Consulting Can Be Criminal*
by Laurel Grisbach, RN
Many nurses understand how a Certified Legal Nurse Consultant can evaluate medical malpractice, workers’ compensation and personal injury cases. But few appreciate the possibility of applying CLNC® consulting services to other types of cases.
Recently, I had the opportunity to use my consulting skills in a new area – criminal law.
If a relatively ‘green’ CLNC® consultant like me can do it, you can, too. I put myself in the right place at the right time.
The case that started my new career was the federal civil rights trial of Rodney Glenn King. This high profile case didn’t fall into my lap by accident. If a relatively “green” CLNC consultant like me can do it, you can, too. Here’s how I put myself in the right place at the right time.
Rule #1: Prepare Yourself for Success
My journey to “fame” started with the arrival of the postman on my day off. As I halfheartedly went about my routine household chores, I found myself anticipating his arrival, always a pleasant morning break. I was not disappointed. Among the catalogs, bills and junk mail, I found a bright flyer from one of my favorite seminar speakers, Vickie Milazzo. Before I could think twice, the check had filled itself out. Not bad – only a few minutes after the mail came, I had registered for Vickie’s program.
Suddenly, I was overcome with uncertainty. How could I justify yet another seminar to my husband? You see, I am a seminar-holic. For years I’d been absorbing ways of using my nursing skills other than in direct patient care. I’d return home from these sessions bursting with enthusiasm. Next thing I know, I’d be so involved in the vicious circle of daily existence I had neither the time nor the energy to plan my career change. My spouse, understanding and supportive as he is, has grown tired of hearing my “Think of This Seminar as an Investment in Our Future” approach and was more than ready for me to put all this education to use.
I finally convinced my husband to back me for “just one last seminar.” This time I promised to make a concerted effort to launch my legal nurse consulting practice.
Rule #2: Just Do It!
Once the seminar was over, the hard part began. Three words came to mind: “Just do it!” I’ve been told that I exude confidence and authority, and I’ve never doubted that I could be a good consultant. Behind that brave facade, however, I wanted to evaporate, especially when confronted with two undeniable facts:
- I was the only person in Vickie’s seminar who didn’t even know an attorney.
- I had absolutely nothing of interest to put on a curriculum vitae – in fact, before the seminar, I’d never even heard of one! For once, I wished I’d graduated from a bachelor’s program, had more certifications after my name and emergency room experience in the double digits.
My postal service buddy was starting to bother me with his relentless delivery of bills and catalogs. Oh well, I thought, just do it!
While trying to pick a lawyer to be the lucky recipient of my first introductory packet, I recalled the name of the prominent attorney defending one of the officers in the Rodney King/LAPD federal trial. I realized I had only a “snowball’s chance” of getting a response from him, but then again, what if I did? I “just did it” and sent him my letter of introduction. Two weeks later I had not heard a word. (In retrospect, I should have followed up on my mailing.)
I had promised my husband an all-out effort, and that was what he was going to get. I requested the roster of the Trial Lawyers Association and began sending out packets. I told myself this was good therapy, as it gave me a new reason to look forward to my postal carrier’s visits.
Rule #3: Get Ready to Get Lucky
(If You’ve Followed Rules 1 and 2)
After a month, I’d almost given up on the Rodney King attorney. Then after a horrific day in the ER, I picked up the kids at the sitter and made my 1½-hour drive home. In my mailbox I found a thick manila envelope.
I could feel my face flushing the moment I realized I was holding the medical records of Rodney King. This was unbelievable. I had just landed what was possibly the most controversial case of the decade. I couldn’t wait to call everyone I knew and share my good news.
Now what? What if I didn’t have anything new to offer the attorneys that they had not already learned during their extensive preparation for the state trial?
Rule #4: Make a Plan and Follow It
With reality staring me in the face, I settled down and formed my game plan. First step – review King’s medical records and make a detailed report for my new client. My approach to interpreting the records was wide open. The attorney’s only request was that I help in any way I could.
As it turned out, my initial fears were unfounded. A quick glance at the records revealed many holes in the charting and virtually no nurses’ notes. Yet none of the physician experts on the state’s side had touched on my observations.
From the outset, two main points struck me about King’s records: the relatively minor physical injuries he actually sustained; and the massive deviations from standards of care during the initial emergency treatment. My report included the following findings:
- The pre-hospital care forms contained several strange entries and omissions. To clarify these inconsistencies, I prepared deposition questions for the paramedics involved.
- The emergency department nurses’ notes revealed multiple late entries with virtually no documentation at the time of treatment. I itemized and explained all the deviations from standards of care.
- I explained the existence of the Los Angeles Medic-Alert Center (MAC) and its role in transferring patients from private facilities to county hospitals. Within minutes of learning that all conversations with the MAC are recorded, the attorney applied for a federal subpoena for the recording.
- I compiled a vital signs chart to demonstrate King’s relatively unremarkable hospital stay and counseled the attorneys about potential changes in vital signs during times of pain, stress or infection. Then I verbally correlated such changes with documented events.
Rule #5: Use Every Resource to the Max
I considered myself somewhat of a sideline expert on this case as I had watched most of the first trial on Court TV. I was aware of the types of information provided by the mega-buck physician experts. The only area already covered in-depth was how King’s fractures could have occurred from a fall or a beating. My familiarity with the previous TV coverage confirmed that the field was wide open for my observations.
After finishing my report, I scheduled a meeting at the law firm to go over my findings. For two hours the attorney listened intently as I pointed out the most basic nursing practices and observations of which he was totally unaware. (What is a late note? Do emergency records generally have late entries? What does it mean when a nurse draws a line to the end of a page and writes her initials?) My training with Vickie was absolutely correct: Pieces of information that seemed simple and basic to me were important news to an attorney who had never taken Nursing 101.
The Bottom Line: Launch a New Career
Throughout the medical testimony in the federal trial, I was present in the courtroom as a consulting expert. I helped the attorney compile questions to ask during cross-examination. My questions brought out many points that made a definite impact on the opposition. The thrill of throwing the prosecution off balance made staying focused difficult – it’s tough not to become engulfed in courtroom strategy when your opposition is frantically shuffling through records to locate some “overlooked detail” you’ve just helped bring to their attention.
The King case has been called the most publicized trial in 50 years, and I found the immensity of it overwhelming at times. The awe of sitting “in the well” with four of the nation’s finest prosecuting attorneys, four highly regarded defense attorneys and four famous defendants will stay with me for years.
Do I feel the police were guilty? It doesn’t matter what I think – that was for the jury to decide. My role was simply to explain the medical records in layman’s terms and convey what those records meant to the attorney’s case.
I do know my attorney-client is now sold on using my services and has been quick to share his discovery with his colleagues.
The bottom line is this: I upheld my end of my bargain with my husband, so you will probably see me around another nursing seminar in the L.A. area. (Now I can afford to pay for it with my own money.) Just look for a tall blond wearing a big grin and telling everyone, “Just do it!”
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