CLNC

My heartfelt gratitude and appreciation to all the Certified Legal Nurse Consultants who attended our successful 2009 NACLNC^® Conference in San Antonio. Our sell-out gathering was a spectacular event, and I hope you had as much fun as I did. It was great to see and talk with all of you again.

I’m sure you’ve already started to “Move Like a Maverick” for more breakaway success in your CLNC^® practice. Here are just a few tips to get you started as you execute the new unconventional strategies that only CLNC^® mavericks know.

1. Decide on one new CLNC^® service you will provide to every attorney-client. Offer to provide that new service the first time for a discounted rate to get them hooked.
2. Reconnect with your attorney-clients by sending a note to let them know you’ve attended this conference for additional education and to renew your CLNC^® Certification. Remind them that this is your way to better serve them and their clients.
3. Send a news release to your community newspaper announcing your completion of this advanced Certified Legal Nurse Consultant training and renewal of your CLNC^® Certification.
4. Commit now to review your 2009 NACLNC^® Conference textbook and all the meaningful notes you took. Listen to the audio recordings of the conference once a week, once a month and once a year after the conference. Repetition helps you integrate and implement the principles and strategies successfully. With each review, you will hear the information in a new way because you’ll be more experienced. Each time you listen, you’ll generate even better ideas. After each review create three new action steps to propel your CLNC^® business to the next level.
5. Continue your success: mark your calendar and sign up now for the 2010 NACLNC^® Conference where you’ll Take the Stage for Legendary CLNC^® Success in Nashville, Tennessee.

We’ll be posting the 2009 Conference photo gallery on “Vickie’s Blog” soon so be sure to check back.

Success Is Inside!

P.S. Please post your comments and share your favorite personal experience at the NACLNC^® Conference.

Welcome all Certified Legal Nurse Consultants who have stormed San Antonio for the 2009 NACLNC^® Conference. I hope you’re as excited as I am about our keynote speaker, Stedman Graham.

Since our Conference theme is Move Like a Maverick for Breakaway CLNC^® Success here are some tips that will help you maneuver through the Conference like a maverick.

1. Start Day 1 off with some fun. Don’t miss out on Texas-style mariachis at 7:00am on Thursday followed by my opening Move Like a Maverick for Breakaway CLNC^® Success.
2. Turn off your cell phone, pager, chiming watch and any other stress-producer you’ve brought with you. This is not only a courtesy to your fellow CLNC^® peers, but also a courtesy to yourself, honoring all you’ve invested to be here.
3. Limit checking your email and voicemail or calling home to just once a day.
4. Be open to all the new recommendations so you can achieve bold CLNC^® success with your legal nurse consulting business.
5. Meet and get to know two new CLNC^® consultants at each break and reception. Eat lunch and dinner each day with three CLNC^® consultants you don’t know. Sell your expertise to each other. You are each other’s best resources for future CLNC^® subcontractors and experts.
6. Practice positive masterminding. Connect with two other CLNC^® consultants and mastermind together at the end of the day. Each of you will process and apply information differently. Focus only on positive ideas for your CLNC^® business. By coming together, you’ll take home new strategies you wouldn’t think of alone.
7. Remember to sign up for your professional photo session while at the Conference to add to your legal nurse consulting website.
8. Don’t miss a session. Go in positively knowing that a single idea can increase your profitability 1%, 5%, even 10% and more.
9. At each session, write down at least one action step you will take to grow your CLNC^® business.
10. Commit to learn one thing from each speaker. While every presentation is packed with useful information for you, the key is being in the right mindset to grab the ideas when they come your way. I once attended a seminar where only 5% of the information was interesting and fresh. But the ideas I got from that 5% added to the growth of my company by as much as 10%. Because I was committed to learning, my mind was ready when the “good stuff” was presented.
11. Take the information presented and create your own new ideas. My goal when I sit in on a session is to come up with ideas that are even better than any I get from the speaker. This mindset will help you achieve a unique CLNC^® business – not a look-alike imitation of someone else’s.
12. Take it easy. If you allow yourself to get frustrated about anything – an airport delay or the person sitting next to you – you’re the only one who will suffer. Stay loose. If you aren’t happy with the person sitting next to you, sit next to someone else in the next session or get up and move. Stay upbeat and attract positive energy.
13. Exercise daily – even for only 20 minutes. Get outside the hotel and renew yourself. Take a brisk walk around the block. Visualize your CLNC^® experience as you indulge in a massage or relax in a hot tub. Treat yourself to a fun memory – buy a Texas souvenir.
14. Remember to put on your comfortable CLNC^®Wear so everyone in San Antonio will know you are a Certified Legal Nurse Consultant.

