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Legal Nurse Consultancy


Tablet - What Do All Those Letters Mean?

What do all those letters mean?

Great question. A doctor Ms. Rojas used to work with once referred to her as “Nurse Alphabet Soup!” As confusing as they may seem, all those letters represent significant aspects of the training, experience, and qualifications of a legal nurse consultant. Specifically…

LNC (LEGAL NURSE CONSULTANT): Anyone who is — or has been — a nurse can use this “title”. No special training or certification is required.

CLNC (CERTIFIED LEGAL NURSE CONSULTANT): A title obtained after completing an on-line course (currently, 45 contact hours) and a subsequent written exam.

LNCC (LEGAL NURSE CONSULTANT, CERTIFIED): The only credential recognized by the Accreditation Board for Specialty Nursing Certification (ABSNC), the lone accrediting body specifically for nursing certification. 
In order to take the qualifying exam, the applicant must have been employed for at least five years as a registered nurse, and also at least 2,000 hours of experience functioning as a legal nurse consultant within the past three years.

Fundamentally, the difference between a CLNC and LNCC is the difference between a certificate and certification. To quote from the AALNC website, “A certification is an earned credential that demonstrates the holder’s specialized knowledge, skills, and experience, while a certificate is typically an educational offering that confers a document at the program’s conclusion.” For more about this distinction, click here.

But wait, there’s more — yes, even more designations…

LNC-CSp, FACLNC, ALNC, PLNC… the list goes on. One actually heads their website with the following:

“Be a Professional Legal Nurse Consultant (PLNC) in just 2 days!”

Enough said. The take home point is that only a Legal Nurse Consultant, Certified (LNCC) requires a significant amount of work experience (2,000 hours!) prior to certification. It’s the only designation recognized by the ABSNC, and the only one comparable to those available in clinical specialties.

Our founder and chief executive, Sharlene Rojas, is an LNCC. In addition, she possesses several other important certifications…

CEN (Certified Emergency Nurse) and CCRN (Certified Critical Care Nurse) are honors conferred by the Board of Certification for Emergency Nursing and the American Association of Critical–Care Nurses, respectively. Both involve passing a rigorous written examination, with the latter also requiring a minimum of 1,750 hours caring for acutely/critically ill patients. They serve to confirm a standard of excellence based on a combination of knowledge, skills, and clinical judgment. Only one percent of all registered nurses in the United States are CEN’s; less than three percent are CCRN’s. The number who have both is of course far, far, smaller.

TNCC (Trauma Nursing Core Course): is a certificate awarded after a comprehensive and concentrated two–day course with subsequent written examination. It focuses on providing “… foundational trauma knowledge, skills, and a systematic process to guide trauma patient care.” Unlike many other certifications, the entire course — and examination — must be retaken every four years.

BLS, ACLS, & PALS (Basic, Advanced Cardiac, & Pediatric Advanced Life Support) are brief (typically one- or two-day) courses focusing on resuscitation of a patient in near- or actual cardiac arrest. They are usually mandatory for all registered nurses working in a hospital setting.

What side — plaintiff or defense — do you work for?

Either. The majority of our current medical malpractice work is with plaintiff’s attorneys, whereas most of our medical liability experience has been on the defense side.

Tablet - What Side - Plaintiff or Defense

I already hired a physician — Do I still need your services?

We think so — and you should too. Consider this: Your physician expert witness (at least the one you should have) often has not just patient care responsibilities, but academic and/or administrative ones as well. They have neither the time, inclination, or experience to perform many of the services we routinely do.  Could they? Of course; but — due respect — the product will likely be delayed, mediocre, and cost you three to four times as much! 


Speaking of expert witnesses… if all you’re getting is, “I have reviewed the chart, and in my expert opinion the Standard of Care was/was not met…”, you’re being shortchanged. You need and deserve more, and Altrium can provide it. Does the medical literature support your witness — or theirs? What about the documentation? What other crucial facts or issues are buried in that morass of paperwork and jargon? Overlooking them can cost you not just dollars, but entire cases. The combination of our medical knowledge, clinical background, and legal experience can help inform and guide you and your team to avoid the mistakes and pitfalls that can lay waste to all your efforts. And if you’re unsatisfied with your experts, we can even help you find better ones!

