nurse

Ownership is a funny thing. We all like to own things: a house, a car, an iPad2^®, a legal nurse consulting business or simply a garden. Then we learn that there’s some responsibility that comes with that ownership. Stand up and look out the window. You probably don’t have to look far down your street to notice that some people are better homeowners than others.

There are some things we’ll probably never own (like that private jet I want) but one thing we all own equally is time. That’s right, we all get the same 24 hours every day and the only difference between us is how we regard our time and what we do with it. Time is one of our greatest possessions.

And just as I care about my home, I care about my time and, more importantly, care for my time. How about you? Maybe it’s time to step back and objectively observe yourself for a day or even a week. Are you a good steward of your time or do you squander it away?

For the record, I love to play as much as I love to work. I started a business to have a life, not to give up my life, and fortunately my New Orleans upbringing helps me to remember to do just that – to play on a regular basis.

Whether it’s work or play, it’s your time and what you do with it is your choice. I’m just sayin’…

Success Is Inside!

P.S. Comment and share the good and bad things you do with your time.

Vickie,

I am an independent Certified Legal Nurse Consultant, but for one attorney-client, I work in-house one day a week. I no longer want to work in-house, as I prefer to focus on the attorney-clients that hire me as an independent consulting expert. I am very successful and do not need this job but I don’t know how to tell the attorney without burning a bridge or damaging what’s been a great relationship. What should I do?

Liz, RN, CLNC

Hi Liz,

Congratulations on making a decision that will ultimately strengthen your CLNC^® business. Start by telling the attorney you are expanding your legal nurse consulting business and can no longer work in-house for him. Emphasize that you value your business relationship and will always be available to him as an independent Certified Legal Nurse Consultant. Next, give examples of how well this works with your other attorney-clients. Finally, emphasize the speed of electronic communication and your availability for personal meetings. Since you are already successful as a Certified Legal Nurse Consultant, you have very little to lose and the attorney-client has everything to gain. Go for it!

Success Is Inside!

P.S. Comment and share your tips for saying no to attorney-clients.

It’s a new year and I am reminded of a line from Sex and the City: “You don’t want to peak in high school.” Life and career are so much more interesting and satisfying when you constantly strive for your next peak. While most of your friends, family and coworkers have moved far past high school, you probably know someone who is still living, or constantly reliving, a “glory day” of scoring a winning point in a sports event, nailing a promotion or getting the biggest law firm in the city as a client for her CLNC^® business.

I’ve hit a few personal and professional peaks of my own: appearing on National Public Radio, Fox & Friends, becoming a New York Times bestselling author and staying happily married for 21 years. But I don’t want to be buried with any of those peaks as my crowning lifetime achievement. Why? Because I don’t want to peak – ever!

Some days we peak higher than others, and that can be okay. For example, I recently hiked in the Rincon mountains outside of Tucson, Arizona. It was a beautiful fall morning and our trail steadily climbed up and down until we reached the top of one mountain where we had a wonderful picnic lunch. There were higher and lower peaks around us, but the peak where we had lunch was a sunny, warm spot with a view of the Mission San Xavier del Bac in the distance as a bonus. That peak was perfect for that day, even though I’ve hiked more challenging trails.

People who never stop peaking are happier because they have something to look forward to besides the distant memory of past peaks, or even worse, high school.

Let’s all keep peaking in 2012! Happy New Year!

Success Is Inside!

You know that thing you have always wanted to do? I confess I am often perplexed by a person who can never for the life of them achieve a goal they’ve set for themselves. They set the goal, they want the benefits of achieving that goal and then that’s the end of it.

For example, a nurse wants to start a legal nurse consulting business to earn more money and have more free time for family. Great goal, but then the reality check: reaching that goal is going to require work, like working before it’s time to report to that full-time job at the hospital, plus working again after getting home from that hospital job and, oh yeah, working on that coveted weekend off. And did I mention work?

I spend a lot of time with nurses all over the U.S. Some of them have a difficult time relating to my success until I remind them I started out just like they are going to have to – with a full-time job at the hospital. Plus, I had to work overtime just to pay my mortgage. To launch my legal nurse consulting business, I was going to have to work. That was okay. After all, nurses aren’t afraid to work. When this mouthy, opinionated, Italian girl faced the choice of working really hard for the rest of my life at a dead-end job, or to get to work on me, you know what I chose.

If you want to succeed as a Certified Legal Nurse Consultant, today I only have three words of advice: Get to work!!!

Success Is Inside!

We all know the person whose life would be totally different and of course much better if only “Y” had happened instead of “X.” The mantra never changes. “If Y had happened, then I could have done X” or “If only W had done Z, then my life would be different” or “If Q was different, I’d be different” and, my personal favorite, “If only Y had happened, I’d be happy or successful or married,” or whatever.

