impressionist painters would submit their work to juried art shows but their paintings would be rejected in favor of lesser artists who painted in the “approved” style of the times.

In order to exhibit their own works, these revolutionary artists rejected the establishment and formed their own society of painters – the Société Anonyme Coopérative des Artistes Peintres, Sculpteurs, Graveurs (Cooperative and Anonymous Association of Painters, Sculptors, and Engravers). Their first show was met with a firestorm of criticism and the term “Impressionist” was given to their artistic style as a derogatory term. The artists chose to adopt this derogatory term “Impressionist” and proceeded to make art history.

The “Impressionist” school captured the scenes they were painting without the strictures placed upon painters by the “Realism” school that was dominant at the time. They focused, or unfocused, on a new way of painting light into scenes of everyday life, rejecting the minute details of realism. When you look at an Impressionist painting up close, there is no detail – there are only short thick strokes and unmixed colors. When you stand back from the painting you see, with a realism not present in the “Realist” paintings, the diffused sunlight on a haystack, people strolling down a boulevard or partying on a Sunday afternoon in a park. The works come alive from a distance.

When an attorney-client is presenting a case to a jury, too many details can bog it down, distracting the jury and leading them down rabbit trails. Your job as a CLNC^® consultant is to help the attorney present the picture with the broad strokes and bold colors needed to show the case in its best light. Sure the underlying details will need to be there to back up your opinions and the attorney-client’s case, but sometimes it’s best to present an Impressionist view of a case to an attorney-client and then to the jury before breaking it down to the details.

They say you never get a second chance to make a first impression. What sort of Impressionist impression are you making on your attorney-clients?

Success Is Inside!

I am at the airport getting ready to leave for Paris with my Starbucks^® coffee in hand. After this long flight, I’ll be ready for that glass of red wine that always accompanies my Parisian breakfast. Click on the video to find out what legal nurse consulting, comprehensive reports for your attorney-clients and Paris have in common.

Success Is Inside!

Okay, I’ve got to admit something. You’ve heard me brag about my dual 20″ monitors on my desk. Here’s the confession. I’ve gotten to the point where I cannot work without two monitors staring me in the face. In my office, I keep my email open on one monitor (the right) so I can do the ADD thing as soon as something important that requires me to drop what I’m doing and immediately attend to someone else’s problem, drops into my email box. I do turn off the sound so the pinging doesn’t drive me totally bonkers.

The left (really center) monitor is my workspace. This is where I do the important things (write my Tuesday Tech Tips, surf the Internet and occasionally some real work). I’m constantly mousing back and forth between the two monitors. If I’m editing documents, I’ll keep one document open on one monitor and drag another to the other. I even accidentally discovered that in Outlook you can right click the calendar or email icons at the bottom left and open either in a new window! That way when I’m putting a deadline from an email into my calendar or preparing another list of my availability dates to send to President Obama, I don’t have to depend on my bad memory, I just look back and forth.

Legal nurse consultants, if you haven’t tried duals you’re missing out. These are even more fun than using tabbed browsing in Firefox to look at multiple websites. The possibilities are endless. I haven’t tried spreading a spreadsheet across the two… maybe later. Think about working on your reports for your attorney-clients. You can have the scanned medical records on one screen and your report on the other while doing research in the background.

“Tom,” you might be wondering, “you’re a lowly laptop user – how did you plug two monitors into a laptop?” Well the answer is simple. I’ve got my dock, and my dock has two different outputs on the back for monitors – a standard VGA output (old school) for the monitor I put on top of the dock’s built-in stand and a DVI output (modern). Probably the designers figured people would have one type of monitor input (VGA or DVI) so they were building-in choice. By buying a second monitor with the DVI output, I was able to plug in a second monitor!

Newer docks are already on the DVI bandwagon and often come with two DVI outputs as well as the one good old VGA output. Check carefully before you buy. After you get your dock, you simply match your monitors to the output and away you go!