Tablet - I Already Hired a Physician

Are you still active as a nurse?

Absolutely. Ms. Rojas, our founder and Chief Executive, works as a hospital nurse at least once a week. As you probably know, current, active employment is a prerequisite to qualify as an expert witness for deposition or trial. It’s also the best way to stay current with diagnostic and therapeutic modalities that impact on the standard of care.

Tablet - Are You Still Active as a Nurse

Are you familiar/comfortable with current electronic medical record systems (EMR’s)?

Yes — and it’s another very important question. We have extensive experience with a variety of systems, including Soarian, Allscripts, and most importantly, EPIC, which is the current EMR system found in almost 80% of the Top 100 Hospitals* in the United States. We’re rapidly approaching a time when the vast majority of records reviewed for medico–legal reasons will have been generated by one of these programs. Significant and ongoing experience in using them — both as a practitioner and a reviewer — is rapidly becoming a prerequisite to be an effective legal nurse consultant.

                     * - Top 100 Hospitals as per Healthgrades

Tablet - Are You Familiar with EMRs

I have a case that’s not listed in your areas of expertise. Can you still help?

Definitely. It’s important to realize that the areas of expertise listed (i.e.: emergency/urgent, trauma, critical, and cardiac care) pertain primarily to the experience (and certifications) we bring from a nursing perspective. Medico–legally, we are familiar with and qualified to work with you in a much wider variety of situations. These include — but are not limited to — med/surg, surgical (OR), obstetric, pediatric, and surgical subspecialty cases.

Moreover, in the rare case it’s an area we are unfamiliar with (e.g.: neonatology), we’ll help you find a qualified legal nurse consultant who can assist — at no charge to you!

Tablet - I Have A Case thats not listed

How long are your case reviews?

That depends — on you. Some attorneys prefer a briefer, more succinct summary — as little as one page. Other clients opt for a longer, more detailed précis. Indeed, one of the first things we ask is what your specific preferences are. Please note that a one–page summary doesn’t necessarily take one fourth of the time and effort as a four–page one. Sometimes, it’s just the opposite!

Tablet - How Long are your case reviews?

What exactly is a case analysis?

Glad you asked. There are indeed important distinctions between case reviews and analyses. Unlike a case review, which organizes and summarizes the key facts, elements, and principals in a case, a case analysis also begins to focus on the merits of the case.

A basic case analysis is centered on whether all four conditions of medical malpractice (duty, breach of duty, proximate cause, and damages) have been met. An advanced case analysis goes on to look at the degree and extent any such violations may have to the damages sustained, and may require extensive research into standards of care, policies & procedures, and the medical literature. Case reviews and analyses can be combined in one document, or separated, based on the client’s preference.

Tablet - What Exactly is a Case Analysis?

How does your expedited service work?

There are two levels of service; our “Super Rush” service features a 72–hour turnover, and includes weekends and holidays. A “Rush” service job will be completed within five business days. Both are subject to availability and incur a significant surcharge. See our fee schedule or click here for more information.

Tablet - How Does your Expedited Service Wrok?

Why a separate rate for travel and/or waiting time?

Altrium Consulting Services feels that is inappropriate to bill attorneys or their clients our full rate when we are mired in traffic or waiting for a principal in a case to arrive. Conversely, our time is valuable as well, and all we have to offer. Hence the (considerably) lower rate for travel/waiting time (greater than one hour per day). Note that trips to hiring attorneys in Manhattan, the Bronx, and lower Westchester County are exempt. See our fee schedule or click here for more information.

Tablet - Why a Seperate Rate for Travel

Do you accept cases on a contingency basis?

Occasionally, and solely at our discretion. After a brief case review, only expenses are billed until the case is settled. At that time, our payment is limited to a very small percentage (usually 1%) of the total settlement. Please See our fee schedule or click here for more information.

Tablet - Do You Accept Cases on a Contingency Basis?

How do you prefer to deal with documents, records, and such?

In a word, electronically. While we of course can — and do — deal with paper records, we feel the former are more efficient and simpler for all concerned. Unless otherwise requested, we output all work as PDF’s, with each page watermarked as “Work Product”. Note that we are proficient with Microsoft Office, and happy to utilize it if so requested.

Tablet - How Do You Prefer To Deal With Documents

Any other questions?

Click here to contact us for more information.

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