Being a Legal Nurse Consultant has gotten a lot of hype over the past few years mostly because it appears to be a profitable line of work.   All the fan fare has unfortunately turned it into something it may not be and overshadows all the other interesting and just as lucrative careers nurses can pursue in the law industry.  Legal Nurse consulting will not be overlooked in this article for those who may be interested.  It just won’t take the cake like it always does.  So, along with Legal Nurse Consulting, nurses interested in law usually go into Healthcare Risk Management, become Attorneys with a specialty in healthcare, or become Nurse Paralegals.

Healthcare Risk Management

Risk Managers are usually employed in hospitals but there are a few companies out there that provide consultancy services.  Nurses interested in a career in Risk Management do not require any specialized licensing or training but it is highly advisable to have your BSN and obtain a certification from the American Society for Healthcare Risk Management.  Many nurses enter the Healthcare Risk Management field through the hospital they already work.
Healthcare Risk Managers are usually responsible for identifying and controlling risk in clinical settings, developing standards for patient safety, maintaining compliance with HIPPA, OSHA and JCAHO standards.
Here is a list of job titles in Healthcare Risk Management along with compensation:

Gross Annual Salary by Title
All    $78,273-$72,000
Director/Manager of Risk Management    $80,244-$79,168
Risk Manager    $68,239-$64,000
Director/Manager of Quality/Performance Improvement/Assurance    $68,345-$65,000
Vice President of Risk Management    $131,080-$125,000
Risk Management Coordinator    $55,870-$53,500
Consultant    $86,270-$80,000
Risk Management Analyst/Staff    $62,481-$60,000
Claims Manager/Director    $80,983-$79,000
Source: American Society for Healthcare Risk Management (ASHRM) – 2004 Compensation Survey for Healthcare Risk Management Professionals

Resources:

•    American Society for Healthcare Risk Management
www.ashrm.org

Nurse Attorney

Becoming an attorney requires successfully completing law school.  As some people know, law school is three years, can be expensive and is usually full time.  Besides that little issue, healthcare attorneys are rarely unemployed in our litigious society and find themselves in high demand.  Nurses who become attorneys can work in a law firm, start their own practice or work in hospitals in the Risk Management department.  Either way, compensation varies greatly depending on where your paycheck comes from but I doubt you’ll be eating Ramon Noodles for long.

Resources:
•    A must read article…Healthcare Law: A Career Guide by David Ahearn Attorney Advisor
http://www.law.harvard.edu/students/opia/docs/guide-health-law.pdf
•    The American Association of Nurse Attorneys
www.taana.org

Legal Nurse Consultants

Legal Nurse Consultants do not require further education or certification.  You call a law firm and ask if they need your services or if your lucky, a lawyer will call you (not very likely unless you’re the one being sued). Legal nurse consultants review medical records and help attorneys decide whether professional negligence occurred in a given case. Disability or Workers’ Compensation cases may require a similar review. The consultant might help the attorney prepare for a deposition of the plaintiff or the physician, perhaps by familiarizing them with medical or nursing terminology. Finally, the legal nurse consultant can testify as an expert witness at a trial.  To improve your credibility, you may want to obtain certification through the American Association of Legal Nurse Consultants, get yourself some business cards and a brochure describing your nursing experience.  Other than that, it’s all legwork selling yourself.  Compensation varies greatly.  Some have to settle for $15 per hour and some may get the whopping $150 per hour that’s been all the hype.

Resources:

•    American Association of Legal Nurse Consultants
www.aalnc.org/

Nurse Paralegal

Paralegal nurses have been around for about 20 years. A nurse paralegal is employed in law firms, HMO’s, Insurance companies and government agencies.  They assist in interpreting and understanding medical issues and may draft pleadings, conduct legal research and handle other legal issues.  Compensation is usually the same if not slightly less than a typical nursing job in a hospital but you have the luxury of nights, weekends and holidays off.   Training as a paralegal is required and consists of either a Nurse Paralegal Certificate, 2 year or 4 year degree.

