- Scott Lister
The medico-legal nurse
Clinical negligence cases are often complex cases requiring lawyers and their experts to unpick treatment offered to patients and determining if this fell below a reasonable standard. The majority of clinical negligence lawyers are not dual qualified as medical staff and therefore are reliant on medical professionals to assist them with the interpretation of claimants’ treatment via medical notes and records.
A growing number of nurses work within the legal industry for both the claimant and defendant sides. There are two types of nursing roles: nurses assisting in the review and preparation of cases, and those providing an opinion as to the standard of care and future care needs of the injured patient. The role of the nurse expert will be explored in future blogs.
The Medico-Legal Nurse Consultant The medico-legal nurse can be employed by a legal firm, insurer or professional defence organisation, offer services independently or work through a specialist medico- legal company such as Apex Health Associates. While there are various titles used across the UK and their role is equally as varied, in general the nurse will carry out the following tasks:
Deciphering medical records The nurse will review, sort and paginate a patient’s medical notes and records. Although this task sounds quite straightforward it is a complicated task requiring medical knowledge and skill (if done properly). Following a detailed sort a bundle of paginated records is produced along with a detailed index. In addition, the radiology images are also reviewed and a schedule produced of those available for review.The nurse’s knowledge and skill is used to interpret the records and, importantly, to identify those that are missing and/or any gaps in treatment
Provide a chronology of the patient/client’s medical treatment Once the paginated bundle of documents is produced the nurse is then able to review all the records and produce a chronology of the patient’s medical history. The nurse has to use their skills and experience in interpreting the records and producing a document that non-medical staff can understand.It is important that a nurse or even a doctor conducts this task as they have the necessary broad clinical experience to understand the content of the records. Staff without or limited medical training should not attempt this as they do not have the necessary medical knowledge.
Taking new enquiries and screening for merit Nurses often use their skills and expertise to assist with obtaining information from potential clients/complainants. Nurses will use their broad medical knowledge to provide an initial view as to patient’s complaint.
Undertaking medical research Nurses can assist with the review of complicated medical scenarios and undertake research into areas of investigation.
Providing medical training Nurses are able to use their skills and experience to provide training within the non-medical environment.
Assisting with the planning of future client care needs Nurses can assist Case Managers and legal professionals to plan the future medical and rehabilitative requirements of clients.At the present time there is no national guidance as to the minimum standard that such nurses have. Therefore, the responsibility of ensuring that the nurse is sufficiently skilled and qualified falls on the instructing party.
There are major advantages to using a specialist medico-legal company. These include having no employer responsibilities or costs, and having access to a larger number of nurses from multiple specialties. In addition, Apex Health Associates is run by senior nurses and therefore offers supervision and specialist training.