Legal RN Reporter (A Publication of Haibeck and Associates Legal Nurse Consulting)

Haibeck and Associates Legal Nurse Consulting REPORTER Medical News You Can Use in Your Law Practice

Volume 1 Issue 1

I did everything no one wanted to do as a volunteer candy striper on the unit at Little Company of Mary Hospital in Evergreen Park, Illinois in 1971. From Candy Striper (to Almost Journalist) to Legal Nurse

existed) versus the school of nursing. I resisted (I didn’t want to wait through two years of prerequisites before I encountered working with real patients) and attended Wesley– Passavant School of Nursing and later completed my bachelors’ and masters’ degrees in nursing through Northern Illinois University. Inspired by the pressing patient education needs and increasing knowledge base surrounding that new specialty “oncology”, I latched onto anything I could learn about cancer care treatment and volunteered to take care of those ‘scary’ patients. No one wanted to talk to or about these patients let alone discuss those ‘growths’ or ‘tumors’ that were killing them. Many families chose not to “tell” their family member the diagnosis, but the patient knew.

As a sixteen year old, I was excited to answer the lights (you never knew what someone wanted), file paper lab reports or deliver a gross looking specimen to the lab. My idol was the “head nurse”, Gloria, (think flying nun nursing cap and all white uniform, hose and shoes), who patiently answered my questions on what being a nurse was “really like”. My career decision dilemma included the fact that I enjoyed writing and was editor-in-chief of the Mustang Monitor, our high school newspaper and could envision myself the editor of something spectacular in the future. Practicality (tuition money) won out as I had a nursing government loan approved, due to the nursing shortage (that never ended) and no family scholarship money. Counselors encouraged me to pursue a bachelors’ degree in nursing (no associate programs of any kind

They were very sick people presenting with stage IV cancer. They went home to die with their family – no life-saving therapy, no ICU, no home care and certainly no hospice. Elizabeth Kubler Ross’s book On Death and Dying , was just published in 1969. Caring for oncology patients and their families began at Northwestern

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EXPERT TIPS & ADVICE

For maximum effectiveness in communication, you have to engage as many of the senses as possible—sight, sound, touch, etc. So be sure to use images, charts, even recordings to present evidence for your client. My exclusive “Day In The Life” videos capture the plight of the injured in a multi-sensory way so you they get the best possible representation and favorable outcome. Contact me to see a sample and find out how you can benefit from a “Day In The Life” video: (630) 750-5486 or email clnc@haibeckandassociates.com.

LEGAL RN REPORTER

One area this is evident is the hand-off process, when a patient moves from one area of care to the next. An example would be failure to communicate information from the treating hospital to the receiving nursing home or extended care where continued medical care and rehabilitation are provided. Although ideally discharge planning begins at admission, the actual day of discharge always is chaotic coordinating the transportation time, family presence and signatures on multiple forms. Often, transfer is sooner than expected. Practical questions being asked by staff and family at the time of discharge include: ▪ Is the bed at the facility ready? Are the transfer orders written by MD? ▪ Does he need a wheelchair or cart? Will lunch be ready for him? ▪ Is staff ready to receive the patient? What’s being paid for? What medicines will he stay on? Does he need a pain medication before transfer? Does he understand what is happening? ▪ What doctor is following his care? Who’s filling out the transfer form? This sounds straightforward, but many of these questions are not answered until the day before or morning of discharge and the patient’s nurse is probably caring for several other patients at the same time. The family is hovering and anxious. There are many opportunities for a medication change or an active diagnosis to be documented. The most important question is - Has the patient’s condition changed overnight requiring reassessment of transfer? All these questions take time: to answer, act upon and communicate to the proper health care professional. What we’ve got here is… a FAILURE TO COMMUNICATE. Failure to communicate is a frequent theme in many medically related cases.

Time is usually in short supply on a busy morning on a hospital unit According to Healthcare Quality and Consulting, the handoff process has become very complex because: ▪ It takes many forms. ▪ It is rarely face-to face. ▪ Cut and paste becomes imbedded in the process. Communication gaps lead to mistakes. Many lawsuits involve some sort of communication gaps in the written process. Oftentimes we are looking for something that was never documented or not transcribed properly to the correct document. Upon reviewing medical records involving any transfer of care consider if everything is in order so you would completely understand the care of the patient once received. Is the skin condition documented? What is patient’s level of awareness? Was there a failure to communicate between any two departments or participants in this patient’s care? You may be surprised at who is not communicating (or documenting) with who. Susan was featured in the Legal Nurse Consulting Success Story section in the CLNC Vickie Milazzo Institute for Legal Nurse Consulting Blog in January 2017. Read about how she built a flexible schedule and steady income as a Certified Legal Nurse Consultant: https://tinyurl.com/SusanSuccessStory

