1. Brous, Edie RN, BSN, MS, MPH, JD


You've seen the ads and you're tempted. Now get the scoop about three careers that combine nursing and the legal world.


Article Content

BECAUSE I'M A NURSE ATTORNEY, nurses frequently ask me about their opportunities for a legal career. In this article, I'll tell you about becoming a nurse attorney, nurse paralegal, and legal nurse consultant (LNC), including the education and personality traits you'd need.


Your experience adds value

As a nurse, you're particularly well suited for medicolegal specialties such as risk management, medical malpractice, personal injury, pharmaceutical litigation, workers' compensation, and managed care. The greatest asset that you'll provide in these settings is your hands-on, real-world experience in patient care. The more clinical experience you have and the more up-to-date you are, the more effective you'll be.


As an experienced nurse, you have specialized knowledge about standards of patient care, medical terminology and abbreviations, medical records, pharmacology, diagnostic procedures, and treatments. Your experience can be invaluable for attorneys and law firms, health care facilities, insurance companies, private agencies, and consulting firms.


What's your personality?

If you think this sounds interesting, consider whether you'd enjoy a legal career. Do you like performing detail-oriented tasks, meeting deadlines, organizing materials, analyzing data, being self-directed, and doing solitary office work? If you do, then legal work might be right up your alley.


Sorting out the three paths

Next, you'd need to consider which of the three careers that combine nursing with legal work is best for you. Here are the job descriptions:


* A nurse attorney, a dual-degree professional, is a registered nurse and a licensed attorney who's been admitted to practice law in at least one jurisdiction. If you choose this path, you'd need to go to law school, which takes 3 years if you go full-time or 4 years part-time. Nurse attorneys work as litigators, legislators, lobbyists, attorneys-at-law, educators, administrators, researchers, and consultants. The American Association of Nurse Attorneys (TAANA) is an organization for nurse attorneys, nurses in law school, and lawyers in nursing school.


* A nurse paralegal is a nurse who's completed a formal paralegal program. Paralegals may perform medical and legal research, analyze and summarize medical records, locate and identify expert witnesses, assist in the preparation of legal documents, file papers in court, prepare exhibits, attend discovery and inspection conferences, review deposition and trial transcripts, and assist in trial preparation.


* A legal nurse consultant (LNC) is a nurse who may or may not have attended a legal educational program but who functions as a liaison between the medical and legal worlds. Although formal education isn't specifically required for this work, many LNCs have completed specialized courses or programs. A university-affiliated program offers the advantage of career placement as well as more in-depth education. The American Association of Legal Nurse Consultants (AALNC) can direct you to educational resources for legal nurse consulting.



Frequently LNCs use their skills for suit reviews, including medical record review, case analysis, expert witness procurement, and medical research. Your professional nursing education and clinical experience give you the insight needed for the legal analysis of claims. And now many courts are ruling that LNCs can be used as expert witnesses in nursing cases. (See Courts recognize nurses' expertise.)


The transition from clinical practice to consulting work will be easier to accomplish if you have a sense of your working style. The AALNC has created a self-assessment tool to get you started. The AALNC also provides much information on this area of practice, as well as a getting-started handbook, and can be accessed at


TAANA has an LNC practice section providing resources, education, and networking opportunities for LNCs, accessible at


Although nurse paralegals and LNCs are distinct professions, they may perform many of the same functions. Their training can be similar too-paralegal and LNC programs offer courses in legal terminology, case analysis, medical and legal research, civil procedure, areas of substantive law, and ethics.


Taking the plunge

Now if you've decided to pursue a legal career, you're ready to take the next step. When you start in your new field, you can work on a per diem or per case basis while continuing your clinical practice.


Finally, if you decide to continue in the legal field, be sure to maintain your clinical expertise and investigate all of the possibilities that are open to you!!


Courts recognize nurses' expertise

The courts are beginning to recognize the specialized knowledge of nurses as well as the concept of overlapping expertise. A 2004 Illinois case illustrates this growing trend. In Sullivan v. Edward Hospital, a physician was used as an expert witness to testify that nurses had departed from nursing standards of practice. The trial court ruled that the physician wasn't competent to testify about the standard of care for the nursing profession. On appeal, the Illinois Supreme Court agreed with TAANA in its amicus brief that, "A physician, who is not a nurse, is no more qualified to offer expert-opinion testimony as to the standard of care for nurses than a nurse would be to offer an opinion as to the physician standard of care."


A Connecticut court recently agreed and held that a physician couldn't testify about nursing standards of practice stating, "[The law] requires that the similar health care provider be licensed by the appropriate regulatory agency and that [the physician] is neither. [The physician] also does not possess training, experience and knowledge as a result of practice and teaching in a related field of medicine[horizontal ellipsis]. Accordingly, [he] is not qualified to testify as to the standard of care of a nurse and his testimony must be precluded."


A 2006 Oklahoma case held that an RN was qualified to testify as an expert in a skin care case, stating, "The registered nurse's expertise makes her an appropriate professional to offer expert testimony concerning the practices of other nurses and the standard of care in the avoidance, treatment and cause of bedsores." The court also recognized "what appears to be a trend towards allowing a nurse's testimony to be treated as expert in an ever-increasing number of arenas." This growing recognition of, and the necessity for, expert nursing testimony suggests that the future for legal nurse consulting is bright.


Sources: Gaines v. Comanche County Medical Hospital. 143 P.3d 203 (Okla. Supreme Court 2006); Markland v. Abrams, 41 Conn. Legal Reporter No. 8, 303 (Superior Court of Conn., 2006); Sullivan v. Edward Hospital, 209 Ill.2d 100 (Ill. Supreme Court, 2004); and Vela v. State, 209 S.W.3d 128 (Tex. Court of Criminal Appeals, 2006).