Lorie A Brown, R.N., M.N., J.D., Author at Empowered Nurses

Top 10 Tips To Start A Nurse Consulting Business

March 4, 2021 1:33 pm 1 Comment

1: Do you love being knee-deep in records and solving puzzles?
That’s what legal nurse consulting is about. You will be given a stack of records and asked to solve the puzzle.

2: Are you able to focus your attention?
As a legal nurse consultant, given a stack of records, you will need to be able to focus on the documentation and condense them into a shortened simplified format so that an attorney can understand it.

3: Are you a people person?
To obtain cases, legal nurse consultants need to get out there and meet attorneys and ask them how their services can benefit them. The LNCs job is to determine if the attorney has a need for your services and how you can fill that need. Initially, legal nurse consultants are hesitant to talk to attorneys. I remind them when they first started being a nurse, they were afraid to talk to doctors and now they tell the doctors what to do. Unlike doctors who have superior medical knowledge, attorneys are relying on you to explain the medical information. So, there is no need to be afraid to speak to them.

4: Are you persistent?
To be an effective legal nurse consultant, you will need to follow up over and over again with potential attorney clients. They are on to the next thing and forget, they may not remember who you are. Persistent follow-up, in the right time, can mean the difference in obtaining a case or not.

5: Do you like creating relationships?
Being an independent legal nurse consultant is all about creating relationships with potential attorney clients. By developing strong relationships, the attorney will use you over and over again. The beautiful thing about being a legal nurse consultant is that once you get your stable of clients, the need to continue to market decreases substantially unless you want to continue to grow.

6: Are there enough cases in my area of specialty?
Yes, you can limit your legal nurse consulting practice to cases in your specialties, however, I believe if you take an overall variety of cases, you will have more business. As a nurse, you are trained in all different areas and have the knowledge and expertise to handle different types of cases. However, and if you don’t know the answer, as a nurse, we know how to find the answer to do a good job in a case.

7: Should I work only Plaintiff or Defense?
As a legal nurse consultant, you can work both sides of the fence as long as you do not have a conflict of interest. A conflict arises when you were working on a case against the hospital and then work for the Defense representing the same hospital. You also do not want to work against a facility where you are still working.

8: Do I have to testify?
There are 2 types of legal nurse consultants, one does behind the scenes consulting and the other does expert witness work. Expert witnesses are required for the Plaintiff to prove their case or to defend Defendant’s case. A behind the scenes consultant is not required. However, behind the scenes legal nurse consultants are extremely valuable in cases because they help the attorney to decide whether to pursue the case or to settle it.

9: Do I need a website?
No. Attorneys are not taught what a legal nurse consultant is in law school. The only way they know you exist and can help is to talk to them. Since many attorneys do not know what a legal nurse consultant is, they don’t know to search for you.

10: Do I need certification to become a Legal Nurse Consultant?
Attorneys are hiring you for your nursing knowledge, not your legal knowledge. A class may help you feel more comfortable but they teach you one way of doing things. Your attorney client may want things done differently. In my experience, many attorneys do not know about certification for Legal Nurse Consultants and therefore, typically will not hire you because you are certified.

Should NPs Be Paid The Same As MDs?

February 25, 2021 12:48 pm 6 Comments

With 23 states along with D.C., Guam and the Northern Mariana Islands having full practice authority (independent practice without physician oversight), it would seem that nurse practitioners (NPs) in those places should be reimbursed at the same rates provided to physicians (MDs). However, these NPs are paid 85% of what physicians are paid for the same services.

Although there are few studies comparing MDs versus NPs, it is clear that NPs are sued less their MD counterparts. However, there are some adverse studies showing that NPs order more labs and diagnostic tests, perform more inappropriate skin biopsies and place more inappropriate referrals than MDs do.

Another study shows that NPs prescribe more prescriptions than MDs, including antibiotics, steroids, opioids, and psychotropic medications.

Some of the those noted studies surprised me.

How can a referral be inappropriate? If an NP is staying in his/her lane then shouldn’t he/she refer patients to experts when needed?

Additionally, yet another study showed that NPs prescribed more medications than MDs. One spotlighted area of increased prescribing is with psychotropic medications. This could be due to the decline in physicians going into psychiatry but there is an increase of primary mental health NPs.