If you don’t yet own a dock (or port-replicator in geek-speak) you can still run duals on your laptop. You simply plug a second monitor into your laptop’s output (VGA or DVI) then boot up the laptop keeping the screen open. Once it’s booted, right-click anywhere on the screen (desktop in geek-speak). Click Properties, click Settings and tell it to Extend my Windows Desktop onto this monitor or specify both monitors as Attached depending upon what you see. If you plug a keyboard and mouse into the laptop, you don’t have to keep it up close and can even mount it on a laptop stand to raise the screen to eye level.

Now it gets cool. You can drag the monitor icons on the Settings screen left or right. This allows you to place your second screen to the left or right of your main and then roll your mouse off the left or right (depending upon where you place your monitor) of your screen and right onto the second monitor. Your cursor can fly through the thin air between two monitors!

Desktop owners, don’t start crying in your beer (or Perrier) yet. You may be able to do the same trick since most newer desktop computers support dual monitors right out of the box. You could be ready and not even know it. Look on the back of your computer (don’t sneeze from the dust). If you can find more than one VGA or DVI outputs on the video card that sticks out from the back of your computer, then you’re ready to go. Buy a second monitor with inputs that match your free output, plug it in and follow the steps above to activate it.

If you only have one output (VGA or DVI) you can haul your computer to the local geek store and they can drop in a second video card or replace your current one with a card that has dual monitor support for under $100. If you really want to create monitor envy in your friends, instead of replacing your old single card – add the second dual port card. Then, if you have the wall space, you can have three monitors! You’ll triple your work output.

There is one other option for the spacially challenged. At home, I don’t have the desk space for duals, instead I had to compromise and install just one freakin’ huge 26″ wide-screen monitor. YEAH, BABY! It’s like sitting in the first row of a movie theater and I love it. It’s big enough that I can open two slightly narrower versions of the dual windows I use at work without feeling (too) compromised by the smaller space and it keeps me from getting claustrophobic. If you don’t have enough desk space for duals, take my advice and do the next best thing, “Go wide, young CLNC^® consultant!”

Time to tech-out here, so think about the duals. I’ve got to warn you – they’re addictive. Now, when I’m on a plane, train or automobile and I’m working from my laptop’s single (but wide) screen I can just about scream from frustration when I can’t work in the dual manner and style to which I have become accustomed.

Keep on techin’,

Tom

P.S. Comment and share your experiences with dual or more! monitors.

Even techies make New Year’s Resolutions and promises to themselves. Some even involve important things. My #1 resolution for 2009 – Install and learn Dragon NaturallySpeaking software (the cheap $76.99 Standard Edition). I’ve talked to way too many people who love this software to keep ignoring it. If you’re like me and can think faster than you can type, this is a tool to try.

I know many legal nurse consultants who end up spending more time concentrating on typing (dare I say pecking) their CLNC reports and end up losing those important thoughts before they can get them on paper. Typing wasn’t taught in nursing school, so chances are you’re not going to win any typing contests at 30 words per minute. The average person speaks at about 120 words per minute (those of you who know me figure I’m slightly above that) but I can’t type that fast (well, I can, but with 0% accuracy). This changes the equation.

The demo I saw just blew me away. Once you get used to this software you’ll be dictating all your reports, letters to your attorney-clients, grocery lists, to-dos and to-don’ts. I’m planning on installing this on Vickie’s computer in January. If Vickie can do it, you can do it. I’ll be giving you an update on how well it works and how easy it is to train your computer to recognize your speech patterns.

Be aware this program only works on 32-bit systems (not newer 64-bit systems). So before you buy, on your Windows-based machine: Open the Start menu. Click on Programs, then Accessories, then System Tools, then System Information. After the System Summary screen fills look on the right side of the screen for “System Type.” If it shows “x86-based PC” you have a 32-bit computer. If it shows “x64-based PC” you have a 64-bit computer. You can also look at the operating system line – if you are running 64-bit XP it will tell you. Another alternative method is to click the Start button, click on Control Panel, click on System and Maintenance, and then click on System. Under System, you can view the system type – it will tell you if you are running a 64-bit system.

Check back in about six Tuesdays!

Tom