Making A Case For The RN/JD
Nurses Bring Unique Background to Practice of Law
As an administrator at Wingate at Wilbraham, a skilled nursing facility, and before that as vice president of Nursing for Noble Hospital in Westfield, Diane Fernald said she would often bump against the law in her work.
By that, she meant that, in addition to the obvious health care aspects to her duties, there were also legal issues everything from real estate questions to new state and federal regulations to matters of liability to contend with. The more she encountered these legal questions and answers, the more intrigued she became.
So, in 1994, she decided to do more than bump against the law; she decided to make it a new career.
That was the start of a sequence of events that eventually made Fernald part of the Health Care Practice Group at the law firm Morrison Mahoney LLP, which has offices in several major cities throughout the Northeast. Fernald is one of three (soon to be four) registered nurses working in the firms Springfield office who left that field to earn law degrees and now blend their talents in both realms to provide a unique level of experience to clients.
Indeed, the group, which also includes fellow RN/JDs Heather Beattie and Jill Lyons, is enabling Morrison Mahoney to expand its scope of work primarily in medical malpractice defense to areas that include regulatory compliance, managed care contracting, credentialing, licensing and privileging issues, peer review, practice formation and acquisition, risk management, and others.
The nurse-lawyers bring to each of these specialty areas a unique eye, said John Bagley, a partner with Morrison Mahoney. Were able to review regulations notjust with a lawyers eye, but with the help ofnurse-attorneys who can talk the talk, ifyou will, understand medicine, and alsounderstand the practical aspects, as well,he explained. So its not just a bunch oflawyers sitting around telling doctors howto practice medicine; its lawyers with theknowledge of how the real world of healthcare works counseling clients.
And by melding their experiences in health care and law, Beattie, Fernald, and Lyons, can offer some unique insight that can help clients after a suit has been filed, but also assist them avoiding claims, and thus the courtroom.
Were not just assisting clients in litigation, Bagley explained. Were helping them avoid litigation.
The Verdict Is In
Beattie recalled for BusinessWest one recent case involving a caregiver and a malpractice suit filed against her.
She cried for two hours; she just didnt believe that someone would question the care she gave and believe she was negligent, said Beattie. I explained to her how simple it is for someone to bring a lawsuit these days and how she shouldnt be upset by it
That case offers just one example of how attorneys with a background in nursing understand both the technical and emotional aspects of legal matters involving health care professionals. Thus, they can provide a level of service that someone with a JD (juris doctor, or law degree) and not a degree in nursing couldnt bring to the table, said Bagley.
He told BusinessWest that he and partner Dennis Anti recognized an emerging trend in the health and legal professions nurses going back to school to obtain law degrees and have expanded their practice to include many of these unique professionals.
There are many reasons why individuals choose to take that route, said Beattie, who worked as a nurse for 20 years mostly in neurosurgery and intensive care before earning her law degree from Western New England. Some get tired of the long hours, strange shifts, and lost holidays, she said, while others (and she put herself in this category)get tired of assisting 300-poundpeople out of bed.
But perhaps the biggest reason for the career shift is the growing number of opportunities for those who can place RN, JD after their names, said Fernald. The increasingly litigious nature of society has created some of these opportunities, she said, noting that long-term care, one of her many specialities (as both as a nurse and a lawyer) has found itself the target of a growing number of negligence suits.
But there are also new waves of rules and regulations that health care providers must live under, said Lyons, listing HIPAA, the Health Insurance Portability and Accountabilty Act of 1996, as just one example of new compliance issues facing constituencies ranging from single-physician practices to health care systems.
To help providers navigate these increasingly treacherous waters, law firms are reaching out to individuals with a legal and health care backgrounds, said Anti, noting that Morrison Mahoney is setting the standard in this new hiring trend.
Were not creating a market for these services, he explained. The market was already there; were trying to meet a recognized need in the health care community.
Together, Beattie, Fernald, and Lyons have more than 70 years of work in nursing and health care administration to their credit. They pursued law degrees for different reasons, but Beattie might have spoken for all of them when she said, I wanted to pursue something I could do until I was 70 or 75.
A growing number of nurses are thinking in those same terms, said Fernald, noting that most law school classes now include at least one RN, and many have several. Meanwhile, many colleges have created courses or degree programs to address the emerging trend; Elms College in Chicopee has a new program in Legal Nurse Consulting.
There is a also a national organization for such professionals The National Assoc. of Nurse Attorneys, which has more than 1,000 members and dozens of chapters, the closest in Boston.
The reasons behind the surge in RN, JDs are many, said Bagley, but primarily, such individuals can offer a perspective and, therefore, a level of expertise that those without a background in health care cannot.
Dennis and I come from strictly a legal background legal education and legal training and, over the course of 20 yearsplus each, weve learned a lot of medicine, he explained. But the RN, JDs … theyve worked in those environments and that makes it easier for them to communicate with the client and advise the client on how to address these problems were seeing in these lawsuits.
The three RN, JDs at Morrison Mahoney bring different strengths and layers of experience to the table. Fernald, who served as administrator of Wingate at Wilbraham for six years (1988 to 1994) and before that served the facility as director of Nursing, specializes in long-term care defense. This includes work with nursing homes, rehab centers, and assisted living facilities. She also handles medical malpractice defense, product liability, and professional liability representation.
She first worked with Bagley at the Springfield firm Egan Flanagan, and Cohen, and later worked for the Commonwealth as an attorney and Medicare program manager, handling Medicare and Medicaid appeals and thirdparty liability.
Beattie told BusinessWest that, while in law school at WNEC, she considered getting into criminal work. She interned at the U.S. Attorneys office in Hartford, and, later, in district court in Springfield. She opted, ultimately, for work that involved both of her professional degrees.
In 1999, she became the first RN / JD to join Morrison Mahoney, and since then has cultivated a multi-faceted practice that includes medical malpractice and product liability defense, general insurance defense, representation of physicians and nurses in Board of Registration in Medicine and Board of registration in Nursing complaints, and general health-law litigation.
Lyons became the latest addition to the team in June. A 2003 graduate of the Massachusetts School of Law, she did some consulting work for the Nashoba Valley Medical Center and also served as interim director of its emergency department. She later joined Worcester Medical Center as director of risk management and patient safety officer.
In those roles, she actually became a client of Morrison Mahoney, working extensively with Beattie and Anti. As the need for additional RN, JD at the firm became evident, work to recruit Lyons ensued and then escalated.
A fourth nurse/lawyer could be hired in the near future, said Bagley, noting that, while law firms are generally conservative when it comes to expanding staff, there is a definite need within the market for the unique blend of talents that RN/JDs can provide.
Together, the RN/JDs will help Morrison Mahoney achieve goals common to every law firm, said Bagley expanding the client list, while also providing a wider array of services to existing clients.
As they talk about the health care profession and their work as nurses, Beattie, Fernald, and Lyons all use the present tense and with good reason.
Thats because while theyre all working a law firm, they are still nurses. In fact, as Fernald told BusinessWest, they are better nurses now than when they were in the field because of what theyve learned in their new profession.
But, ultimately, they are more than nurses. They are RN/JDs, and thus on the cutting edge of what would have to be considered a healthy career track literally.
George OBrien can be reached at[email protected]