Why Faking It Is Dangerous: Building Trust

LNC services

“Fake it until you make it.”

A legal nurse consultant posted those words in a Facebook group recently. I understand the impulse behind them. When you’re new, you feel vulnerable and inexperienced. You want attorneys to see a seasoned professional, not someone still figuring out how to format a chronology.

But faking it is dangerous in this field. Attorneys make decisions worth hundreds of thousands of dollars based on what we tell them. They decide whether to accept a case, which experts to retain, and how to question an expert witness or a defendant at deposition. When an LNC provides shaky advice and bluffs, the attorney is the one standing in front of opposing counsel on a weak foundation.

Trust is the product you are really selling. Your medical knowledge matters, and an attorney won’t use it unless they believe in your guidance.

What Attorneys Are Weighing When They Hire You

Attorneys hire LNCs to reduce risk. Every time they send you a case, they’re asking an unspoken question: “Can I rely on this person?”

They evaluate you over time by watching how you handle deadlines, questions, invoices, and mistakes. One inflated claim can erase months of good work.

I heard of an LNC who claimed to have clients in every state of the union. I knew for a fact that she had only a handful of clients. Attorneys talk to each other, too. A reputation for overstating things travels quickly through local attorneys.

I knew a legal vendor who tried to establish rapport with attorney prospects by asking them their mother’s name. No matter how they responded, he always claimed his mother had the same name. He also claimed to have gone to the same college as the attorney. This lie is trickier because if the attorney probed for details, the vendor could be caught unable to answer questions.

I wonder if any of these prospects ever compared notes. “Richard told me his mother’s name was Sarah.” “Oh, he told me his mother’s name was Rachel.”

Be Honest About Your Work Product

Honesty starts before you accept the file. If an attorney asks whether you can review a complex neonatal case and your background is adult cardiac care, say so. You might still take the case if you have a colleague you can consult. You might refer it out or hire a subcontractor who is appropriately credentialled. Either choice builds trust. Pretending you know the NICU does not.

The same principle applies to the report itself:

  • Separate what the records show from what you’re inferring. “The MAR shows no insulin given at 2100” is a fact. “The nurse likely forgot” is speculation, and it should be labeled as one.
  • Tell the attorney when records are missing. A gap in the nursing notes might be the most important finding in the file.
  • Deliver bad news plainly. If the case has a causation problem, the attorney needs to hear that now, not after filing suit.
  • Own your errors. If you misread a date on a chronology, correct it and notify the attorney right away.

I’ve seen LNCs soften their conclusions because they worried the attorney wanted a different answer. That doesn’t serve the client, and attorneys eventually recognize it. The LNCs who get repeat work are the ones who tell attorneys what the records actually say.

Integrity in Billing

Your invoice is a statement of fact. Treat it with the same care you give your analysis.

Bill for the time you actually spent. Don’t round a 10-minute phone call up to an hour. Don’t bill a second client for research you already did on the first case. If you’re slow because you’re learning a new specialty, consider absorbing some of that time rather than passing your learning curve to the attorney.

Attorneys review invoices, and many pass costs to their clients or seek to recover them. Some invoices end up in front of a judge or opposing counsel. A padded bill can embarrass the attorney who hired you, and that’s a fast way to lose a client.

Keep Your Charges Transparent

Transparency means no surprises. Before you start, tell the attorney:

  • Your hourly rate and any minimum charges
  • How much of a retainer you require
  • How you bill for travel, copying, and other expenses
  • A realistic estimate of hours for the scope of work

If you discover the file is twice as large as expected, call before you exceed the estimate. Attorneys work with budgets and clients, too. A quick heads-up shows respect for their decisions: “This file is 4,000 pages, not 1,500. I’ll need about 5 more hours. Do you want me to proceed?”

Itemize your invoices clearly. A line that says “Record review, 14 hours” invites questions. A line that breaks down the work by task answers them before they’re asked.

Treat Ethics as Part of the Job

Legal nurse consultants carry two sets of obligations: those of the nursing profession and those that come with working inside litigation. The AALNC Code of Ethics and professional standards give you a framework. A few principles come up repeatedly:

  • Protect confidentiality. Case details don’t belong in social media posts, even with names removed.
  • Run a conflict check before accepting a case. If you’ve worked for the other side or know the defendant, disclose it.
  • Stay within your role. You don’t give legal advice, and you don’t practice beyond your nursing license.
  • Don’t work with pro se plaintiffs, even if they are your neighbor, friend, or a stranger. They must have an attorney, who hires you, for you to take on their case.
  • Never tie your fee to the outcome of the case. Your opinion must stay independent of whether the attorney wins.
  • Don’t accept an agreement that involves you waiting until the case is resolved to get paid. This gives the appearance of you being paid to help the attorney win, rather than being paid for your time. And with cases taking 3-5 years to resolve, you are doing your cash flow a huge disservice to postpone payment.
  • Don’t shade your analysis to please the client. Objectivity is what makes your work valuable.

Confidence Without Pretending

There’s a difference between faking it and being confident. Confidence says, “I haven’t handled a case like this one, but here’s how I’ll approach it, and here’s who I’ll consult.” Faking it says, “Sure, I do those all the time.”

New LNCs can build credibility honestly. Accept cases that match your clinical background. Find a mentor who will review your early work. Promise a little less and deliver a little more. Ask questions when you don’t understand the legal issues.

Attorneys don’t expect you to know everything. They expect you to tell them the truth. And they will respect you for that. Build your business on truth, and you won’t need to fake anything.

Pat Iyer caricaturePat Iyer MSN RN LNCC is president of The Pat Iyer Group. She has almost forty years of experience developing resources to assist LNCs in obtaining more clients, making more money, and achieving their business goals and dreams.

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