At Discovery NP Legal Consultants, one of the most common questions we get asked is if our Nurse Practitioners review cases involving personal injury caused by negligence outside the healthcare setting. The answer is a resounding “Yes! We do!” In fact here are the top 5 reasons why a Discovery NP Legal Consultants’ Nurse Practitioner is the best choice when looking to engage a consulting expert for a personal injury case.
Ambulatory vs. Acute Care Setting
The vast majority of personal injury cases involve an evaluation of damages over time in the outpatient setting. Most consulting expert RNs, also called legal nurse consultants or LNC’s, have extensive experience in the acute care, or hospital setting. The documentation in the inpatient setting is drastically different from that found outside the hospital. While inpatient RNs may be able to understand the anatomy and physiology and medical terminology, they may not be as familiar with the navigation of the outpatient electronic medical record. In fact, Nurse Practitioners not only know how to read and navigate those SOAP-y notes, but, as providers, they actually write them themselves!
Longitudinal vs Cross-sectional Care Experience
Nurse Practitioners in the outpatient setting have longitudinal relationships with their patients; over months, years, or even decades. Inpatient or acute care nurses care for an individual patient only during a “snapshot” of their illness or recovery: hours to days, potentially weeks or months at most. Thus, RNs in their clinical experience have generally seen only a crosssection of the progression of a given illness in the clinical setting. Their knowledge is substantial, but it is generally obtained through a composite of these experiences in various stages. Furthermore, RNs may be less familiar than Nurse Practitioners with the subtle presentation of subacute illnesses or injuries or of early signs of reinjury.
Differential Diagnosis and Special Testing
Like physicians, Nurse Practitioners diagnose conditions independent of physician oversight in most states. They engage in differential diagnosis, which involves a process called physical examination. Physical examination is different from the nursing counterpart of physical assessment, and at times involves diagnostic maneuvers. Among these, Nurse Practitioners are trained in their graduate programs in the performance of numerous “special tests” performed on specified body parts to identify the anatomical structures that have been damaged or that are functionally inadequate. This makes Nurse Practitioners more equipped than nurses to evaluate the findings on an IME/DME because they, themselves, are intimately familiar with the proper techniques in these procedures, what constitutes a positive finding, and what the implications of that finding may be.
Ortho/Spinal First Assists in Surgery
RNs who spend their entire career in the operating room rarely drum up the courage to return to their roots and tackle the intense and grueling graduate schools of nursing in pursuit of their family Nurse Practitioner degree and license. Why? Well, for one thing, family Nurse Practitioner training takes you back to learning about babies, pregnant women, and children, among other uncomfortable topics for such specialized nurses. That’s why finding a nurse who obtained her first assist credential and then went back to become a Nurse Practitioner is such a rare find. Discovery NP Legal Consultants presently contracts two of such unicorns. These two Nurse Practitioners specialize in ortho/spinal surgeries and have a deep understanding of sports medicine and other related fields. They can not only decipher the subtle changes in the radiologists’ reports but are knowledgeable enough to note the changes in the images and scans themselves. Your average nurse is not trained to read the scans.
Causation and Pre-Existing Conditions
In the clinical setting, orthopedic/spinal Nurse Practitioners are tasked to obtain a comprehensive medical history of present illness (HPI) from their patients. The specialty NP’s extensive understanding of human anatomy, especially the musculoskeletal system, gives them an advantage over other registered nurses. This in-depth knowledge– learned in nursing pre-requisites and only sparsely revisited in nursing school–dwindles in the average RN after about the second year of nursing school. Armed with this intimate familiarity Nurse Practitioners who specialize in orthopedic care can more accurately corroborate or refute whether a particular mechanism of physical orthopedic or spinal trauma does or does not match the alleged or observed injuries, or the radiographically-evident abnormalities. In short, Nurse Practitioners are best equipped to identify injuries solely attributable to pre-existing conditions versus an those proximately caused or exacerbated by the incident in question.