In a study reported in Forbes, it was shown that there are 28,000 psychiatrists in the United States that number is decreasing as 3 in 5 practicing psychiatrists are currently over the age of 55.

Senate Bill 5222 in the Washington state legislature is requesting equal pay for both NPs and MDs. MDs argue that why should NPs’ pay be increased to the same level as MDs when the latter have invested much more in the way of money for their medical educations and have a undergone many more hours in training, internships, and fellowships before being allowed to independently treat patients.

NPs who perform the exact same services as MDs should be paid the same rate regardless of what it took it took to get them to their level of skill and expertise. The value of their services is no less than those of a MD.

Medicare also pays physician assistants at a rate of 85% of that paid to MDs. However, unlike NPs, physician assistants are unable to practice independently and must have the oversight of an MD.

This is going to be an interesting battle for which I am looking forward to seeing what comes of it.

What are your thoughts? Do you think NPs should be paid the same as MDs? Let me read your comments below.

19 Years In A Row!

February 11, 2021 3:02 pm Leave a Comment

Sometimes broken records are good! Nurses are again in the spotlight for the 19^th consecutive year, based on the results of a 2020 Gallup Poll as they are rated the most ethical profession. Eighty-nine percent (89%) of Americans rated nurses very high or high. That is even higher than the previous two annual polls which, of course is due to nurses thrust into the spotlight due to the pandemic that erupted last year.

Interestingly, physicians and pharmacists ethics ratings also improved. Nursing home operators are at 8^th place, a new high for the category at 36%, significantly higher than in polls of recent years.

Nurses ranked head-and-shoulders over other professions. Excluding the pandemic, the public over the years has witnessed the heroic acts of nurses after hurricanes and other natural disasters and in the aftermath of mass shootings. However, this past year, it was very unfortunate that nurses were thrust into the spotlight because of the pandemic.

It is nice to see nurses at the top again as they deserve to be. However, in my practice, I sometimes see where nurses are so interested in helping others that they forget about the ethics of their work.

Now, if you are faced with a situation which does not feel quite right in your gut, but you still want to help, the answer is … don’t do it!

Let me give some examples. Because a nursing home patient in an assisted living facility cannot make an ATM withdrawal herself, she asks you go to a nearby bank on your lunch break and make the withdrawal for her. As much as you may want to help her, this is unethical as you are practicing outside the scope of your profession.

For another example, a fellow nurse tells you that she had already wasted a narcotic and asks you to just go ahead and cosign for her. You agree and sign the chart though you did not actually witness the wasting. You’re putting your license in danger.

And for yet another example, you are a home care nurse, and a patient asks you to destroy non-controlled medications he no longer takes since he has no way to destroy them. This is considered diversion because you are altering the course of medication from the person or the place to destroy it. There are local take back programs or it they can be returned to a hospital or pharmacy, but you should not take these medications from the patient as you are altering the course of where they are supposed to go and are not authorized to take the medication. You are doing it to help but it is an ethical violation.

While I am extremely grateful that the public has turned to nurses to be on top of the most ethical list again this year, I would caution that if you get that gut feeling that if you’re being asked to do something that is not right, yet you want to do it help, then I suggest that you think again.

I would love to read your comments below about when nurses make decisions to help someone else when it is an ethical violation to prevent others from having this problem.

Nurses In Leadership

February 4, 2021 3:06 pm 2 Comments

Registered Nurse and Nurse Practitioner Rear Admiral Susan Orsega has been appointed as acting US Surgeon General. I am so happy that a nurse has been appointed to this position. Who better to advise on how we as Americans can improve our health and reduce the risk of disease other than a nurse? She will oversee the United States Public Health Service. Given the state of the world today and the pandemic, I think she is uniquely qualified to fill this position.

Another leadership initiative by nurses to improve the health of our communities and the nation is by the Nurses on Boards Coalition. Their mission to promote health is by having nurses serve on boards. It can be any board. It can be the PTA/PTO, homeowners association, nursing association, anything to have nurses sit at the table to discuss matters that improve health. Health pervades every area of our life including our family, neighborhoods and of course, ourselves. Nurses on Boards set an intention to have 10,000 nurses on boards by the end of 2020. They exceeded their goal! If you serve on a board, sign up to be counted and if you want to serve on a board, the Coalition is happy to share resources. We do make such a difference and can share our expertise on a bigger scale by stepping into leadership positions in our communities.

