The nursing profession is a great place to find expert witnesses for lawsuits that involve medical issues. Lawyers hire nurses to review adverse medical events, discuss nursing standards of care, and testify in court. These are just a few instances where nurse insights can make or break a case.
But how do busy lawyers find nurses with the right expertise and experience to best help their case? The nursing profession has exploded in the last 25 years. There are all kinds of nursing credentials and specialties which can inform expert witness selection. Clinical experience both in and outside of hospitals bears significant weight on a witness’ credibility and ability to speak to the issues at hand.
Here’s the skinny on navigating the array of nursing educational credentials, primary duties of different nurses, and how to select the right nurse expert witness for your case.
Know Your ABCs of Nursing
Let’s be honest—nursing is rife with acronyms. Finding a nurse expert can feel like you need a translator just to understand the degrees and roles. Here’s a primer on the alphabet soup of RNs, APRNs, CNAs, and LPNs.
Advanced Practice Registered Nurse (APRN)
Advanced practice registered nurses, known as APRNs, sit at the top of the nursing pyramid. These highly-educated professionals earn a Master’s of Science in Nursing to become certified nurse practitioners, nurse anesthetists, nurse midwives, and clinical nurse specialists. Depending on their subspecialty, specialized certifications or additional clinical experience may also be required.
These folks diagnose and treat medical conditions, order and evaluate tests, and refer patients to specialists. You’ll also find RNs with master’s degrees managing nursing teams or becoming leaders in hospital administration. You’ll find a large pool of APRNs for expert witness needs—employment is projected to grow 31% from 2016-2026.
Registered Nurse (RN)
A registered nurse is a licensed professional with an associate’s degree in nursing or a bachelor of science in nursing. They must pass an exam to become a licensed RN. Registered nurses monitor patient symptoms, administer medications, and oversee medical equipment. They are also responsible for recording patient medical histories, performing diagnostic tests, and collaborating with doctors in caring for patients.
Certified Nursing Assistant (CNA)
Certified Nursing Assistants, or CNAs, assist patients in hospitals or assisted living facilities with dressing, bathing, eating, bed and wheelchair transfers, and bathroom needs.
Licensed Practical Nurse (LPN)
Licensed Practical Nurses, or LPNs, attend technical schools or community colleges and are licensed to perform tasks such as catheter insertion, changing bandages, and performing blood pressure tests.
So Many Nurse Experts, So Many Choices
Now that you have a sense of the canopy of nursing credentials and the roles they execute in medical care, how do you decide which nurse expert will be more convincing in your case? It all depends on what medical analysis or issues you face.
For example, if a hospital is being sued for medical malpractice and the standard of care and action taken by an ICU nurse is a central issue, an RN with clinical experience in an ICU unit may be the best bet. He or she can testify to the standard of care in the context of administering direct patient care and making instant decisions in critical situations. An ICU registered nurse can give the jury a feeling for how nursing standards are applied in this intense environment where lightning-quick actions can mean life or death for a patient.
On the other hand, if you are attacking the hospital’s standard of care policies and how the staff enforces them, you may want an APRN who has held a leadership position in a hospital and has been responsible for policy creation and monitoring. Or better yet, an APRN who provides policy development consulting services across many hospitals and can bring a wide variety of perspectives on best industry practice.
Certainly, in wrongful death cases involving delivery complications under a midwife’s care, a midwife APRN would be a highly credible and knowledgeable witness. These cases can elicit emotional reactions injuries who naturally feel for the parents that lost a child. What could be worse for a family? This puts a premium on finding a highly respected midwife who can deliver testimony in a neutral, factual tone that helps jury members see the facts that support your goals.
What if your client suffered a stroke while in the care of an assisted living organization? Their relatives come to you for advice on a malpractice and negligence suit against the entity and employees. As you put your case together, you may want to consult with several different nurse experts to unwind the tale of who is responsible. Was it the LNP who neglected to administer and record daily blood pressure metrics? Or did the supervising RN neglect to review the patient stats for a week and fail to notice that the blood pressure readings were absent or skyrocketing? Should the doctor have prescribed high blood pressure medicine? If the patient was on the medication, was it consistently given as directed?
A Director of Nursing or an experienced RN expert, for example, could analyze the patient records for blood pressure measurements and medicine administration patterns. They could also help you parse through any failures of supervision. A nurse practitioner—remember they diagnose and prescribe medications—could assess whether the patient’s history indicates they should have been on high blood pressure medicine to reduce the risk of stroke.
Making the Right Expert Witness Choice
There is no end in sight for clients needing lawyers’ help in medical lawsuits. As the nursing profession has gained more autonomy and accountability over the years, nurse expert witnesses are playing central roles in the outcomes of medical litigation and investigations.