What successful people, especially successful Certified Legal Nurse Consultants, do is live in the world of “what next”, not in the world of “what if”. If an attorney-prospect says “I’m interested, let’s stay in touch”, the CLNC^® consultant knows what’s next and does just that. The CLNC^® consultant doesn’t go into the space of “If the attorney had just given me the case today, I’d be on my way to quitting my job at the hospital.”

The first attorney-prospect I connected with asked me to call him two weeks later because he was preparing for trial. I waited two weeks and called, but he never returned my call. I called again; he still didn’t return my call. I called a fourth time and on that day he took the call. The rest is my legal nurse consulting history. It wasn’t easy during those waiting periods, but I stayed out of the “what if” space and just continued to move in the “what’s next” space. I didn’t allow “If he didn’t have that trial then…” or “If he’d just returned my phone call then…”; if I had, I predict I never would have made the fourth call and I wouldn’t be where I am today.

The only “what ifs” in your life and your legal nurse consulting business should be the “what if” questions you ask yourself about what you should be doing at this very moment.

• What if I make five sales calls right now?
• What if I practice my interview questions before I meet with that attorney-prospect?
• What if I call that attorney-client back right now?
• What if I turn off that TV and turn on my commitment to taking action on my legal nurse consulting business?

Now it’s my turn to ask you a “what if” question. What if you did all these things you know you’re supposed to do? Answer: Hmmm.

Success Is Inside!

An email titled Send This to Everyone in New York Who Handles Nursing Malpractice Cases was forwarded to me by one of my attorney-clients. The author was the managing partner of New York City’s largest medical malpractice firm. For the last six years, I had been trying to think of a creative way to get referrals from this firm. Vickie’s blog on intuitive vision was still fresh in my mind. I knew immediately that I had to stop reviewing a complex medical record, put the day’s usual business on hold and focus on this potential opportunity.

This partner described a complex home health care case that had been won by the defense and just reversed by the appellate court. Essentially the court opined that the RN who administered an IV steroid as ordered by the physician was negligent for failing to ensure that epinephrine, which was not ordered by the physician, was available in case the patient experienced anaphylactic shock. I decided to get a little playful and titled my email My Two Cents. I started my opinion in a succinct, professional manner.

To my surprise, the response came in the form of an immediate phone call from the partner himself. My CLNC^® education from Vickie Milazzo Institute prepared me to deliver my two-minute unique selling position (USP). I was thrilled to be invited to discuss my experience with nursing chain-of-command issues at the law firm.

The attorney scheduled a full hour with me prior to the presentation, and after 15 minutes, he called the RN in charge of coordinating nurse expert reviews. He said, “Put Margaret at the top of the list for expert reviews.”

The presentation was attended by 74 attorneys who work solely with medical malpractice cases. Within a week of that presentation, I started to receive referrals and cases.

Acting on my intuition that day not only opened the door to an ongoing opportunity, but also helped me to grow my CLNC^® business even more.

Guest Blogger Profile

Margaret M. Gallagher, RN, BSN, MSN, CLNC has been a staff nurse, RN educator and senior nursing and hospital administrator for over 30 years. She founded Patient Care Executive Consulting in 2004 and became a Certified Legal Nurse Consultant in 2005. She is an assistant professor at Wagner College in Staten Island and has reviewed over 800 medical malpractice cases.

Remember when you were in grammar school and had to write reports? Remember how the students with the best handwriting always got better grades? When I clicked to that fact I concentrated on making my handwriting as neat as possible, hoping to score a bonus point or two. And except for my grades in conduct, I did a great job of accomplishing that goal.

First impressions are indeed lasting in all aspects of life and that fact is especially true for Certified Legal Nurse Consultants and their attorney-clients. My first subcontractors were my typist’s children. She had eight kids and I used seven of them in my business through the years. They became excellent assistants, pulling the results of my research from the shelves of the medical library. I personally taught each and every one of them the art of making flawless, straight copies of those research studies. Their work contributed to the first impressions I was making with my attorney-clients.

My typist and I were both equally attentive to the appearance of the reports. By the time the attorney sat down to absorb them he was ready. Nothing (no typos, bad formatting or messiness) was getting in the way of his receiving, accepting and trusting my opinion. Our attention to impression also contributed to those attorneys becoming long-lasting clients.

Today I critique a lot of work product from legal nurse consultants and sometimes my best advice is “Go back and create a new first impression, because if you don’t, you won’t get a second chance with that attorney.” Your legal nurse consulting business, like life, isn’t a video game. You won’t get a mulligan, do-over or a reset button on an attorney-client.

You rarely get a second chance, so make your first impression count for real the first time.

Success Is Inside!

My favorite vacations include hiking. The more remote the trail, the more I enjoy the experience. While I don’t mind seeing people, I much prefer to share the trail with wildlife than “wild life.” Being in the woods recalibrates all of my senses and rebalances me.

I’m not the fastest hiker and I’m probably not the slowest either. But a common question I get when I share a hiking experience is “How many miles did you hike each day?” as though my answer could give them any insight into the experience. Like most sports, the time or distance alone tells an incomplete story. The experience is also about the intensity which is influenced by high altitude, elevation gains, trail conditions and even the weather.

