recession proof

It’s hard to believe that in my lifetime I’d ever see layoffs in the nursing field. Like many of you, I remember the good times when there were billboards around my city advertising signing bonuses for nurses at local hospitals. That’s all changing. Two recent articles in the Wall Street Journal (1) (2) and one in the Washington Post are focusing on the fact that, while there is still a nursing shortage, there is now a shortage of nursing jobs. That sounds like a contradiction in terms but it’s not.

In a March 2009 report, the AHA revealed that 53% of the hospitals surveyed were operating at a negative margin or in plain English, they’re losing money. Hospitals in some areas of the country are reducing hospital staff. Just a year ago hospitals that were taking just about any skilled nurse who walked through the door are now finding it easier to be selective in their hiring. In short, this ain’t your mother’s nursing profession anymore.

If the news from nursing wasn’t already bad enough, there’s a news story about Dean Health System which announced its intention to “immediately” lay off 90 employees. This included a nurse who was assisting in a surgical procedure and was called out of surgery to be told she was laid off! Okay, I can understand cost cutting, but don’t you think it’s a little extreme to lay someone off in the middle of a procedure? Has the world just gone crazy? What if they’d laid off the anesthesiologist? Or the surgeon? I shudder to think of the consequences (Dr. Smith, please report to HR, stat!).

The good thing about legal nurse consulting is that medical malpractice and personal injury litigation is recession proof. Now that we’re seeing financial stress on hospitals and doctors, I believe we’re going to start seeing more and more medical and nursing malpractice as well as the delivery of substandard healthcare.

A recent study in the New England Journal of Medicine, showed that a fifth of Medicare patients were rehospitalized within 30 days of their initial discharge! When the pressure is on to cut healthcare costs by reducing care, testing and length of stay; as nursing shifts come under more pressure with fewer nurses covering more patients; and as healthcare continues to devolve into what I call the “Dark Ages of Medicine;” you can be sure that Certified Legal Nurse Consultants will be on the front lines working with attorneys to redress the wrongs that are certain to happen.

One of the things I like best about being a self-employed entrepreneur is that the only person who can lay me off – is me (and that isn’t happening any time soon)!

Stay busy!

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 nonmeritorious 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 nonmeritorious 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!

You’ve heard the news: bailouts for this industry, bailouts for that industry, bailouts for everyone except for the honest business woman or man. It seems like you have to be a pretty big crook or a terrible money manager to get a bailout from the government.

This morning, over some healthy green tea, my staff and I discussed what a government bailout might look like for the average entrepreneur:

• A pair of rose-colored glasses to help you to see the financial news in a better light.
• A lottery ticket to give you something for your retirement fund that has better odds than the stock market.
• A used TSA quart-size baggie containing leftover government office supplies (that you and I paid for anyway) such as bent paperclips, broken black binder clamps, stump-ends of staples and an empty bottle of white glue to help keep your business together.
• A roll of duct tape in case the above fails (BTW – here in Texas my friends call it “hunnert-mile-an-hour tape” and you can too – when your business gets rolling again).
• An open, and partially consumed, bottle of Jack Daniels (probably from the Treasury Secretary’s liquor cabinet) to help take your mind off your financial problems.
• A bottle of extra-strength Tylenol^® to help cure the effects of your late-nite discourse with “Gentleman Jack.”
• A bag of generic coffee to give you something to wash down the Tylenol^® that morning and give you the energy to go to work and focus on your business (and not the economy).
• And finally, a Travel Doodle Pro to help you stay in communication with your office after your Blackberry^® account is cancelled.

All of this would arrive postage due, in a damaged box, courtesy of the folks who brought you the sub-prime mortgage crisis and the Big Three bailout.

I’m hoping that it doesn’t come to this, but in a world that’s seeing its first big nursing layoffs, I’m glad I work in what my friend, Dale Barnes, (Check back for an upcoming interview with Dale) calls a recession-proof profession, legal nurse consulting. One thing’s for sure – the stock market may run short of money, but America will never run short of attorneys!

If the government is going to let the auto industry suffer and die, it won’t help entrepreneurs either. Don’t wait for the government to bail you out. Only you can bail yourself out.

Success Is Inside!