Common Pitfalls in Report Writing

The inexperienced legal nurse consultant learns in the same way as the new clinical nurse – through on the job training. In nursing school we gain a tremendous amount of “book smarts” in the classroom but the most valuable training is accomplished in the clinical setting.

Likewise, a nurse can learn the basics of legal nurse consulting though nothing solidifies this knowledge like hands-on case review experience. As an educator in a legal nurse consulting education program, I have seen the inexperienced, though highly educated, legal nurse consultants make the same common mistakes.

Common Pitfalls in Report Writing

Just a few of these frequent pitfalls in report writing are described below:

1. Failing to include a medical analysis and recommendations in your report. The inexperienced legal nurse consultant may be so focused on the chronology that he/she may forget to include the analysis of the findings. Yes, this has actually happened! Providing the attorney with the chronology without an analysis and recommendations will not result in a repeat customer.

   Do not lose focus on the purpose of the report. What is your client asking you to do? A paralegal skilled at reading medical records may be able to create a chronology, but a legal nurse consultant uses medical knowledge to see beyond the facts of the case and to help the attorney understand the implications of the details.

2. Not asking enough questions. Who is your client: an attorney, risk management department, or insurance carrier? Is this a plaintiff or defense case? Is this a personal injury or a medical malpractice claim?

   I have seen beautifully written reports making a great case for the plaintiff when the client is actually representing the defendant. If you aren’t sure who your client is representing you need to ask. This is one of the biggest pitfalls in report writing.

   You look like an idiot if you don’t know who hired you.

   The plaintiff attorney represents the patient but there are many attorneys working on the defense side. These attorneys may represent the physician, nurses, pharmacists, or equipment manufacturing company, for example.

   If a plaintiff’s case has progressed into the discovery phase it is helpful to ask how the opposing counsel is defending the case. You can then assist the attorney to build a stronger plaintiff case. Always keep your client’s needs in mind.

3. Focusing on the wrong issues. When in doubt, go back to the basics. Clinical nurses know to focus on the ABC (airway, breathing, and circulation) in the event of an emergency. Legal nurse consultants must always be sure that the four basic elements of negligence are present when performing a case review.

   For example, newer LNCs (aka ‘newbies’) may so fixed on the blatant breaches in standards of care in a fall case that they fail to recognize there are minimal damages representing no real dollar amount. Always ensure there are breaches in the standards of care as well as damages. In cases with limited damages you may want to have a conversation with the attorney to determine whether there are enough damages to justify moving forward with litigation.

4. Failing to thoroughly review and edit your report. This is your work product and therefore it is representative of you. If your report contains misspelled words, inaccurate information, does not follow a reasonable sequence of events, or it does not look or sound professional it is not likely that the attorney will use your services in the future.

   Take a step back away from your report once you are finished before coming back to proofread and edit the report. Do not rely on solely on spell check to catch your errors.

5. Failing to interpret critical medical issues and define medical terms. Referencing laboratory data and medical terminology without defining the terms or explaining the significance is not helpful to the attorney.

   If the patient died from cardiac arrest in the presence of severe hyperkalemia you must explain the correlation between these two findings. Too often inexperienced legal nurse consultants write their material as if the reader was a medical professional, not a legal professional. Worse yet, they may write a report as if they were charting in a medical record. Be sure your client can understand your report and utilize it throughout litigation.

Angie Duke-Haynes, RN is President of Premier Medical Legal Consulting, LLC, co-owner of Legal Nurse Consulting Institute, LLC and co-presenter of an all new webinar on polishing your writing skills

To learn more about record reviews and how to WOW your clients check out this information about an all new webinar on how to polish your writing skills.