Resources:

•    A must read article: From Bedside to Courtroom by Shirley Kawa-Jump
http://www.medhunters.com/articles/fromBedsideToCourtroom.html

•    Paralegal Associations
http://www.paralegalgateway.com/associations.html

Thanks for reading and be sure to check out my updated blog at http://alternativenursingcareers.blogspot.com

For whatever reason you need to leave traditional nursing, understand that you’re in a unique situation because you’re not changing careers per se. You are expanding on the one you have with little or no information out there to guide you. Nurses who have left the profession, whether it was to do something completely different or to go into careers were nursing was an asset, have not shared their experiences with other nurses in order to offer some advice. At least I have yet to find any. But, all is not lost….there is some interesting info out there. Below is a short and sweet description of three vital steps to get you started on your new career.
First off you must accept the fact that you deserve to have a happy and fulfilling life. You are only limited by your thoughts so get your thinking straightened out a bit. You deserve to feel good about yourself and your work. You deserve to come home feeling like you accomplished something. You should never dread or fear going to work. You should never feel invisible, ignored, patronized, bullied, walked on, threatened, exhausted, frustrated, panicked, starvation and/or a bursting bladder because there is no way you could eat or pee. Here’s a list of books and other sources to clear your head and get you in a good frame of mind:

• Book: Self Esteem: A Proven Program of Cognitive Techniques for Assessing, Improving, and Maintaining Your Self-Esteem by Matthew McKay (Author), Patrick Fanning (Author)
• Book: How to Succeed at Being Yourself: Finding the Confidence to Fulfill Your Destiny by Joyce Meyer (Author)
• A Good Article by Michael Lee http://www.goarticles.com/cgi-bin/showa.cgi?C=604693
• Book or DVD: The Secret by Rhonda Byrne
• Podcasts. Amazing freebies from experts all over the world. Do a search on iTunes or Yahoo on any subject. You don’t need an MP3 player. Just click on the podcast and it will play through your computer. Here’s a good one as an example: Morgan the Empowermentor

Next step is to figure out what you might be interested in. Easy right? Actually, if you take this important step bite by bite…which is how you eat an elephant… you will find your answer. Here are just a few of the questions you need to ask yourself and you will not find the answers in “How to Change Your Career” books:
• What kind of lifestyle do you want?
• Where do you want to live?
• Who do you want to be friends with?
• Do you want to work from home, out of a suitcase, in a small office or big conglomerate?
• How much money would you like to make?
• How much time do you want to spend at work?
There is an amazing amount of options out there for you. Start reading, talking to people in these jobs and maybe even shadow a few. It will give you a clear idea of what your life could be like. Here are a few resources to get you started:

• Article: Spreading Your Wings: Career Alternatives for Nurses by Donna Cardillo RN, BS www.dcardillo.com/articles/spreading.html
• Article: Hot Jobs, Emerging Careers by Sally Parker www.minoritynurse.com/features/nurse_emp/02-12-04a.html
• 101 Careers in Nursing by Jeanne M., Ph.D. Novotny, Doris T. Lippman, Nicole K. Sanders, Joyce J. Fitzpatrick
• Web site: Quintessential Careers Resources http://www.quintcareers.com/career_exploration.html
• Book: Do What You Are: Discover the Perfect Career for You Through the Secrets of Personality Type by Paul D. Tieger, Barbara Barron
• Book: The Career Adventure: Your Guide to Personal Assessment, Career Exploration, and Decision Making by Susan M. Johnston