How are you a leader in your community? Do you serve on boards? What difference are you making by sharing your expertise outside of your job? I would love to hear your comments below.

A Rose By Any Other Name …

February 1, 2021 12:05 pm Leave a Comment

A frequent question I am asked from new business owners is, “What should I name my business?”

Keep in mind that people are not hiring you for the name but are hiring you for you! Regardless of what name or website name you choose, I strongly suggest owning your name as a url. Unfortunately, for mine, loriebrown.com was already taken. Dot coms are still the best so even if you put in your middle name or a title, like LorieBrownRN.com, LorieBrownLNC.com or LorieBrownConsulting.com that is helpful.

“Should I trademark/register my name?” That’s a question that pops up once you settle on what you are going to call your business. It is difficult to trademark a name. It has to be unique like Kleenex or Coca Cola. Think about the new drugs that are out there. The only way they become known is by the pharmaceutical company spending tons of money advertising their product’s name on media. It would be amazing if your business could get to that point but chances are, at least at this point, that you’re not ready to put millions of dollars to advertise your business.

If you want to find a great name, first brainstorm a bunch of names and, if you don’t want to use your name, what is important to you. For example, if you like horses you might try “The Winner’s Circle” which might sound good. If you are a legal nurse consultant and value integrity, “Integrity Legal Nursing Consulting” might be what you would like.

Make sure the internet domain is available. If it is not, then there’s a good chance that someone else is using the name you chose.

There are a lot of names that are similar. Use a web search to see if someone has already laid claim to the name you want.

There are so many legal nurse consultants that, my tagline from 21 years ago, “Bridging the Gap Between Law and Medicine” is widely used by other legal nurse consultants.

Unfortunately, these taglines are not available to be patented or trademarked.

The next thing you can do is go to your Secretary of State’s website and search business names to see if there are any businesses in your area with a similar name.

Remember you can always change names. I started out as “Nurse Protection Association” and eventually changed it to “empowerednurses.org.”

The first name may not always be right for you and you find a name that explains your business better.

You may want to search the uspto.gov to see if your name is taken and register your intent to use that business name if it is not taken. This is a way to avoid patent or trademark infringement on the name. This may be unnecessary unless you are going to have a huge staffing agency or create a product that you want to get in the hands of millions.

Again, you are always safe using your own name and that helps you build a relationship with your potential clients.

Nurses Say “Aloha” To Hawaii

January 21, 2021 1:41 pm 2 Comments

It’s interesting that Hawaii nurses get the best annual pay of all nurses in the country: $104,060.00 per year. Story. At the same time, California nurses get the highest pay per hour at $54.44 per hour. Nurses in those 2 states are mostly unionized.

If you want to go to the Aloha state for your nursing practice, you will have to quarantine for 10 days with a negative COVID test from an approved provider tested within 72 hours prior to departure to the islands.

However, Kauai, opted out of this program in early December and now they have what are called “reverse bubbles.” Story. In these reverse bubbles you can wear a tracking device and participate to access pools, dining and potentially even the beaches during this 72-hour quasi-quarantine period.

You cannot leave the resort other than for medical care and your movement will be tracked by this bracelet.

This seems to be an interesting workaround but what a great way to enjoy Hawaii before you start as a nurse in that state.

I was surprised to learn that Hawaii was number 1 in salary. How about you?

Covid Fatigue Is Real!

January 14, 2021 12:57 pm 2 Comments

The number of nurses in acute care is dropping as they are leaving the profession in droves.

It is scary to think that we’ve had a nurse shortage even before the CV-19 pandemic erupted but we now are seeing nurses walking away from their careers in even larger numbers. Today’s nurses have never faced such devastation, disease, and death in their lives.

When there is a mass shooting or similar high-volume casualty catastrophe, the clergy, social workers, mental health providers and caretakers are brought in to help those witnesses or those who are aware of the situation deal with their feelings. However, this is not true with nurses. When 5 patients code and die on a shift, there is no clergy or support for the direct caregivers.

