How I Survived Downsizing and Divorce to Triumph as a Certified Legal Nurse Consultant*
by Dale Barnes, RN, MSN, PHN, CLNC
Seven years ago, I was director of home care, home infusion, hospice and lifeline emergency services at a well-known hospital – a prestigious job with excellent salary and benefits. The work was challenging and fun, and I really enjoyed my coworkers, both administrative colleagues and my staff. I had built a cohesive team, doubled my department’s revenues, decreased costs and implemented many new systems. I was proud of becoming a businesswoman while remaining a nurse, and I was on a “high.”
My efforts started paying off. Before I knew it, attorneys I did not know or contact myself were calling me.
However, the hospital hired a new CEO who had very different plans. My job was eliminated, and they hired a businesswoman to run the department. She had no idea about the staff’s nursing and clinical needs. Two years later, they realized their mistake and hired a clinical person for the position.
Meanwhile, I found a similar job as head of a hospital department for all home-care-related services. This job presented two major challenges: the department had no computer system and the employees were unionized. Just as things began coming together, the hospital was sold to a large corporation. Within two months, my department was closed, and all employees received severance packages and were sent on their way.
I was the victim of downsizing yet again. As if these career catastrophes weren’t enough, four-and-a-half years ago, I got divorced for the second time.
What was I to do? Here I was, divorced, jobless and not wanting to go through another downsizing episode. My severance package would not last forever, and being dependant on my ex-husband did not appeal to me.
For a long time I had been receiving information about Vickie’s CLNC® Certification Program. It sounded interesting, but I hadn’t had time to pursue it. Now I pulled out one of those flyers, called for more information – and felt I had found my answer.
Determination Paved the Way to Certification
Many years ago, I owned my own home-care agencies. I liked being my own boss. I had good business sense and people skills, and I enjoyed a challenge. My background was in oncology, then home health and hospice. I had my master’s in psych and had worked in that arena for a while. I knew such an eclectic background would serve me well as a Certified Legal Nurse Consultant, but I needed to earn money while building my CLNC business.
I called on a friend in the home health field, the nursing director of a home infusion company. He said he needed another field nurse, and I jumped at the chance, knowing that as a per diem employee I would have a lot of flexibility. I loved working with the patients and could work as little or as much as I chose.
I ordered Vickie’s CLNC Certification Program. I watched portions of the program almost every day. I was sure I’d be able to finish the course, study and take the exam in six months. But life has a funny way of throwing us curve balls.
On my 50th birthday, I boasted that I did not feel 50. Nine years earlier I had an inoperable, nonmalignant brain tumor. I had an annual MRI to ensure the tumor had not moved or grown, and I felt well and healthy. But two weeks after my 50th birthday I got very sick. I had some strange auto-immune symptoms and was left with no hearing in my right ear and unsteady balance. I was told that the 8th cranial nerve had been permanently destroyed, but that the problem was unrelated to my brain lesion. I was unable to ascertain from which direction sound was coming. That problem remains with me, but I have learned to compensate.
The most annoying and frustrating result was that I couldn’t study the CLNC® Certification Program for a few months. I felt a sense of urgency about completing the necessary work. Finally, I finished the program and passed the CLNC Certification Exam.
I Contacted Attorneys Every Day
I was anxious to get started and decided to be a little aggressive. First, I contacted attorneys I knew, regardless of their specialty, and asked for referrals. My attorney friends were intrigued by what I was doing.
I made phone calls every day. I put together a packet of information to send to new contacts. My first legal nurse consultant job came from a friend who practices estate law. She had me go with her to a hospital to help assess a terminal patient so she could write a bedside will. I addressed the client’s competency to make decisions based on physical condition, mental status and any medication effects. This case brought more referrals from the estate attorney.
Another friend who practices labor law had no work for me himself, but passed out my flyers at a meeting of plaintiff attorneys. The next morning, I got a call from an attorney who had picked up a flyer. He desperately needed the services of a CLNC consultant and asked how soon I could come to see him. I was in his office within two hours and walked out with a personal injury case related to a motor vehicle accident. This attorney became a good client and gave my name to several colleagues.