Check back on March 16, 2009, when you can read my tips in Plan Your Moves After the 2009 NACLNC^® Conference.

Success Is Inside!

P.S. The quickest and easiest way to find me is at the Vickie Milazzo Institute exhibit.

P.P.S. Please comment and let me know how you’re enjoying our Conference.

I’m celebrating my birthday today and want to thank all of you who sent the fantastic cards, emails and presents. Your generous thoughts, prayers and messages mean so much to me. (Whoever sent the 2005 Chateau Petrus Pomeral… you really shouldn’t have.) Also, I would love to share what Tom has planned for this evening, but this blog is rated G. Suffice it to say, “What happens in Texas, stays in Texas.”

Each day I strive to wake up a new and different person and on my birthday I like to think I’ve become a lot more than just a year older.

Whoever says you can’t defy gravity as you get older has merely lost sight of who they are and stopped dreaming. I’m not one to be content riding the surface of life. I like to go all in – which my Italian heritage certainly trained me for.

Every year at the NACLNC^® Annual Conference I walk down the aisle and up to the stage to sing our CLNC^® national anthem with a ballroom full of excited and exciting CLNC^® consultants. To some (especially the introverts in the audience), I probably look foolish. And that’s one of my favorite strategies for NOT aging – daring to look foolish, but not too foolish (no karaoke for me).

In 1982 I started my legal nurse consulting business and pioneered the profession because I didn’t want to be shackled by someone else’s boundaries; especially those defined by hospital administrators and doctors. I didn’t want to stay the line. To succeed, I had to be willing to appear foolish along the way and sometimes do things that appeared foolish to other, shall we say “less imaginative,” types. As Sri Sri Ravi Shankar so eloquently wrote: “A fool is somebody who does something very unique, which is not accepted by others. What is wrong with being a fool? What is wrong with standing alone, apart from the crowd? Let the crowd act however it wants. I stand apart from that. I act my way.”

If you are never foolish in your life at least some of the time, you miss your life and the joy in it.

When your birthday comes around I wish for you the gift of defying gravity. Refuse to accept the limits that others define for you – both in your personal life and your legal nurse consulting business.

You CAN have all you’ve ever wanted, if only you dare to occasionally appear foolish to those who steadfastly stay the line. Give yourself the gift of acting and maybe looking foolish. After all, it’s your birthday – they make those silly hats for a reason – to foolishly have loads of fun.

Wherever you are on your birthday, I hope you hear my “Happy Birthday” greeting and this, my birthday message to you.

Happy Birthday whatever day yours is!

Success Is Inside!

Even though I grew up in New Orleans, I love Texas, where I’ve lived since my college days. I agree with native Texans who say you never have to leave the state to experience what all the other states can offer put together. So, for the students and Certified Legal Nurse Consultants coming to the 2009 NACLNC^® Conference on the San Antonio Riverwalk, March 12-13, 2009, here are just 15 fun ways for you to enjoy your Texas-sized weekend.

