Friday, June 11, 2010

Just what kind of attorney are you working with?

This is a question that we as legal nurse consultants should ask ourselves when we embark on a new attorney-client relationship. I am not referring to the attorney’s area of specialization or their orientation towards defense or claimant work. I am speaking about their business and personal preferences, their personality, their quirks. Despite having your own (dare I say strong) personality, you must adapt yourself to the communication and business style of your client.

I have a good relationship with all of my attorneys and a close relationship with a select few who share anecdotes, snippets of family life, do not begin emails with salutations nor end them with good wishes. We save our grammar and formatting skills for professional reports and forgive the incomplete sentence, lack of capitalization and generally casual style of email. When I consult on their cases, there is little if any direction given to me. The records appear as if by magic, sometimes with a dolly. We have a telephone conversation; they are open about their knowledge of the case, but often hold back their own impressions until they have mine.

There are also those attorneys who are very formal. You will recognize them immediately by their communication style and you should respond to them in the manner they address you. If their emails address you by title, respond accordingly and do not dangle your participle. These people may have a sense of humor but they are not ready to share it with you.

They often have a very specific idea of what they want from your reports. They may want a detailed chronology and your personal opinion, but they may not want to share it with colleagues, experts, or their own client. They may want a second chronology that does not have your name on that report, or your opinion in that author's column. They want to keep you as their private resource and they want the opinions of others to be based on clinical facts, not your intuition or experience. They may not want anyone to know you exist. This is where software like Casemap truly shines, by the way. This type of attorney is not for the nurse who uses MS Word for tables.

There are also those attorneys who simply do not know what they want. This may be a case that falls outside their comfort zone. They will call you and ask you how to proceed with experts, or if you think their reasoning is sound, and they are generally open to input. While this may stroke your ego, it is the trickiest case to manage because you cannot cross the line between nursing and the law. Their neediness rapidly translates into blame if events do not proceed as expected.

Be comfortable with yourself, and never accept demeaning or verbally abusive behavior. must also put aside your ego for your attorney-client. I can tell you that this is a challenge for most nurses. We are an opinionated bunch and our opinion is what gives us value. Nonetheless, remember that no matter how close your affiliation with an attorney may become, it is first and foremost a business relationship. Their chief goal is to advise and satisfy their own client. Your primary assignment as a legal nurse consultant is to help them achieve that goal by asking them what kind of report, what kind of information, and what type of presentation they expect of you. And then deliver.


  1. Great blog post Alice! I think it's important to be comfortable with yourself. Comfortable in your own skin. Then, voicing your opinion or making comments seems natural and without hesitation. My favorite is the next -to last paragraph. The attorney who doesn't know what he wants. That is funny! but it is also sad. Especially if you have done this for any amount of time and know that taking on an injury claim can be very expensive. It's a good idea to know what you want and where you are going at all times lest money start to fly out the window. I to think that is where we come in and lend a helping hand though. I don't really find that they point fingers at me. Usually, they know the mistake is theirs because they are the manager of that case. I think it's just difficult for them when an error is recognized because it is a reflection on them.
    Loved this topic.
    thanks for sharing!

  2. Love this post. All very good advice. I especially like your comment about nurses being an opinionated bunch! That we are. I think most of us are brilliant chameleons as well. We deal with so many personalities in a day: doctors, ancillary departments, patients, patient families, and most importantly, other opinionated nurses!