Debate rekindled over what constitutes a “certified” legal nurse consultant, entities spar over best approach

The Gist
• Nurses and attorneys should know the differences in certification programs.

By Dan Clifford, Publisher, and Rose Clifford, Editor
© The Medical-Legal News 2007

The recent adoption by the American Association of Legal Nurse Consultants (AALNC) of the American Legal Nurse Consultant Certification Board’s (ALNCCB) position statement on legal nurse consultant certification has sparked debate over what is an authentic certification. Confusion seems to arise from how each conferring entity defines certification.

Debate swirls around the best approach to becoming a legal nurse consultant (LNC) who is “certified.” Numerous private for-profit entities offer a certification, as defined by themselves, based on completed coursework. Many public colleges now offer a certificate of completion, either usually within nursing continuing education or paralegal programs.

While legal nurse consulting is recognized by the American Nurses Association (ANA) as a specialty of nursing, many LNC programs have taken different approaches to putting nurses on the path toward officially being one.

AALNC’s web site differentiates between certification and a certificate. AALNC, a nonprofit professional organization, confers a certification based on many hours of past real-world experience and an examination.

The concept behind the for-profit approach is that a novice LNC needs some training before diving into the field, since AALNC requires five years and 2,000 hours of hands-on experience as an LNC before an individual can sit for its examination.

While the AALNC has existed since 1989, numerous for-profit certification programs have sprung up, possibly because novice LNCs feel the need to have entry-level coursework.

It should be noted that most all conferring bodies require a student to be a registered nurse first, and it also should be noted that there are no rules regarding the use of the term LNC. AALNC, in fact, does not recommend that a nurse use LNC after his or her name.

Karen Huff, immediate past chair of ALNCCB, states, “As legal nurse consulting is a nursing specialty recognized by the ANA, it is vital that LNCs have a pathway to a recognized certification. The LNCC [Legal Nurse Consultant Certified — the credential acronym given by AALNC] is the only certification in legal nurse consulting accredited by the American Board of Nursing Specialties (ABNS).” AALNC established the autonomous ALNCCB to administer the LNCC program several years ago. The ABNS is a nonprofit establishing and certifying organization for nursing specialties.

But confidence in other boards exists. Veronica Castellana, owner of RN Market, a private for-profit LNC-training entity, insists, “Our nurses are put through rigorous training… LNC STAT [the RN Market course] is the only Advanced Legal Nurse Consultant Certification course available to nurses that is approved by the International and American Association for Legal Nurse Investigators (IAALNI). The IAALNI web site is advertising its first annual summit and board meeting in May, 2007.

Among the other private conferring entities are the Vickie Milazzo Institute and Evans & Associates. The largest of the private schools,  in terms of novice graduates, is the Vickie Milazzo Institute. Some colleges offer LNC certificate coursework such as Canyon College , the University of Central Florida , Wilmington College (part of a masters program), Sullivan University , and Kaplan, among many others.

The  Milazzo Institute’s web site defines its certification as… “the first and most widely recognized legal nurse consulting certification in the nation,” and goes on to say that it is… “the only national certification for beginners, no BSN or legal nurse consulting experience required.”

A growing number of LNC programs are wrapped into schools’ paralegal programs, an approach that makes many established LNCs bristle. There is a fear that nurses working as paralegals will drive down the price LNCs can charge, or possibly thrust nurses, who are medical professionals, into the role of paralegals.

Some LNCs have shunned the whole concept of displaying certification, especially those who work as expert witnesses. These LNCs have found that certifications may generate confusion among opposing counsel during deposition. Kristen Harris, an expert witness nurse in Oregon , says, “Although I have completed training and passed my certification exam with Vickie Milazzo, and could use the initials CLNC®, I choose not to. My consultant work is as an expert witness and I am hired because of my clinical knowledge, education and the fact that I am currently actively practicing as a nurse practitioner and labor and delivery charge nurse. I prefer to highlight my credentials as a nurse, however the knowledge from the Milazzo course has greatly prepared me for deposition and trial testimony.”

According to Pat Bemis, president of the National Nurses in Business Association, “A certification or registration in legal nurse consulting means nothing when marketing legal nursing services to attorneys. Attorneys are looking for an RN who is an expert in his or her field. Expertise can be demonstrated by education degrees or specialty certifications. Certifications in legal nurse consulting are seldom helpful in obtaining cases.”

The RN Market web site concurs, “You do not have to be certified or have a certificate to be a legal nurse consultant.” •