1. Stroll the Riverwalk. Almost 2½ miles of footpaths, shade, restaurants, secret gardens and shopping. It’s magical in the evening when the trees are lit up, and your mouth waters from the delicious aromas coming from the fantastic array of restaurants.
2. Have tacos for breakfast. It’s the Texas way to start your day. Spice it up with some chorizo (Mexican sausage). Margaritas are optional.
3. Remember the Alamo! Yes you can’t go to San Antonio without a visit. Make sure you see Davy Crockett’s buckskin vest (bring your own coonskin cap).
4. Visit the Menger Hotel. Have a drink in the bar where Teddy Roosevelt recruited cowboys, cattle rustlers and Texas Rangers to form the Rough Riders he later led to fame in the famous charge up San Juan Hill. Take a wander around the hotel while you’re there – you may see a ghost (even before that drink).
5. Do your souvenir shopping at Market Square. You’ll find all the marimbas, maracas, piñatas, sombreros and coonskin caps you can carry as you walk these fun, pedestrian-only streets.
6. Take a meal at Mi Tierra Cafe y Panaderia. A San Antonio landmark, at least for tourists. It’s a great place to eat your first baby goat (cabrito – a Mexican delicacy). If someone’s already gotten your goat, then go to the panaderia (bakery) for some terrific Mexican-style pastries – a great choice any time of day!
7. Visit the world-famous Buckhorn Saloon and Museum. Proudly serving beer since 1881, it’s also home to the Hall of Texas History Wax Museum. Speaking of horny, it has over 1,200 trophy mounts from more than 500 species and “Old Tex,” the world’s largest mounted longhorn with horns that span eight feet, nine inches.
8. If you have a car, take a potty break at the Toilet-Seat Museum. It’s just ten minutes north of the city and I don’t think I need to say any more.
9. Military nurses might want to visit the Army Medical Department Museum at Fort Sam Houston (just one of four military bases in the San Antone area).
10. Eat a moveable feast by arranging for dinner on any of the barges that float up and down the San Antonio River – it’ll be a night to remember.
11. Think your spouse has big feet? Then go see the world’s largest pair of cowboy boots at the North Star Mall near the airport. At almost 40-feet tall and 20-feet long they’re even bigger than my husband’s feet.
12. Beat the heat with a root beer at Schilo’s Deli that is served in a frosted mug with a frothy head. Schilo’s has been a local destination since 1917. My favorite reason to go there – your second mug is free!
13. Ride to the top of the Tower of the Americas and look out over the beautiful Texas Hill Country – you can even wave to your ground-hugging CLNC^® friends far below.
14. Take a walking tour of San Antonio’s first neighborhood. La Villita is now a thriving art community that stands as a monument to San Antonio’s past.
15. Send your family to Six Flags Fiesta Texas for the day. They can feel like Superman on the Krypton Coaster, beat the heat in the water park or just hang out in the kiddie park. Whatever the age of your children – 5-55, they’ll love it!

Before you set out on your maverick tour of San Antonio, remember to come prepared to keep the pace at the 2009 NACLNC^® Conference.

• Come relaxed and ready to discover new ideas. The NACLNC^® Conference is much more fun when you’re rested, and you’ll learn so much more if you leave your stress behind.

• Pack energy bars, raw nuts and other healthy snacks to maintain your energy. The “Betcha Can’t” margaritas wear off quickly.

• Bring plenty of business cards to swap out with the 1,000 new CLNC^® friends you’ll meet.

• Go online and print the NACLNC^® Conference textbook sessions you plan on attending.

Have a great trip and check back on March 11, 2009 to read my tips on how to Master New Unconventional Strategies During the 2009 NACLNC^® Conference.

Success Is Inside!

P.S. Comment on your favorite fun things to do in San Antonio.

According to the Western Hemisphere Travel Initiative (WHTI) U.S. citizens traveling by land or sea to Canada, Mexico, Bermuda or parts of the Caribbean must show proof of citizenship in the form of either a passport, passport card or WHTI-compliant document (government-issued photo ID and birth certificate) to get back into the good ole’ USofA. So, if you’re a Certified Legal Nurse Consultant who is considering a future NACLNC^® Conference cruise, you’ll need to have one of the above to get back to your home office once your ship comes in.

The easiest form of proof of citizenship is the government-issued photo ID and birth certificate copy. Just make sure you have a readable, notarized copy of your birth certificate. Next easiest might be the so-called U.S. Passport Card (good only for land/sea travel – not international air travel). This is handy if you live near a border crossing and travel on a regular basis to meet your attorney-clients in such exotic locales as Tijuana or Montreal.

If you’re getting a new passport for traveling overseas as part of your CLNC^® business, or just for fun, you might be surprised to know that you’ll get one of the new e-passports. That’s right, an e-passport. Beginning in August of 2007 the Department of State has issued only the new RFID chip-enabled e-passports.