Walking in my home town of Houston poses little challenge and because it’s so flat I can’t even call a 6-mile walk a hike. That makes it easy to walk but presents challenges when I’m trying to train for a real hiking trip. Over the years I’ve hiked in all sorts of conditions. The coldest hike (snow-shoeing really) was in sub-zero temperatures in Colorado’s Rocky Mountain National Park and the hottest hike was across a lava field in Hawaii’s Volcano National Park. The worst conditions I’ve encountered were in the Torres del Paine mountains of Patagonia, crossing a long section of loose scree along a precipice during a cold and driving rainstorm and the scariest were in a grizzly bear-filled section of thick forest in Alaska (I let Tom carry the food pack on that hike). I enjoyed every one of these trips – especially after I was back at the lodge with a healthy glass of red wine in my hand.

The toughest and most intense hiking I’ve done was in Nepal. There, in the beautiful Himalayan mountains, I encountered not only long distances (one day I hiked 12 hours, not counting breaks), but also large altitude changes (I live at sea level) and thousands of stone steps. I couldn’t even tell you the distance I covered – I don’t remember, only the intensity of the experience remains.

When hiking, the intensity presents itself to you if you let it. The more intense the conditions, the stronger your body becomes. Over time you’re not only able to cope with the intensity but you miss it when it’s not there for you, like I do when I’m back home in Houston.

Intensity is easy to find when we’re in the woods or mountains. But what about when you’re in your office working on your CLNC^® business?

When you’re analyzing a medical-related case you have to create the intensity and the challenge. You have to consciously go deeper and faster, challenge your own assumptions and produce a work product that is richer than the last. The next time you sit down to work on a case, don’t ask yourself how many hours you worked, ask how intensely you worked. Your output is directly influenced by the answer you’ll be able to give to that question. I’ve often wished I could bill by the intensity, not the hour. What about you?

Success Is Inside!

Vickie,

When proofing a revised draft of a contract for my CLNC^® business, do I really need to read it word for word?

Julia, RN, CLNC

Hi Julia,

That’s a great question. Of course everybody’s preference is to generate a contract that will not require revisions. This works well with legal nurse consulting subcontractors who usually sign our contract without revision requests. This allows us to quickly move on to doing business together. In 29 years, I have only had two subcontractors request minor changes to our form contract. With vendors though, negotiations are more common. Especially with large vendors, it’s not unusual to have 5-10 drafts, depending on the vendor, size and type of contract (IT services company, software, hotel, etc.).

Once the negotiations start and the versions start flying back and forth, I often joke (or not) that I’m getting drafted to death, but sometimes it’s necessary. As the number of versions increases, it can quickly get harder and harder to keep track of the changes. One way I keep track of the documents is by writing “Live” and “Past” along with the dates on the top of each hard copy version. My preference is to proof a hard copy rather than the electronic version. Most of us read and proof more accurately from paper than from a computer screen. Also, I keep all printed and electronic versions in file folders for easy reference.

With Microsoft^® Word, you can use the track changes feature which shows the additions and deletions made by the parties. The document can get pretty “busy,” so once we hit a certain level of agreement on the changes I’ll accept the changes/deletions to create a “clean” document. Then we can continue the editing process, but fresh, with fewer changes to track.

When reading a contract from one draft to another, the experienced Certified Legal Nurse Consultant will always read and compare each draft to the prior draft word for word to ensure that nothing has been deleted or added either accidentally or intentionally. Word processing errors and text drops do occur, despite the best intentions of the parties involved. The best way to do a comparison reading is to lay each contract side by side and read and compare them one paragraph at a time.

“Lazy” legal nurse consultants can also just compare the first or last word in each line of each paragraph in one contract to the other to ensure they match. This isn’t a perfect system but can be quick. Another more accurate but still “lazy” method is to hold each page from the contract against a sun-lit window and then lay the corresponding page from the other draft on top of the first page. You can then compare text and look for text drops or spacing changes. I shouldn’t even be telling you these “lazy” tricks because neither of them should be considered a replacement for a full read, especially on the final executed copies.

When you finally sign the paper copy of the contract you’ve so carefully negotiated, you want to be sure that what you get back from the other party is what you sent them. My solution is to initial and date the bottom of each page in blue ink. When the fully-executed copy is returned to you, it will be clear there have been no page “substitutions.” We also sign our contracts using blue ink. This will always help you distinguish the original from a copy. If we’re sending the final versions over for signature, I sign the contract in advance. This process helps guarantee the other party signs the copy we sent.

We often scan and email a signed copy of the contract and we accept scanned copies of executed contracts as final. What matters to the Institute is that we have a final signed contract, no matter the method by which it is sent.

Finally, make sure you file the original signed version in a secure location (hard copy and electronic) so that you’ll be able to locate it quickly. Be sure to calendar the expiration of the terms and the dates of any notices that must be filed.

Success Is Inside!