Interestingly enough, my attorney-clients had either plodded through the medical records or hired physicians. Many of them wanted to know why I thought I could do a better job than they could. They believed that because they had been doing it for so many years themselves, they really understood the medical issues. Fortunately, I was able to show them that they did need me, and that using my expertise was more cost-effective than doing it themselves. A couple of my best attorney-clients said they wanted to use me on every medical-related case. This was a good break for me, but unfortunately, these clients were not getting dozens of such cases every week. So I continued to work my day job.
My Marketing Efforts Paid Off Big
I joined three different networking groups and attended meetings religiously. After a while other members get to know you, understand what you do and become confident in giving you referrals. Most referrals from these groups came not from the attorneys in the group, but from attorneys other members knew and had me contact. I also started sending out an information newsletter every other month.
My efforts started paying off. Before I knew it, attorneys I did not know or contact were calling me. Attorneys for whom I worked were giving my name to other attorneys. I also gained three steady clients from my newsletters, a good response given that my mailing was only going to about 400 attorneys at the time.
One of these steady clients is an attorney who specializes in dog bites and manages cases from coast to coast. I get 10-12 of these cases per month, from simple cases to those involving disfiguring injuries. I summarize the medical records for each case and provide the attorney a 1-2 page overview describing the injuries, treatment and possible future treatment. I charge for my time tracking and reviewing the cases and writing the reports. This client provides me with steady income every single month, and the work is the easiest I do. I have other steady clients, but their assignments are more complex. The combination is exciting and challenging.
Referrals Kept My CLNC® Business Flowing
Last year I moved from Los Angeles to San Diego. About six months before the move, I asked an attorney friend in L.A. if he knew any San Diego attorneys. He came up with several association lists of both plaintiff and defense attorneys. I made numerous phone calls and set up appointments with as many of these potential clients as I could. I always used my friend’s name, stating that he had referred me and given me their number. Although he only knew a few of them personally, no one came right out and said they never heard of him.
From these contacts came a multitude of new clients. One attorney actually handed me medical records as I left his office after our first meeting. Another attorney asked me to speak to his firm about the CLNC services I could provide on bad faith insurance cases. Another contact referred me to his buddy in the San Diego city attorney’s office, who became a client.
Word of mouth was again a plus for me. After I had lived in San Diego for only three weeks, 40% of my client base was here. Referrals have helped my San Diego clientele grow. I have already received inquiries and requests for my CLNC services from attorneys who heard about me through other attorneys. I stressed to my Los Angeles clients (still 60% of my client base) that their cases will continue to receive the same quality service as when I lived in L.A. Email and FedEx® are wonderful.
I Made the Leap into a Full-Time CLNC® Business
Despite these successes, until recently I continued to see home health patients for two agencies to earn “bread and butter” money. I always knew I could supplement my income with home health visits if the phone stopped ringing for a few days. In addition, my home health work gave me the clinical continuity to feel comfortable testifying about clinical issues.
At one of the NACLNC® Conferences, Vickie talked about taking that leap and letting go of secondary work in order to build your CLNC practice into a full-time business. I really wanted to do this, but it was scary. After that conference I went home and told both home health agencies to call me only if they were really desperate for a nurse. Slowly, I weaned myself away and was able to tell them to take me off their rosters.
When attorneys ask about testifying, I tell them I will find a clinically active nurse to testify. I explain that although I still testify to the findings of medical record reviews, I no longer testify to clinical issues. This too was a leap, as my rate for testifying is double my consulting rate. I felt like I was letting go of a lifeline, but I reminded myself that testifying to clinical issues was not the bulk of my business. Then I took the plunge anyway.
Sometimes I am so overwhelmed with work that I cannot complete it all in a timely manner. I then subcontract with other CLNC consultants.
What my CLNC business has brought me is total freedom. I feel emancipated. I no longer need the home health visit income; I have more than surpassed that. I don’t have any desire to go back to a clinical setting. At times I do miss the patient contact, but I often get quite involved with the attorneys’ clients. Many of them call me to ask for medical resources or nursing advice.
I feel like I have the best of all worlds. I am so happy Vickie encouraged me to step out of my comfort zone. I love what I am doing. I’m busy, challenged and financially secure, and I am so proud to be a Certified Legal Nurse Consultant. I’ve overcome both downsizing and divorce to achieve more than I ever felt possible.
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