What’s the buzz about RFID? RFID chips are radio frequency identification devices that are really tiny microchips you can implant in an item of inventory, a pet or just about anything. Depending upon the strength of the chip, you can use it to identify and track inventory in and out of a building, the movement of chips around a casino (and betting patterns), the location of your French Poodle (not husbands yet – sorry Vickie) and today – an e-passport.

According to the U.S. Department of State, RFID chips in e-passports make them easier to scan and less prone to counterfeiting. Assuming (correctly) that even paranoids have real enemies, it is theoretically possible for the proverbial bad guy to walk through a crowd with a cell-phone-sized receiver and pick out the passport-carrying American citizens by the signals their passports give off (and not by their “I’m with Stupid” t-shirts and sneakers).

This frightened me until I learned of a solution – MobileEdge makes an ID Sentry Wallet that surrounds your passport in a cool-looking leather case that contains an imbedded shield that blocks the RFID signals from escaping. This turns you into just another face in the crowd. It does not interfere with the passport and so, is completely legal. By the way, the U.S. Passport Card also has an RFID chip embedded in it, but it comes with a shielded sleeve when you receive it from the government.

Paranoid? Maybe I should be. Safe? You bet I am. This ID Sentry Wallet is the best $30 travel accessory you can buy if you plan on going anywhere your passport can take you. Now, when you’re cruising the markets in Bariloche, Bangkok or Bumthang you can stop walking backwards in fear someone will sneak up behind you.

Keep on techin’,

Tom

Whether you are screening medical malpractice cases for plaintiff or defense, as a Certified Legal Nurse Consultant, you should be on the lookout for those obvious meritorious cases. When you see them, the red flags go up as long as there is significant injury or death. For example, maternal death gets everyone’s attention. The plaintiff CLNC^® consultant’s response is – this is one the plaintiff attorney should absolutely represent. The defense CLNC^® consultant’s initial response is – the defense should settle and settle fast.

Plaintiff attorneys usually want to see significant injuries, even in obvious cases of medical malpractice. They have to weigh the cost of litigation against the return. They must consider if it makes sense. They don’t want to spend $150,000 to win back $250,000.

The Centers for Medicare and Medicaid Services (CMS) recently made it so easy for plaintiff attorneys to successfully litigate 13 types of medical malpractice cases that plaintiff attorneys may be more willing to take on these 13, even if the damages do not meet their usual expected criteria.

To start at the beginning, the National Quality Forum (NQF) endorses a list of 27 serious, preventable and reportable “Never Events.” CMS, issued a ruling last year, effective October 1, 2008: CMS would no longer reimburse for 10 selected “Never Events” – events that should never happen and which are clearly caused by the hospital and/or its staff. Then, effective January 15, 2009, CMS issued another ruling adding three additional, surgery-related “Never Events.” In other words, CMS is trying to save lives by saving money.

Cases involving “Never Events” account, according to AON, for a large percentage (12.2% or more) of medical malpractice claims and will be difficult to defend and easy for the plaintiff attorney to settle fast, thus reducing their litigation costs. Insurance companies will fear taking these cases to trial and losing at great expense. They can settle out of court cheaper.

“Never Eventland” provides the perfect playground for a law firm’s new, young and inexperienced associate attorneys to practice on.

Add these 13 CMS “Never Events” to your “Plaintiff Alert Signal” list.

1. Unintentional retention of a foreign object after surgery.
2. Air embolism.
3. Blood incompatibility.
4. Pressure ulcers (Stages III and IV).
5. Hospital-acquired injuries from falls and certain traumas (fracture, dislocation, intracranial injury, crushing injury, burns and/or electric shocks).
6. Manifestations of poor glycemic control.
7. Catheter-associated urinary tract infections (UTI).
8. Vascular catheter-associated infection.
9. Deep vein thrombosis (DVT) or pulmonary embolism following total knee replacement and hip replacement procedures.
10. Surgical-site infections following certain orthopedic procedures, mediastinitis following coronary artery bypass graft (CABG) and/or following bariatric surgery for obesity.
11. Surgery on the wrong body part.
12. Surgery on the wrong patient.
13. Wrong surgery performed on a patient.

Educate your attorney-clients about “Never Events.” Offer to do a 20-minute presentation for all of the attorneys in the law firm. Even with attorneys, small wins are good.

