Interview/LNC: Katie Morales, RN, C, CLNC, BSN
Katie Morales: a new LNC gets busy
© 2009 The Medical-Legal News
Katie Morales, RN, C, CLNC, BSN has been a registered nurse for more than 23 years and has experience in ICU, ER and med/surg. She has served as a nursing instructor, house supervisor for a 200+ bed hospital and NCLEX item writer. In 2005 she added legal nurse consultant to the list, as owner of DisceRNment, LLC, in Ellijay, Ga. (http://discernment.biz). Her husband, Rolando Morales, a pharmacist with over 25 years experience, is a pharmacist consultant and her business partner. The two specialize in screening cases, chronological summaries, expert witness location and deposition preparation. Katie is the 2009 president of the Atlanta chapter of AALNC (www.atlantaaalnc.org). She formed the Georgia Legal Nurse Consultant Society in 2005 (http://glncs.freehosting.net). Katie can be contacted by email at Katie@DisceRNment.biz.
Q: What degrees and professional titles do you hold?
A: I have a bachelor of science in nursing, an associate degree in nursing, Vickie Milazzo Institute legal nurse consulting course, American Nurses Credentialing Center certified in adult medical/surgical, basic disaster life support, advance disaster life support, basic cardiac life support and advance cardiac life support.
My professional memberships include American Nurses Association, National Alliance of Certified Legal Nurse Consultants, Sigma Theta Tau honor society, president of American Association of Legal Nurse Consultants (Atlanta chapter), RN Response Network, Georgia Legal Nurse Consultant Society, Atlanta Bar Association Disaster Response Committee and Outreach Subcommittee, GNA ad hoc committee for Nursing Practice and Reference Committee and legislative ad hoc committee.
Q: Are you presently working clinically?
A: Yes, I work in the intensive care unit at Union General, a 50 bed hospital in Blairsville, Ga.
Q: How many years have you been in LNC practice?
A: This is my fourth year.
Q: Why did you go into LNC practice?
A: Colleagues had recommended it, but I was hesitant to be part of a group that I perceived as crucifying nurses. I believe most nurses enter the profession because they care and do their best to help the patients. Then I heard Vickie Milazzo say LNCs could define the standard of care. This appealed to me rather than allowing the standard of care to be imposed by others outside of the profession.
Q: How hard was it for you to get started in LNC practice?
A: I heard the average time that LNCs wait before receiving the first case is six months and I found this to be an accurate estimate. I was beginning to become discouraged, but kept reminding myself of the average time frame. I had a few false starts, but would not celebrate my first case until I had the file and retainer in hand. I marketed in every way known to mankind and had a lot of fun, but kept reminding myself this is a business, not a hobby, and so it has to be profitable as well.
Q: What barriers did you face?
A: Location was somewhat of an issue as many people continue to adjust to the technology advances such as working remotely, by e-mail and with electronic records. Also, attorneys would inquire about LNC experience and ask for attorney references, which I initially did not have.
Q: Did you obtain any formal training? If so, where?
A: I took the five-day Vickie Milazzo class in Atlanta. This was a good starting point and I plan to take the AALNC certification once I have enough experience.
Q: Describe your first attorney interview.
A: I went to as many practice interviews as I could, such as interviews with accountants, financial planners, etc., so that I would be more prepared for my first attorney interview. Still, one day while making cold calls, my mouth fell open when the receptionist ushered me back to the attorney’s office. I did not walk out with a case in hand that day, but have received several since then from this attorney.
Q: Do you use or are you interested in subcontracting?
A: Yes to both. I found the following tips useful when subcontracting: Request a sample work product, a copy of any policies and procedures that will apply (e.g. dress code) and at least one day of training. Have clear terms regarding length of employment. Remember the goal is not long-term employment. You are not training a subcontractor for long-term. Hire an editor for format changes to free the subcontractor to address content. If a full-time employee checks the work it may be more cost effective to have him or her enter needed changes rather than giving it back to the subcontractor to make any such changes. New LNCs should hire experienced subcontractors. Have a fellow subcontractor review and proof work prior to submission.
Q: What is your biggest marketing challenge?
A: Cost is always a factor. As an independent LNC I have to ensure that my advertising dollars pay off. I have had a lot of fun thinking of ways to reach the most people in the target audience within my budget constraints.
Q: What do you think is the biggest reason you continue to receive cases?
A: Although I continue to advertise, I find word of mouth and referrals have yielded the most cases for me.
Q: Have Georgia’s damage caps on medical malpractice actions affected you?
A: Tort reform did indeed pass in Georgia about the time I became an LNC. I do believe it makes a difference in that attorneys are more selective in cases they take on and are more limited in spending money to develop cases since they are limited in amounts they could be rewarded. I have noticed attorneys seem to wait until the last minute to select and engage experts (I believe) in order to avoid that expense if the case settles.
Q: Have you written any articles? Any chapters or books? How many and on what topics?
A: I have contributed to the following: Advance for Nurses, 2004, June; Diabetes Interview, 2002, May; American Fitness, 2000, January; Nursing2000, 2000, May; Nursing93, 1993, June; Health/fitness contributor, Times Courier, 2008 – present; Legal Nurse Consulting: Principles & Practice third edition; reviewer of Developing an Independent Legal Nurse Consulting Practice; and Emergency Nursing Bible.
Q: Have you given any presentations?
A: I have given the following presentations: “Pandemic Flu Preparation” to Gilmer School 2008; “Elements of Malpractice” to the Georgia Nurses Association, 2008; “Elements of Malpractice” to the Georgia Association of Nursing Students, convention, 2008; “Charting Tips” to Union General Hospital, 2008; “Disaster Life Support” to Gilmer High School, 2008; “Aging Awareness” to Senior Connections, 2007; “Pandemic Flu Preparation” to Gilmer Senior Center, 2006; and “Pandemic Flu Preparation” to ETC Television, 2006.
Q: Give three areas of interest other than legal nurse consulting.
A: I enjoy playing my flute, a book discussion group and photography. I have won many ribbons for my photography at the Gilmer County Fair, including two blue ribbons.
Q: What recommendations would you make to a new LNC about the challenges of our specialty?
A: Join the National and Local Chapter of AALNC (www.aalnc.org). I would suggest comparing industry average benchmarks for the business type. Subscribing to a professional periodical such as The Medical-Legal News helps me keep current. Listserves such as the local AALNC firstname.lastname@example.org or the LNCexchange (http://health.groups.yahoo.com/group/LNCExchange) are invaluable resources. Other helpful resources are SCORE (www.score.org), U.S. Small Business Administration ( www.sba.gov), and the U.S. Chamber of Commerce Small Business Center (www.uschamber.com). Free online training for small businesses is available from The Small Business Company (U.S.A.) (www.tsbc.com)