A nurse at the frontline of fighting the COVID epidemic is not likely getting the mental health breaks that they so badly deserve. In fact, there are incidences where nurses aren’t even being paid for time off when they have been exposed to COVID or are showing symptoms. If this is the case with you, please contact a Workers Compensation attorney.

As hospitals are filled with sicker and sicker patients, who is available to help our nurses?

Since there is relatively little help for us, we must help ourselves. This means all the things that you know to do and teach everyone else. But we nurses tend to sacrifice ourselves to take care of everyone else because the patients depend on us.

If nurses are not there to do their job, and don’t have the mental stamina to do their tasks well, it’s our individual licenses that could be on the line.

Should you be having trouble sleeping, are irritable, stressed and feel like you can no longer take the pressure any more …GET THE HELP THAT YOU NEED!

Go to your EAP and find a mental health provider. Many are doing it by phone, without hesitation, find the support you need and take the time off to tend to yourself.
Although we may seem to believe ourselves to be superhuman, we are not! The lives of countless patients depend on us and, if we not there to fully do the job expected of us, then we are the ones who suffer.

Please let my message here serve as “a wake-up call” that stress and burnout are just as deadly as the COVID. Please take care of your community, your patients, your family, and yourself. Everyone is relying on you.

Discrimination Complaints In Nursing School

January 7, 2021 3:30 pm 2 Comments

Imagine you are a member of a minority who is being discriminated against at a nursing school that is costing you over $50,000.00 a year?

That is exactly what has been going on a Yale School of Nursing. Who would have guessed that one of our most prestigious Ivy League universities would see a rise in racism complaints? See article.

Yale has a council called “Inclusion, Diversity, Equity, Action, Solutions” (IDEAS) which created a 7-page list of demands.

The allegations included that a guest lecture about dermatology used hundreds of slides on how to identify dermatological conditions, no slides contained black skin.

Another complaint discussed that race can be a factor when it comes to certain diseases. This is happening right now with the COVID virus although it does not know race. COVID is an equal opportunity virus and how sick you will get is based on your underlying comorbidities.

In fact, the racism at Yale was so bad that the Director for Diversity, Equity and Inclusion resigned citing an “oppressive status quo.”

The former Director of Diversity stated that since the murder of George Floyd and the movements of global unrest that have followed, it has become abundantly clear that Yale has always been a dangerous place for black people to learn and work but even more dangerous place for us to speak out.”

I’m glad that those at Yale are speaking out and advising the school of their concerns. They wrote a 7-page demand which includes public acknowledgment that racism is an act of violence and that the current anti-racism plan is inadequate by failing to address the real problem.

In full transparency, I realize now that I believe I was given certain assignments in my nursing career because of my race. I have realized that recently because when you’re in the middle of it, it seems normal for which I apologize. I have a lot to learn in this area.

It takes information like this to enlighten all of us about the problems that are happening in the world and what people of color are really experiencing.

I so appreciate the Yale nurses for taking a stand for equality and not just making it words on a page but to hopefully enact it and change the imbalance of power in the school of nursing and ultimately in our society as we are human beings on this planet regardless of the color of our skin. Nursing school is hard enough, however dealing with discrimination makes it even harder.

I would love to hear your thoughts on this matter. Let me know your comments below.

Will 2021 Be Your Year?

December 31, 2020 9:17 am Leave a Comment

Every year in December I have a retreat with my staff but because of the CV-19 pandemic, this time around we are holding it next month instead. We meet to plan for the year ahead.

Back in the day I used to run my legal nurse consulting business in my garage (every good thing, like Apple Computers, started in garage, right?) and we would get a room at the local branch of the Indianapolis public library for these annual retreats. We would bring in a poster-sized Post-it notepad, put it on an easel and, with different colored markers, map out our entire upcoming year. We would then wallpaper the room with the posters from our creative planning.

Let me share with you some of my yearly planning secrets.