Success Is Inside!

Read Part 1. Read Part 2.

How has your income level changed in this economy?

Dale: Vickie, I’m proud to say that last year I was a little ahead with my legal nurse consulting business compared to the prior year – which is saying something when so many other types of businesses experienced a downturn. I’m going to be away for most of January, on a trip to East Africa. People are amazed that I can afford to leave my business during this economy.

Every attorney I have a case with or who I am on the verge of getting a case from will have a contact number to call me directly, if I’m needed. I also have someone for them to call if they need a live body to take care of something while I’m gone. And I’ll be in contact with everyone by email. I’ll never disappear so that a client can’t find me, which gives them a level of comfort yet doesn’t keep me anchored to my desk. That’s one of the joys of being a CLNC^® consultant.

Do you still love being a Certified Legal Nurse Consultant as much as you did in the beginning?

Dale: More. I’m 60 years old and I can’t imagine ever retiring. Every case is different. Every situation is different. People often ask me what a typical day is like. There isn’t one – and that’s what I love about what I do. I feel like Columbo putting the pieces together in a puzzle that deserves my special kind of CLNC^® expertise, and it’s fun.

I think being a CLNC^® consultant is the best of all worlds for RNs. We get to use our nursing experience and expertise, we get to use our brains and we also get to be independent. We interact with people who appreciate us – working with attorneys is much better than working with physicians. Attorneys think we’re terrific.

Any CLNC^® consultant who is feeling bombarded by bad news in the media should just ignore the economy and keep doing what they’ve been taught by Vickie Milazzo Institute. The legal nurse business is out there, perhaps more than ever before. Attorneys need us, perhaps more than ever. Keep marketing, keep the lines of communication open and you’ll get where you want to be.

Success Is Inside!

Read Part 1. Read Part 3.

Obstacles have to be overcome in every economy. What obstacles are you facing now?

Dale: Vickie, my biggest obstacle is time. Particularly trying to squeeze in time to continue marketing every month. I’ve been a CLNC^® consultant for 9½ years, so I don’t have to market at the same level I did in the beginning, but I know that being busy is no justification for not marketing. You taught me to always keep marketing to assure the phone is ringing.

Another challenge during a tough economy is maintaining attorney-client relationships with attorneys who may be dealing with the stress of their clients. Do you have any suggestions?

Dale: One word: communication. In any situation, that’s the factor that enables me to enjoy an excellent relationship with my attorney-clients and to keep them coming back. I’m always a phone call away, and I never let much time pass without being in touch. But more important, anytime I decide to go a different route on a case from what we’ve discussed, or when I have some new ideas, I don’t go forward until I call and talk to my attorney-client. Usually, they’re fine with whatever I’m suggesting as the Certified Legal Nurse Consultant, but they appreciate being kept in the loop. Then, if they get a bigger bill at the end of the month, they’re not startled. Nobody likes surprises of that nature.

Also, if I see something in the record that’s not good for the attorney’s case, I pick up the phone quickly and lay it on the line. It may not be what the attorney wants to hear, but he always appreciates the heads up.

Forging ahead when the world is taking a “wait and see” position shows a very independent and entrepreneurial disposition. How has your independent streak contributed to your CLNC^® success?

Dale: Tremendously. Every day I do what I can to make certain my business is secure, my work is secure, that I have all my ducks in a row and that I have new business coming in. When the world seems to be falling apart around you, everything you do in your legal nurse consulting business takes on a different level of importance. For me, it’s about maintaining what I have and gaining a little too.

What is your best piece of advice to CLNC^® consultants getting started right now?

Dale: My biggest piece of advice is to be prepared for rejection and frustration and to keep plowing ahead. It will pay off. CLNC^® consultants who say, “I’ve spoken to ten attorneys and nobody’s interested,” are going to lose out. Business is a numbers game, and ten attorneys are nothing. Even CLNC^® consultants in rural areas, where attorneys are not as numerous as in cities, can succeed handsomely in their CLNC^® business. You don’t have to market only in your own backyard. You can market anywhere.

