As with any law firm who takes on cases in the healthcare industry, having someone with an intimate knowledge of medicine is essential for success. Attorneys rarely have that type of firsthand knowledge, which is why having a trusted consultant on the team is so important.
For over 11 years, Debbie Pritts has been Wexler Wallace’s Legal Nurse Consultant. As well as being the president of the American Association of Legal Nurse Consultants, Debbie draws from her 25 years of clinical experience as a nurse to support our attorneys and clients in some of the firm’s most complex medical cases.
We caught up with Debbie to get her thoughts on her career, and the healthcare industry as a whole.
Thank you for making the time to sit down with us today. Can you describe your role at Wexler Wallace to our readers?
I help to bridge the gap between the fields of medicine and the law, researching from a variety of sources such as specialty peer-reviewed journal articles, medical textbooks or maybe government agencies such as the FDA and other healthcare organizations. The research I locate is necessary to support the causation and the standard of care or to provide an overall general knowledge to educate the attorney on the medical issues. Many times I have located expert witnesses for our cases through this research or through a network of my colleagues. I further assist the attorneys by working with our experts throughout the case. I also assist the attorney when preparing for depositions and at trial.
A large part of my role remains in developing chronologies from the medical records by creating timelines and narratives to convey the events that helped to come to my conclusion of the cases I review. I have taken medical records totaling several thousands of pages and condensed them into a document that may be less than one hundred pages. Many times I feel the attorney reads the summary and thinks “what took her so long?” but that’s the value of having a nurse review and summarize the records. Deciphering the handwriting and drilling the information down to what is important and presenting that to the attorney is much more palatable to read than a box of repetitive records. I also work closely with our attorneys to educate them on the underlying medical issues at hand. This may include formatting visual aids to enhance work product for explaining medical diagnoses and procedures used for overall education or collaborating with other companies to create demonstrative evidence for use at trial.
Initially my role was to be the point of contact with the client at their initial time of inquiry, directing the staff in the medical records needing ordered, as well as reviewing all medical records for product identification and damages. Wexler Wallace has grown their mass tort division so much in the past eleven years I have been employed here that it just became impossible for me to be the only point of contact for our clients. The silver lining is that our staff has grown in numbers as well! I work with our staff to educate them in how to perform intakes by creating intake forms and explaining new cases to provide them with a thorough understanding for completing intakes, ordering the necessary records, locating product identification in the records and recognizing the damages.
What originally prompted you to make the career change and become a Legal Nurse Consultant?
I wish I could say I had some grand vision but it really came about after receiving an advertisement for continuing education from a university. This piqued my interest to look further into legal nurse consulting, so I searched several programs until I located one that I felt best met my needs. I already had the knowledge and experience in the medical field so it really was a course to explain how to review a medical record with a legal eye to discover the information an attorney needs to evaluate a case and proceed.
What was it like making the switch from the healthcare field to legal consulting? Were there any challenges to overcome in the transition?
Sitting at a desk! Clinical nurses do not sit at the nurses’ station like they are portrayed on the television. I had run the halls of a hospital for over 20 years and now to sit for so long at a desk has been the worst part of the job. On a more serious note, I worked in oncology nursing at a teaching institution for several years. My colleagues and I worked long, hard hours in an emotionally draining environment. And at the end of a shift, I felt like I gave my best to my patients. It troubles me now when reviewing records to see how care was not up to the standards. It also troubles me to read documentation of care that is less than adequate and recognize how that might have occurred.
You currently serve as the President for the American Association of Legal Nurse Consultants (AALNC), in addition to acting as Wexler Wallace’s Legal Nurse Consultant. Both of these positions require expert medical knowledge, but are indirect roles. Do you ever miss working directly with patients?
I very much enjoyed clinical nursing and I miss it. I loved caring for my patients’ physical needs, providing emotional support to them and their families or being a patient advocate. I also very much enjoyed teaching my patients about their diseases and their treatments. I still feel like I perform some of these tasks, obviously not the physical care, but when I speak with our clients its always in conjunction with an attorney. Whether an attorney is first considering taking a case, or needing ongoing investigation in another, the aspects are multifactorial with both medical and legal considerations. Our clients (similar to my former patients) appreciate a thoughtful and knowledgeable review and explanation that I can provide from a medical point as much as what they receive from the attorney.