CELEBRATIONS. As business owners, we’re chasing a carrot on a stick, always looking for what’s next rather than looking back and celebrating all the things that went well and worked well during the previous year. I promise you, if you acknowledge and celebrate your wins it will make growing your business a lot more fun as well as give you more joy and satisfaction.
WHAT’S WORKING AND WHAT’S NOT WORKING. Make a list of what has worked and what did not work in your business over the year. When you recognize what is working, you can celebrate those accomplishments, as noted in item 1. When you recognize what has not worked, you can figure out what is in the gap between what’s not working and working. Sometimes you may not have a solution to what is in the gap but acknowledging it helps. I have put people on the list who from my law practice, were difficult to work with. And I would be shocked when those people had left their positions so I no longer had to deal with them. So, even if you can’t do something to make it workable, other than being nice and professional, you can see that things have a way of working themselves out.
GOALS. Make a list of them and the strategy that you are going to use to achieve those goals. The goals can be in terms of money, clients, programs, services … anything! Be as specific as possible and make sure the goals are measurable so that you will recognize when you can celebrate completing those goals, again, as in item 1.
INTENTIONS. An intention is a predetermined outcome. They are going to happen no matter what. However, you need to take action to make that happen. Intention + Action = Results! The only way that intentions do not work is either (a) you didn’t take action or (b) there was a competing intention that was bigger than this intention. We always have 3 financial goals. The first goal is a mandatory we-must-meet-this-goa. The second goal is something we really want to strive for and our third goal is a shoot-for-the-moon goal. We work toward our goals with an anticipation of eventually reaping rewards. My staff loves taking off the week between Christmas and New Year so that is one of our goals. They also like financial bonuses as well and the financial bonuses go up as the 3 levels of our goals between the necessary, would be nice and shoot-for-the-moon goal.

Regardless whether you have been in business for a while or just starting your business, I strongly suggest that you write down these 4 areas so you can really map out the strategy to your success so your 2021 can be amazing!

If you would like more help with this process or if I can be of any assistance in helping you with any aspect of your business, feel free to schedule at
CallWithLorie.com. Whatever way I can, I am always happy to assist at no charge to you and see if how I can help make 2021 your best year.

Nurses Sue Hospital For Endangerment

8:57 am 2 Comments

A group of healthcare workers and their union filed an action against Riverside Community Hospital, an HCA owned facility in southern California. [Story] The Plaintiffs are 4 healthcare professionals that state claims they were not provided adequate protective equipment and that they were pressured to sacrifice safety precautions to meet quotas.

Additionally, the hospital failed to alert staff to possible COVID-19 exposures and pressured staff to work even if they had symptoms of the disease. In fact, one of the healthcare providers is believed to have infected his mother, also an employee of the hospital, who eventually passed away.

This is so sad and reflective of the crises that nurses are facing around the globe. Nurses on the frontlines are advocates encouraging everyone to social distance and wear masks, yet they are not being protected and are not being provided adequate safety measures to ensure their own wellbeing.

Interestingly, each of the healthcare professionals who are involved in this lawsuit are a member of a racial minority making them more likely to contract COVID-19. Studies have shown that minorities are at increased risk of contracting COVID-19.

One of the employee plaintiffs tested positive and a month later, while reporting that he was still experiencing symptoms, was directed to return to work unless he tested positive for the virus again. This healthcare provider worked 1 shift and then received the 2^nd test results which gave a positive reading. Consequently, he could have infected patients and other coworkers.

Also, in the Complaint, the hospital workers claimed they were “verbally abused” by supervisors for requesting masks and face shields.

It is sad that hospitals are garnering more money to take care of COVID patients and not providing proper equipment to staff. HCA reported a net income of 1.08 billion for the 2^nd quarter which included 822 million in government relief to help offset costs to hospitals incurred during the pandemic.

I previously wrote a blog on a lawsuit by the New York States Nurses Association against Montefiore Hospital. However, the lawsuit was dismissed by the court. [Story] Even though the case was dismissed, for healthcare providers in the Empire State, some good came out of that legal action in that:

Nurses are being properly fit for N95 respirator masks;
Nurses are legally required to receive sick pay if they have been out of work due to COVID-19 infection;
Facilities are to expand COVID-19 testing to more nurses working with COVID-19 patients; and
Facilities are to establish additional compensation benefits for every frontline worker to recognize their extra work effort and personal sacrifices.

These safety improvements were made because of nurses fighting for working conditions that protect not only themselves but their patients as well.

Is your hospital now providing you with proper equipment? Is it supportive of you to be tested or take time off if you have symptoms? Let me read your comments below.

Author Archives: Lorie A Brown, R.N., M.N., J.D.