Nurses generally have it pretty easy when it comes to the job hunt. Jobs come to us; we don’t usually have to lift a finger. Besides multiple full color full page spreads in Sunday papers, there’s billboard adverts, radio and TV commercials, mailings, job fairs, generous sign on bonuses, paid relocation expenses and the list goes on. For all my years in nursing, I’ve never had a real interview, had to produce a resume or really make much of an effort to get a job except show that I have a current untarnished nursing license and a pulse. Our non-nursing friends however, have had it a little different and have had lots of practice selling themselves. Now it’s your turn and because you have a high self-esteem and know what you want to do, this step will be just filling in the blanks…right?
Start off by polishing your image. Let’s face it; we wear pajamas to work. Scrubs are great, they are comfy, cheap, don’t need to be ironed or dry cleaned but you wouldn’t wear them to a job interview. Invest in some business attire and treat yourself to a new hair cut. You deserve it anyway. If you’ve got the cash, call on an image consultant. They can help you find a look that not only suits you but also comfortable and easy to live with.
Write a winning resume and cover letter…piece of cake. There are thousands of books, articles and businesses out there specifically aimed at creating the perfect resume. It is what your future employer will see first and what will be the impression you leave on them. Since most nurses never had to create such a monster, it is all new ground. Remember; don’t cheat yourself by copying a template. You are unique and have plenty to offer. Use templates as a guide only.
Go on a few interviews. Start off with jobs you’re not that interested in and/or don’t qualify for. Interviews are great practice. You will learn this art of selling and communication only by practice. If you develop a good relationship with the interviewer despite not getting the job, ask what you could do to improve your image. What can it hurt? Here are a few sources to lend you a hand:

• Book: Resume Magic: Trade Secrets of a Professional Resume Writer by Susan Britton Whitcomb
• Book: Cover Letter Magic: Trade Secrets of Professional Resume Writers by Wendy S. Enelow and Louise Kursmark
• Book: Resumes For Dummies (Resumes for Dummies) by Joyce Lain Kennedy
• Web site: How to write a resume and cover letter by JobStar Central
http://jobstar.org/tools/resume/index.php
• Web site: Resume help by Resume Resource
http://www.resume-resource.com/
• Association: Association of Image Consultants International www.aici.org
• Web site: Job interview advice www.jobinterviewquestions.org/
• Book: Competency-Based Interviews: Master the Tough New Interview Style And Give Them the Answers That Will Win You the Job by Robin Kessler

CLINICAL RESEARCH

A CRA spends a lot of time visiting clinicians who are performing clinical trials to ensure that everything is being done correctly, that the patients are not being compromised, and that the data collected are accurate. A CRA can work either for a pharmaceutical, biotechnology, medical device companies, academic medical centers, government agencies or a Contract Research Organization (CRO). The latter is contracted by companies to run their clinical trials.
A clinical trial is a research study in humans of a drug, medical device, biologic (such as a vaccine) or treatment. Individuals who volunteer to participate in a clinical trial are called “subjects” or “participants”. We generally conduct clinical trials on these products to determine if they are safe and effective for use by the general population. For example, pharmaceutical products must be tested in clinical trials before they are approved to be prescribed by a doctor.
Skills needed to perform this job are problem solving, interpersonal skills, and the ability to work as part of a team while being independent. The most important skill is clinical skills. That’s why nurses are ideal candidates for CRA positions and why many apply for positions and get them without any formal training or education as a CRA. However, it is recommended that you do increase your chances of getting a job as a CRA by taking a few courses offered by the following associations, your local community/technical college or any other entity offering classes.
Training for CRA is offered worldwide. If you can’t find something close to home, contact any of the associations here and they will guide you in the right direction.

The Best Resource

CenterWatch Clinical Trials Listing Service. This site has everything: Reading, training, jobs, associations, online training programs. www.centerwatch.com/index.html

Associations

Association of Clinical Research Professionals www.acrpnet.org
The Society of Clinical Research Associates, Inc www.socra.org
The Institute of Clinical Research www.instituteofclinicalresearch.org

