writing reports

As a Certified Legal Nurse Consultant, you will frequently give attorney-clients verbal opinions on medical-related cases, but you will also render written opinions on cases. When it’s time to sit down and compose your written report, you want to do so fast and you want that report to be the best it can be.

I love writing reports. Let me qualify that statement. Once I’m writing, I love writing. Sometimes I’m challenged to get into the writing and I will find all kinds of excuses to avoid getting into the writing process – urgent emails, seminar preparation, the toilets need cleaning…you get the idea.

Here is a five-step writing process for composing reports of all lengths from brief to comprehensive. These five steps will help you jump in fast and never again choose a toilet over a report.

Step 1 – Start with a Preset Pattern

The pattern-seeking logical brain likes to know the order of things, so start with a preset pattern for the result you want to achieve. Picture the result. Define the result. Walk through the result mentally. Look at one of the Institute’s sample reports to use as a template. If you have a model, image or pattern in mind, it’s easier to get started.

Step 2 – Stuff Your Brain

Stuff your brain with all the information you can get on the subject. Research relevant standards and scientific literature. Talk to essential players such as the attorney, a CLNC^® subcontractor, a plaintiff or defendant. Don’t focus on formulating opinions; just take it all in until your brain feels thoroughly saturated. The more information you take in and the more you absorb, the more likely you are to reach the correct conclusions.

Step 3 – Buzz Off

Take a break. Sleep on it, when possible. At least take a walk. Incubation is an essential step in any creative process. During this time, think about anything except what you’re working on. Likewise, capture those brilliant thoughts you have when you’re not supposed to be thinking about the case report. I find that I reach my best analysis after sleeping on a case or situation overnight (not at my desk). Sometimes I’ll reach my “eureka” moment in the shower or while cleaning that toilet.

Step 4 – Pour It Out

This is a no-wrong-answers brainstorming dump. Let the creative right brain take over to synthesize the material and develop a raw first draft. Suspend judgment. Don’t get it right, get it written.

• Put on slow (60 beats a minute), low-volume music. This will stimulate your mind without the overstimulation of Lady Gaga-esque dance music.
• Turn off the phones, children, spouses and other interruptions (no email either).
• Spill the beans. Dump everything out of your brain without editing, simply write, type or talk into a recorder.
• Don’t think about what you’re doing; ignore misspelled words and incomplete sentences. They’ll only move you from productive to editing mode. If you catch your left brain trying to muscle in to add logic, push it away and keep pouring out the raw material.
• Go until you’re empty. Spend 20-50 minutes, or until your brain feels drained and the ideas dwindle to nothing (it may happen sooner).

Repeat this brain dump as many times as needed with breaks in between. If you do take a break, make sure it supports the creative process. For example – grabbing a bite to eat, taking a walk or stretching, all support your goal by keeping the creative process free (unless you’re making a Dagwood sandwich). Interruptive processes like checking email and voicemail have the potential of disrupting your goal big time by focusing you on other issues or problems.

Step 5 – Structure and polish

Go back and assess your work product to see whether you agree with the content of what you’ve written. Ask yourself, have you said all you need to say? Is your opinion the same? If not, make the necessary change. When you’re done, move to structure and polish. Now it’s time to haul out the left brain and set it loose to create the stellar report you want to produce.

• Select the ideas that work.
• Arrange them in a logical order that fits the pattern your left brain thinks will work best.
• When you’re 90% satisfied, lay it aside (overnight, if possible). Let that “mulling” process think it over once more.
• Return to your report later for a final polish.
• Finally, proof a printed copy of the report.

Even when you have only an hour for the entire job, this process works (just take shorter breaks). Encourage both sides of your brain to do their best work, and the result is a fresh, creative approach presented in a pattern that makes sense – to you and to others.

Success Is Inside!

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!

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!