Origins of the Profession
The title of "Legal Nurse Consultant” (LNC) emerged in 1989 and was formally adopted by the American Association of Legal Nurse Consultants, which was organized that year. LNC began in an informal way as law firms consulted nurses to help them in prosecuting or defending cases. LNCs went beyond the role of advisors and soon were used as expert witnesses in nurse malpractice cases. In the past physicians had testified as to the standard of care in nurse malpractice cases. Eventually, the bar (i.e., attorneys) and the bench (i.e., judges) came to realize that nurses were better suited to perform expert witness roles in cases dealing with the profession of nursing. A nurse is a better judge of the nursing profession than is a physician. Correspondingly a physician is a better witness in a physician malpractice suit.
The rise of Legal Nurse Consultants was influenced by the rise of nursing as an independent profession. Originally limited as primarily a function of the church or the military, the nursing profession during the 19th century became an autonomous profession, and by the 20th century each state had its own licensing board for nursing.
By the 1980s, law firms were seeking nurses to explain medical terminology to them. The field of law has no specialized undergraduate degree requirements. As a result, many, if not most, lawyers have less scientific or medical knowledge than most nurses do. Law firms value the input of LNCs, and to a large degree LNCs have replaced physician consultants.
In addition to law firms, LNCs also work with insurance companies, for corporate legal departments, and for the government. They may act as assessors of risk and as case managers. Some develop life-care plans for presentation at trial. LNCs can offer their expertise to all sorts of personal injury and employment hazard cases as well as high profile cases, such as toxic torts.
Scope of the Profession and Standards of Practice
There are four basic components of Legal Nurse Consulting: Practice, Professionalism, Education and Research. Because LNC relies upon the research and training of other professions, until recently it was not considered to be a profession of its own but a functional specialty practice of nursing.
The LNC is a usually a licensed registered nurse or physician's assistant who performs a critical analysis of health care facts and issues and their outcomes for the legal profession. Many LNCs work as independent professionals. However, since the LNC is not a lawyer, the nurse is not allowed to give legal advice in any state. The LNC is qualified to assess adherence to standards of health care practice as it applies to nursing and other health professions. For plaintiff’s law firm LNCs work toward recognizing the full extent of the plaintiff’s injuries. LNCs working for defense insurance companies attempt to diminish the extent of injuries and damages.
Standards and Ethics of Legal Nurse Consulting Practice
The Standards of Legal Nurse Consulting Practice were adopted by the American Association of Legal Nurse Consultants in January 1994 and were amended April 1995. Standards of professional performance refer to a competent level of professional behavior, related to quality of practice, performance appraisal, education, collegiality, ethics, collaboration, and resource management.
The AALNC Code of Ethics was adopted in 1992. These ethical goals are provided in addition to the ethical standards of the American Nurses Association and the American Bar Association. The code is rather short, and reads as follows:
1. The legal nurse consultant does not discriminate against any person based on race, creed, color, age, sex, national origin, social status, or disability and does not let personal attitudes interfere with professional performance.
2. The legal nurse consultant performs as a consultant or an expert with the highest degree of integrity
3. The legal nurse consultant uses informed judgment, objectivity, and individual competence as criteria when accepting assignments.
4. The legal nurse consultant maintains standards of personal conduct that reflect honorably upon the profession.
5. The legal nurse consultant provides professional services with objectivity.
6. The legal nurse consultant protects client privacy and confidentiality
7. The legal nurse consultant is accountable for responsibilities accepted and actions performed.
8. The legal nurse consultant maintains professional nursing competence.
In professional practice, these eight sections of the Code of Professional Responsibility guide the LNC’s interaction with the law firm, clients, or other professionals.