Reading

From Test Tube to Patient: Improving Health Through Human Drugs. Published by the US Food and Drug Administration Center for Drug Evaluation and Research. (1999). http://www.fda.gov/fdac/special/newdrug/ndd_toc.html
So You Want to Be a CRA: A guide to careers in clinical Research (5th ed). Published by Ingenix Pharmaceutical Services (1999).
Stonier, PD (ed), Discovering New Medicines- Careers in Pharmaceutical Research and Development. John Wiley and Sons (1994).
Zivin, JA. Understanding Clinical Trials. Scientific American, April 2000 (p 69-75)
Spilker B. (1997) Guide to Clinical Trials. Philadelphia: Lippincott-Raven Publishers.
Centerwatch http://www.centerwatch.com/patient/backgrnd.html (go here for more information about clinical trials including an online glossary of terms)
Lui, M. and Davis, K. Lessons from a Horse Named Jim (2001) Duke Clinical Research Institute.

Education (These are just a few of the many programs offered throughout the US)

Certificate Program in Clinical Trials University of Washington, Seattle www.outreach.washington.edu/ext/certificates/cli/cli_gen.asp

Certified Clinical Research Associate McMaster University Continuing Education Department Hamilton, Ontario www.mcmaster.ca/conted/ccra/

UNC Chapel Hill School of Nursing Continuing Education Department Clinical Research Associate/Clinical Research Coordinator Course Chapel Hill, NC http://nursing.ce.unc.edu/schedule.html

Clinical Trials Research Associate Program Durham Technical Community College Durham, NC www.durhamtech.edu/html/prospective/programsofstudy/clintrialsqa.htm

Delaware Valley College Certificate Program Delaware, MA www.delval.edu/continuing/certs_cra.htm

The Norton Training Institute for Clinical Research Excellence Lexington, SC www.nortonaudits.com

Rutgers College of Nursing Clinical Research Associate/Clinical Research Coordinator Course Newark, NJ http://nursing.rutgers.edu/

Northwestern Center for Clinical Research Chicago, IL www.medschool.northwestern.edu/nccr/index.html

Who’s Hiring (this list is the tip of the iceburg)

Any, every and all academic medical centers have research and/or clinical trial departments

Quintiles www.quintiles.com

Sarah Cannon Research Institute www.sarahcannonresearch.com

Johnson & Johnson www.jnj.com

Abbott Laboratories www.abbott.com

Clinforce (staffing agency) www.clinforce.com/clinforce/

Prometrika (contact research organization) www.prometrika.com

Actavis www.actavis.com

Covance www.covancecareers.com

Delta-Pharma (staffing agency) www.delta-pharma.com

Clinical nursing is not always the answer. Maybe it never was or maybe it was for a while and now it isn’t. Either way you found yourself digging through the Internet for answers and have found very little. Don’t let that fact for one-second lead you to believe your options are slim…they are just the opposite.
Your career in nursing has opened countless doors for you. You just have to open your eyes to all the possibilities and stop focusing on your perceived limitations…and I mean perceived.

Here’s a list of perceived limitations:

I don’t have my BSN
I’m too old
I just lost my license
I don’t have enough experience
I’m a new grad
I have a mortgage
I have children
I have too much debt
I don’t want to go back to school
I can’t afford to go back to school
I can’t afford to take a cut in pay
I don’t want to work 9-5
I’ve never done anything else
I don’t have a resume
I don’t know how to write a resume
I not really good at anything else
I’m not qualified for anything else

Need I go on…because I could. I’m not saying these perceived limitations don’t exist..just don’t use them as excuses not to get out of a situation that is making your life miserable. You know the old saying, “life is short.” Well, it is and it’s never too late nor is it ever wrong to be happy. Just think about how successful you are now in an environment that does not encourage you. Now imagine being in one that does…what would you be capable of then!

Now, here’s the dirt. I have been researching alternative nursing careers for over 10 years. So, I have a small idea of what’s out there and how to get it. Every month I will feature a career that a registered nurse is qualified to work in. Along with the featured career, I will provide recommended reading, courses, seminars, associations; companies that offer such jobs and other pertinent resources to help you explore that particular option. I hope you find my research helpful and I always welcome feedback!