In any economy, you need to make a marketing plan and stick to it. Whatever marketing methods you use – whether contacting attorneys in person, on the phone or via mail – be consistent and follow your plan. And always follow up.

Vickie, you always say, “Do what works, not what’s easy.” I’ve known legal nurse consultants who created their marketing packet, mailed them, then sat back and waited for the phone to ring. They were surprised when no one responded. The same thing happened to me. Even when I sent out ten letters and followed up with a phone call, at least half the attorneys said they never received my packet and had no idea who I was. Attorneys, like the rest of us, toss mail they don’t readily recognize.

So I call my attorney-prospects before I mail anything. It takes more time but new CLNC^® consultants should try it.

If you can’t always get through to the attorney, that’s okay; ask for their voice mail. The attorney gets to hear your voice, who you are and why you’re calling. A brief voice mail presentation lets him know that you’re a professional who understands his legal practice. He knows you’ll be sending a packet and that you’ll be following up. I get a much higher success rate when I call first.

Success Is Inside!

Read Part 2. Read Part 3.

For the first time in my memory nurses are getting laid off in significant numbers. The deteriorating health of our economy is affecting almost every U.S. job – this includes nursing. But as I am hearing from the registered nurses I’ve trained, a career as a Certified Legal Nurse Consultant is a recession-proof choice.

My sincere gratitude to Dale Barnes, RN, MSN, PHN, CLNC for taking the time to talk with me about how the economy has affected the health of her CLNC^® business. Dale has been a CLNC^® consultant since 1999 and specializes in medical malpractice, bad faith insurance and general personal injury.

How is today’s economic climate affecting your CLNC^® business?

Dale: Vickie, I’m here to tell you working with attorneys is recession proof. I’m busier than ever. Everything a CLNC^® consultant does is related to medical issues and healthcare, and those cases are still pouring in. During a tough economy, some people look at a lawsuit as another revenue stream. So attorneys are busy. Even when I tell my attorney-client, “There’s no merit here,” I still get paid, plus it keeps non-meritorious cases out of the system.

Are new attorneys approaching you?

Dale: Just last week a new attorney called and hired me as a legal nurse consultant for his bad faith insurance case. When people are financially strapped, an insurance claim becomes an asset. The claimant expects the insurance company to cover everything so when a claimant feels undercompensated or cheated, they call an attorney.

What other kinds of medical-related cases are you seeing?

Dale: Everything. I just finished a large home care defense case. A man’s wife had multiple sclerosis, and he was her sole caregiver, refusing to have anyone else in their house. Over the years, as his wife’s health deteriorated, the home care nurses noted that he was noncompliant with instructions for his wife’s care. He wouldn’t turn her every two hours, as directed, and she got one decubitus ulcer after another. She had a Foley catheter for a time and got a urinary tract infection. When she finally turned septic and died, the husband filed a suit, claiming that the wound care supplies the nurses used had caused her infection. This was off base, but the case went on and on. He was obviously trying to make a buck. I helped the defense put together a strong case, and the husband struck out.

You must have felt like a CLNC^® champion on that case.

Dale: Absolutely. I had another case recently that involved using restraints on a hospital patient. The nurses had orders to use restraints but decided not to. The woman fell out of bed, suffered a subdural hematoma and died. A terrible situation, in which fault and liability are not clear.

So the types of cases run the gamut. I’ve had a number of motor vehicle accident cases. I have one attorney-client who does nothing but dog bites, and he sends me several cases every week. They take a long time to come to fruition, because the cases usually involve children, but this attorney’s business isn’t down one bit, and I’m still getting all of it.

Do you handle more cases for defense or plaintiff attorneys?

Dale: About equal. Whichever side I’m on, if I see a weakness, I tell my attorney-clients up front. And, as you teach, Vickie, we are saving our court systems time and money by keeping non-meritorious cases out of court – another plus in a down economy.

Do you use a network of CLNC^® consultants as subcontractors to help you with your busy caseload?

Dale: Yes. I use CLNC^® consultants for two reasons: 1) to leverage my time during those periods when my caseload is just too much for me to handle, and 2) when I get a case that is out of my area of expertise. Being part of the National Alliance of Certified Legal Nurse Consultants is the best place to look for my CLNC^® subcontractors.

Success Is Inside!