As president of our national professional organization, I am hoping to promote to the attorneys and instill the concept of what I believe in to other nurses, that by polishing my skills as a legal nurse and keeping up to date in both medical and legal components, I ensure that I am not only a valuable but essential asset to the legal team.
Everyone has a “career-defining” moment that makes all of their training and hard work worth it. What would you say is your career-defining moment?
I had a particularly busy day on the oncology unit where I administered chemotherapy, some based on standard doses while others were involved in clinical trials. We had many standards in place already to ensure the right patient, drug, dose, route and time were checked. One of my patients was participating in a clinical trial testing escalating doses of one of our commonly used chemotherapy medications. She had randomized to the highest tier of the trial, meaning she was getting a much larger dose than the standard. The drug dose was prepared in the pharmacy and delivered to the floor. Looking at the drug I knew it was a larger dose but in my mind I reasoned “she was on the highest tier of the doing in the trial.” Still I was not comfortable and our standard was to check the dose with a second nurse before administering and she signed off, but I was still not comfortable. So I took the extra time to re-read the handwritten orders from the MD (which were difficult to read due to poor handwriting, which is not unusual).
I discovered the pharmacist had filled and delivered the total dose my patient was to receive over two days, into one dose! I was giving day 2 of the drug (she received day one the previous day) and if I had given that amount, the outcome would have been devastating. It really shook me to my core realizing that I could have inadvertently hurt someone if I was working too quickly or did not take the time to trust my gut and check a second time.
If you could make one permanent change to the healthcare industry, whether it’s altering common practices or regulations for the better, what would it be?
Improving communication! Not only will this improve patient outcomes but it will decrease medical errors. Having an open and positive relationship with your patient laced with enhanced communication skills will help a patient to better understand their disease and recommended treatment resulting in improved management of their medical condition. Improving communication between healthcare providers, especially during transitions in care, helps to raise awareness to not only track the relevant health information data but also comprehend it and plan an appropriate response, thereby reducing errors and resulting in better patient outcomes.
Your work keeps you extremely busy. How do you unwind after a long day?
I work remotely for our firm and I live in West Virginia, in the small town of Weirton, which is about 40 miles west of Pittsburgh, PA. I like working from home but I truly enjoy coming to Chicago to work in our office several times a year and just working alongside with our team. I don’t have a whole lot of down time on a day-to-day basis. In addition to my role here in our firm, for the past four years I have served on the board for my national professional organization, the American Association of Legal Nurse Consultants (aalnc.org) where I presently serve as president. I am also attending school to attain my Bachelor’s degree in Health Informatics, to better understand the electronic health record and how health data is mined. Now you can understand why my days are long! But I start most days by going to the gym with one of my best friends. I can exercise and socialize at the same time.
I also take the time on weekends to spend time with my family and friends. My husband, Alan, works for Mitsubishi Electric as a field service technician. He works out of town all week so we mainly have the weekends together. I have traveled with him a few times. Our daughters are grown and on their own. Chelsey lives in nearby Pittsburgh, PA and is employed full time as a dental hygienist and is in school working on her Master’s Degree in Health Informatics. Our younger daughter, Alanna, just graduated from Mississippi State University with her Doctorate in Veterinary Medicine. She has been away from home for four very long years, but has just accepted an offer with a clinic in Pittsburgh, PA. So both of our girls will be within an hour from home.
What advice would you offer to our readers who may be considering a career in health care or consulting?
Nursing is one of the most trusted professions and provides many opportunities in healthcare as well as other areas. I happen to think nurses are pretty amazing, not just because I am one, but because nurses are generally kind and compassionate as well as extremely knowledgeable. As a legal nurse I feel we have strong interpersonal skills we used at one time to balance the needs between patients and doctors and now can provide this link between clients and attorneys. If you feel you have these qualities in addition to excellent communication and problem solving skills, empathy and sheer endurance, I think you would be a great fit in the field of nursing.