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MEDICAL NEWS YOU CAN USE IN YOUR LAW PRACTICE

Memorial Hospital, where I stayed to work as an RN after nursing school graduation. I believed I could help those acute leukemic teenagers and their families cope better with the diagnosis. Reflecting on my career, I realized none of the specialties I worked in existed when I graduated from nursing school in 1975 ( the same year ibuprofen came on the market – patients were getting two aspirin for complaints of pain at that time). Chemotherapy, radiation therapy, venous access devices, cancer genetics were all examples of subspecialties in which I participated. Legal nurse consulting has been my most recent nursing endeavor and I have been serving attorneys and their clients since 2015. Making a difference in a client’s life or an institution’s policies and procedures by being an involved member of the legal medical team motivates me. My knowledge of nursing culture and inpatient and outpatient settings lends a unique perspective to a health-related case. Learning something from every case, no matter what the issue or specialty, I strive to provide my attorneys and their clients with an exceptional work-product. —continued from page 1 From Candy Striper (to Almost Journalist) to Legal Nurse

FAVOR I T E P L ACE S

Magic of Mackinac Island

It’s been around a long time, but I only recently discovered the magic of Mackinac Island. Although tourists impact the population during high season of May through September, the year round population is only about 500. Yes, they have a year round school and I talked to one of the teachers there while she was driving the horse –driven carriage taxi during the summer. You see, the locals banned cars to the island in the early 1900’s, because the automobile noises frightened the horses. And it’s been that way ever since. Your car is left on the mainland and a thirty minute ferry ride gets you over to this three mile wide island. To me, it’s absolutely beautiful and historical. Horses have the right of way, then bicycles and pedestrians. I love the gentle clip-clop sound of the carriages and horseback riders passing. I have stayed at the same bed and breakfast, The Inn on Mackinac every time I’ve gone.

The Inn on Mackinac

I even took a watercolor class with a local artist – which is outside my comfort zone, and loved it. I don’t

Watercolor student work

think I’ll ever have my own exhibition, but I enjoy it. Shown are the samples of the students’ work – I’m not telling which is mine! Mackinac Island was a strategic center for the fur trade. Fort Mackinac was built by the British in the 1800’s and is open for tours. I hope to return this summer to continue my Mackinac Adventures. The fudge and ice cream are phenomenal!

The Legal RN Reporter Newsletter is a publication of Haibeck and Associates Legal Nurse Consulting. To subscribe, visit www.HaibeckAndAssociates.com This publication is for information purposes only and is not intended to be legal advice. The information in this newsletter may be freely copied and distributed as long as the newsletter is copied in its entirety. Design and publication by Zine (www.zinegraphics.com). Copyright © 2018 by Haibeck and Associates Legal Nurse Consulting. ABOUT SUSAN HAIBECK: As a legal nurse consultant with cancer nurse specialist experience for over thirty years, Susan has analyzed oncology cases such as failure to diagnose, extravasation of chemotherapy and non-chemotherapeutic agents, failure to obtain consent for chemotherapy, radiation therapy and surgical oncology cases. Susan provides value and benefit to her attorney clients with comprehensive and efficient reviews of medical records, preparation of deposition questions and affidavits, coordinating a ‘Day in the Life Video’ to visually portray impact of injuries, locating expert medical witnesses, assisting in exhibit preparation, conducting medical literature searches and integrate the literature into case analysis, and providing additional legal nurse consultant services as requested. For a complimentary review of medical records for your case, contact Susan at (630) 750-5486 or email clnc@haibeckandassociates.com

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Haibeck and Associates Legal Nurse Consulting 581 South Saylor Ave Elmhurst, Illinois 60126

(630) 750-5486 clnc@haibeckandassociates.com www.HaibeckAndAssociates.com

INSIDE THIS ISSUE

I often come across interesting articles or medical facts concerning medically related cases that I would like to share with the attorneys I work with and the attorneys I haven’t met yet. This is my vehicle to do just that. Enjoy! WELCOME to the Legal RN Reporter!

▪ From Candy Striper (to Almost Journalist) to Legal Nurse Consultant ▪ What we’ve got here is …a FAILURE TO COMMUNICATE. ▪ Favorite Places: Magic of Mackinac Island.

CANCER QUESTION CORNER As an oncology nurse specialist for over thirty years, I have guided many patients and families during cancer treatment. In each issue, I will answer a common, but frequently misunderstood question, that I am asked.

Q. Why do I have to have a biopsy? The doctor said it looks like cancer.

cells, which means the tumor started in the colon, not the liver. Knowing where it started, as the primary cancer, definitely affects treatment decisions. It is not “one chemo fits all”. There are over 200 different chemotherapy medicines. Having this answer leads to many more questions which I will address in future issues.

In order to determine a plan of treatment, the physician needs to be sure it is truly a cancer and not benign (non-cancerous). After the biopsy, a specially trained physician, a pathologist will look at a piece of the specimen under the microscope to determine the type of cell and what organ it came from. Sometimes, it is an unexpected answer. A liver biopsy may show colon cancer

After the biopsy, a pathologist will determine the type of cell and what organ it came from.

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