AALNC Position Statement on the Role of the Legal Nurse Consultant as Distinct from the Role of the Paralegal and Legal Assistant

Attorneys and others in the legal arena consult with psychologists and engineers, for example, because of their expertise in their respective professions; similarly, they consult with LNCs because of their expertise in nursing and healthcare. Many LNCs have bachelor's and advanced degrees in nursing and other health-related fields. Some LNCs practice as independent consultants; others are employed by law firms, insurance companies, and other institutions in a wide variety of roles.

While many legal nurse consultants have acquired knowledge of the legal system through such experience as consulting with attorneys and attending seminars, legal education is not prerequisite to the practice of legal nurse consulting. (In contrast, legal education is frequently a requirement for paralegals.) Professional nursing education and healthcare experience make LNCs unique and valuable partners in legal processes.

The AALNC Code of Ethics and Conduct ¹, Scope of Practice for the Legal Nurse Consultant ², and Standards of Legal Nurse Consulting Practice and Professional Performance ³ describe the specialty of legal nurse consulting. The primary role of the legal nurse consultant is to evaluate, analyze, and render informed opinions on the delivery of health care and the resulting outcomes.

The following list of activities helps to distinguish the practice of legal nurse consulting:

• Facilitating communications and thus strategizing with the legal professional for successful resolutions between parties involved in healthcare-related litigation or other medical-legal or healthcare-legal matters.
• Educating attorneys and/or others involved in the legal process regarding the healthcare facts and issues of a case or a claim.
• Researching and integrating healthcare and nursing literature, guidelines, standards, and regulations as related to the healthcare facts and issues of a case or claim.
• Reviewing, summarizing, and analyzing medical records and other pertinent healthcare and legal documents and comparing and correlating them to the allegations.
• Assessing issues of damages and causation relative to liability with the legal process.
• Identifying, locating, evaluating, and conferring with expert witnesses.
• Interviewing witnesses and parties pertinent to the healthcare issues in collaboration with legal professionals.
• Drafting legal documents in medically-related cases under the supervision of an attorney.
• Developing collaborative case strategies with those practicing within the legal system.
• Providing support during discovery, depositions, trial, and other legal proceedings.
• Testifying at depositions, hearings, arbitrations, or trials as expert health care witnesses.
• Contacting and conferring with vendors to develop demonstrative evidence or to collect costs of healthcare services, supplies, or equipment.

Legal education programs offered for nurses by legal assistant or paralegal education programs also cause confusion about roles. To the extent that legal education is provided to nurses by legal assistant or paralegal education programs, it should be considered separate from the education of paralegals and legal assistants because of the differences in their practice in the legal arena.

In March 1998, the Standing Committee on Legal Assistants of the American Bar Association (ABA) decided that "... legal nurses and legal nurse consultants fall squarely within the ABA definition of 'paralegal/ legal assistant' ..." ⁴ In contrast, AALNC recognizes a clear distinction between the roles of the legal nurse consultant and the paralegal.

The ABA also determined that " ... the educational programs designed to train [legal nurses and legal nurse consultants] are paralegal programs or program options ..." and as such are required to meet ABA guidelines and to be approved by the ABA if offered by an institution with an approved program. ⁵ AALNC does not support required ABA approval of legal nurse consulting education programs.

AALNC has defined legal nurse consulting as a specialty practice of nursing. AALNC's position, therefore, is that legal nurse consulting education should be developed and presented as specialty nursing curricula by nurse educators in partnership with legal educators.